Inflammatory low back pain in Axial Spondyloarthritis versus mechanical low back pain

Inflammatory low back pain in Axial Spondyloarthritis versus mechanical low back pain

What features in the history and physical examination are helpful in differentiating inflammatory LBP in axSpA from mechanical LBP?


Inflammatory LBP
Mechanical LBP
Age of onset, years<40Any age
Type of onsetInsidiousAcute (typically after injury)
Symptom duration>3 months<4 weeks
Morning stiffness>60 minutes<30 minutes
Nocturnal painFrequentAbsent
Effect of exerciseImprovementExacerbation
Effect of restExacerbationImprovement
Back mobilityLoss in all planesAbnormal flexion
Alternating buttock painPresent in early diseaseNot present
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