Back pain is a very common problem in general population. Most common is simple low back pain, that is self-limited and does not require further investigation.
Approximately 5 % of cases may have inflammatory back pain (IBP), that is hallmark of axial spondylo-arthritis (axSpA). axSpA is a chronic progressive inflammatory disease. The disease typically develops in young adulthood, leads to permanent spine changes with hypomobility and impairs quality of life if misdiagnosed.
The key factor for first line medical doctor is to identify individuals with suspicion on axSpA and refer them for further specialised rheumatology examination. IBP is main symptom that helps to reveal patients with axSpA, helpful may also be HLA-B27 positivity.
Several reference strategies have been established to help early diagnosis of axSpA. Only early diagnosis and adequate treatment leads to inhibition of the inflammatory process and prevents permanent spine changes.