BackPainTest.org - A screening tool for ankylosing spondylitis

Information For Physicians

The actual number of patients who suffer with Ankylosing Spondylitis (AS) but who remain undiagnosed is unknown.

The current approach to recognizing whether or not back pain is inflammatory is inefficient at best. That said, recent advances have been made in this regard. A study published in the January 2009 issue of Annals of Rheumatic Diseases by M Rudwaleit, R Landewe, D van der Heijde, et al, entitled, "The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal" indicates the primary criteria that experts use to identify inflammatory back pain.

These are:

  • IMPROVEMENT WITH EXERCISE

  • PAIN AT NIGHT

  • INSIDIOUS ONSET

  • AGE AT ONSET

  • NO IMPROVEMENT WITH REST

The more of these 5 parameters that are present, the more likely the pain is inflammatory in nature.

Early symptoms of AS include pain in the lower back and/or buttocks and a feeling of spinal stiffness when inactive. Studies suggest that an average of 7 to 12 years may pass before a diagnosis of AS is finally made. Such delays in diagnosing AS are relevant to patient outcomes since actual damage to the spine and the sacroiliac joints usually take place with the first 10 years of active disease. In many cases, the diagnosis is missed entirely. The result is that patients may simply continue to endure unnecessary pain and are not likely to seek treatment that could improve the course of their disease if received early enough. Therefore there is a great need for tools that facilitate and/or hasten the proper diagnosis of AS as needed.

In 2003, the Spondylitis Association of America, a 501 (3) c organization located in Los Angeles County, set out to develop a symptom based questionnaire to assess a chronic back pain patient's likelihood of having some of the symptoms associated with AS. The objective with regard to developing a weighted questionnaire, was to help identify new cases, greatly accelerate diagnosis and to encourage care seeking among patients with symptoms of AS.

This site and associated validated questionnaire represents the efforts and output of several years of work by the distinguished advisory board listed below.

Arthritis Care & Research
Vol. 62, No. 1, January 15, 2010, pp 19-27
DOI 10.1002/acr.20009
© 2010, American College of Rheumatology
Development and Validation of a Case
Ascertainment Tool for Ankylosing Spondylitis
MICHAEL H. WEISMAN, LAN CHEN, DANIEL O. CLEGG, JOHN C. DAVIS, JR., ROBERT W. DUBOIS, PAMELA E. PRETE, LAURIE M. SAVAGE, LAURA SCHAFER, MARIA E. SUAREZ-ALMAZOR, HSING-TING YU, AND JOHN D. REVEILLE

Disclaimer   |   Spondylitis Association of America   |   Contact Us   |   About The Test

This test has been scientifically validated:
Click Here for Information

Your use of this website constitutes your acceptance of and adherence to the Terms of Use, available here. Taking a screening test for Ankylosing Spondylitis ("AS") is a quick and easy way to determine if the symptoms you are experiencing are potentially caused by AS. This screening test is for informational purposes only and is not a substitute for medical diagnosis and treatment. The diagnosis and treatment of AS require a consult with a qualified, licensed medical professional. Neither the SAA nor its staff warranties the information contained in this screening test nor shall the SAA or its staff be liable for any decision or action taken in reliance on the information contained on this web site, as more specifically described in the Terms of Use. This screening test and this website are © 2010 by the Spondylitis Association of America. Downloading and printing by visitors is permitted for personal use only. Other transmission, copying, or distribution is prohibited without the written consent of the SAA.

Supported by a research grant from the Spondylitis Association of America, with funding supplied by
Centocor, Abbott, Amgen, Wyeth, and Pfizer.