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I notice I've been having more and more episodes of low back pain. It seems to come and go depending on what activities I engage in. I'm especially stiff after a day of gardening or doing heavy chores around the house. My doctor has labeled me as a chronic back pain sufferer. I don't really like that label. How do they decide who is chronic and who isn't?
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The International Association for the Study of Pain (IASP) defines chronic pain as pain that has lasted three months or more. Other experts consider pain to be chronic if it has been present six months or more. There are variations on the intensity, freqency, and duration used by different groups to describe chronic pain.
In a case like yours, where the pain "comes and goes", the physician must evaluate you over time to see if each episode is a recurrence of the initial bout of back pain -- or if you are experiencing new symptoms of a different kind each time. For most people with chronic nonspecific low back pain, it's one long episode interrupted by acute flare-ups of the same old problem.
Nonspecific means there is no known cause. Fractures, tumors, infections, and other specific soft tissue or disease mechanisms for the pain have been ruled out. There simply isn't a clearly identifiable cause of the symptoms. This doesn't mean you don't have pain -- clearly you do! But the exact reason remains a mystery.
If you are uncomfortable being given a label, talk to your physician about this. Having a better understanding of his or thinking in making the diagnosis may not make you feel any better about being described as a "chronic" anything. Just keep in mind that the term describes length of time, and is not a statement of medical condemnation or personal judgment.
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