SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg ErmannInflammatory back pain: a concept, not a diagnosisCoath, Fiona Louise; Gaffney, Karl Author Information Rheumatology Department, Norfolk and Norwich Hospital, Colney Lane, Norwich, UK Correspondence to Fiona Louise Coath, Rheumatology Department, Norfolk and Norwich Hospital, Colney Lane, Norwich, NR4 7UY, UK. Tel: +01 60 328 9670; e-mail: [email protected] Current Opinion in Rheumatology: July 2021 - Volume 33 - Issue 4 - p 319-325 doi: 10.1097/BOR.0000000000000807 Buy Metrics Abstract Purpose of review The concept of inflammatory back pain (IBP) describes a cohort of patients with chronic back pain (CBP) who have distinct clinical characteristics, rather than being a diagnosis in and of itself. IBP is a common and important feature of axial spondyloarthritis (axSpA) but this is not the only differential. This review examines the utility of IBP in both primary and secondary care settings. Recent findings There are a number of suggested referral strategies for patients with suspected axSpA that include IBP. These strategies attempt to strike a balance between ensuring potential axSpA patients are not overlooked, whilst simultaneously not overwhelming secondary care services. Their success relies on the clinicians who first encounter these patients being familiar with IBP as a concept; however, it is still poorly recognized by many healthcare professionals. IBP may be helpful as part of a referral strategy; however, other clinical features, laboratory investigations and radiology must be incorporated for the final diagnostic outcome in axSpA. Summary Delayed diagnosis is a major clinical problem in axSpA and is associated with worse clinical outcomes. When recognized and utilized correctly, IBP can be a useful tool to promote prompt referral to rheumatology services. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.