Chronic back pain is a huge burden, in Australia and globally. In Australia, it is estimated that 3.7 million Australians report chronic back problems and this is likely to be an underestimate.
Chances are you or someone you know has this condition.
There are a number of causes for chronic back pain and it’s fair to say the one that’s commonly missed is Inflammatory Back pain (Read about the difference between Inflammatory and Mechanical pain).
Inflammatory back or spinal pain is common, estimated to affect at least 5% of sufferers of chronic back pain. It’s commonly missed with the prototype disease being ankylosing spondylitis.
There is an average delay of almost 10 years to diagnosis. It can be confusing unless you’ve seen a practitioner who is already aware of this entity and who thinks about it.
There is not a single test to diagnose inflammatory back pain and/or ankylosing spondylitis.
But there are clear pointers in the history and nature of the back pain.
In you have had back pain for longer than 3 months, you can try this simple test to determine the likelihood of having inflammatory back pain:
1) Did your back pain start before the age of 40?
2) Did your back pain develop gradually?
3) Does your back pain improve with exercise?
4) Does your back pain NOT improve with rest?
5) Do you suffer from back pain at night, which improves after getting up?
(Screener adapted from ASAS IBP criteria: Sieper J et al. Ann Rheum Dis 2009;68:784–788)
If you’ve answered ”Yes" to at least 4 of the 5 questions, you may have inflammatory back pain.
The classification criteria used worldwide to help in classifying this is again confusing but here are links to help make more sense of this:
A proper diagnosis does require you to see a doctor who is experienced in treating this type of problem, such as a rheumatologist.
I hope this blog post and the links help empower you with knowledge.
Do you have inflammatory back pain? Do you have Ankylosing Spondylitis?