Inflammatory Back Pain 4/5 (3)

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Inflammatory back pain is among the common symptoms that lead to it Spondyloarthritis og Ankylosing spondylitis. However, only about 30% of such symptoms develop such a disease (reference: Wang R, 2018). Thus, the benefit (specificity is low but sensitivity is high) is less than previously thought (reference: de Hooge M, 2019); Poddubnyy D, 2018). The criteria for inflammatory back pain are therefore not suitable for making such a diagnosis without additional studies involving a thorough clinical examination, MR and HLA-B27 in the blood.

Criteria for inflammatory back pain

There are at least three versions of criteria for inflammatory back pain: Calin A, 1977, Rudwaleit M, 2006 and ASAS IBP (Sieper J, 2009). These are largely overlapping and include: Symptom onset before the age of 40, duration at least 3 months, improvement in physical activity, no relief from rest, night pains that are relieved when one gets up and moves.

Rudwaleit's definition has the highest specificity (81%, sensitivity 70%) and is reproduced below:

Inflammatory back pain (reference: Rudwaleit M, 2009):

  • Morning stiffness in the back for at least 30 minutes
  • Improvement by physical activity, not to be at rest
  • Wake up in the second half of the night because of pain
  • Alternating pelvic pain (gluteal)


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