Inflammatory back pain (IBP) is a relatively recent and well-accepted concept whose precise definition remains elusive. The definition of IBP varies by criteria set, as does its sensitivity and specificity regarding screening and case ascertainment in various clinical or epidemiologic settings. This article reviews the history of efforts to define IBP, particularly the criteria sets that have been built around its measurement, describes assessment of IBP in the clinical setting, and illustrates how IBP has been used in epidemiologic and clinical research.
Key Points
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In theory, IBP is assumed to be characterized by inflammation in the sacroiliac joints and the lumbar spine.
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The generally accepted primary features of IBP are young age of onset, pain lasting continuously for more than 3 months, morning stiffness, and pain improved by activity or exercise.
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According to population based studies in the USA, IBP is present in 6% of the population whereas back pain itself is present in 20% of the population.
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IBP performs well as a case ascertainment tool to enrich a population of patients who come to seek medical care for back pain for further studies.
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The frequency of IPB of 6% and SpA of 1% present a challenge to determine what constitutes this gap; more studies are needed.
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