Background/Objectives: Social support, sex and age emerge as key variables that may shape how pain influence well-being and quality of life. This study aims to examine whether perceived social support mediate the relationship between chronic pain (CP) or non-chronic continuous pain (NCCP) and health related quality of life (HRQL), and whether this mediation varies according to sex and age.

Methods: A cross-sectional study was conducted with 7,058 participants, representing the Spanish adult population. The variables collected included sociodemographic information, presence of CP/NCCP, perceived social support (DUKE) and HRQL (SF-12v2). Bivariate analysis and two serial mediation analyses were performed.

Results: 25.9% (95%CI: 24.8-26.9) of the respondents had CP and 7.7% (95%CI: 7.1-8.3) had NCCP. Across both models, the moderated mediation analyses indicated a partial mediation. For the physical component (PCS), the direct effect of CP on PCS was robust, while the indirect effect via social support was statistically significant but of moderate magnitude, and conditional on age (significant in younger and middle-aged). For the mental component (MCS), both the direct and indirect effects were significant, but the indirect pathway through social support showed stronger influence relative to PCS, again moderated by age.

Conclusions/Recommendations: This study highlights the important role of perceived social support in the relationship between CP and HRQL in the Spanish adult population, reducing the impact of CP on HRQL, especially among younger and middle-aged individuals whereas older adults did not exhibit this mediation effect. Our findings emphasize the need to consider age-specific differences when developing interventions aimed at improving HRQL in CP patients.

Funding: Foundation for the management of Biomedical Research of Cádiz (FCÁDIZ) and the Grünenthal Foundation.