OBJECTIVES: The acute back pain arising in relation to vertebral compression fractures (VCFs) has traditionally been viewed as the most important driver for the health-related quality of life (QoL) decrement associated with the fracture. The objective was to quantify the impact of different health dimensions on overall quality of life using the EQ-5D collected in the SWISSspine registry. METHODS: The analysis was based on the SWISSspine registry, covering BKP treatment of 1027 fractured vertebrae in 765 patients with osteoporosis, trauma and cancer, from 2005–2011 in Switzerland. In the registry, data is collected before operation and at follow-ups at 3–6 months, 1 year and annually thereafter. The health-dimensional contribution to the overall quality of life improvements was analysed by isolating the impact of each dimension on quality of life based on the EQ-5D. It was assumed that the change in QoL over one year was solely due to treatment received. RESULTS: Mean age was 70.4 years and 70.1% of the patients were women. The mean accumulated QoL improvement compared to pre-surgery over one year was 0.40, 0.46 and 0.38 for osteoporotic, trauma and cancer patients, respectively. Changes in pain, as measured by EQ-5D, explained 45% of the QoL change for osteoporotic patients, 40% for patients with cancer and 35% for patients who suffered trauma. Mobility and self-care were the second and third most important dimensions respectively, varying between 19–29% for all indications. Improvement in usual activities contributed 9–14% to improvement in quality of life and anxiety 2–7%. CONCLUSIONS: Changes in the pain dimension of health are the most important driver for overall quality of life in patients treated with BKP. However, ignoring the impact of mobility and self-care would lead to an underestimation of the actual improvement in overall quality of life.