Which history feature is most consistent with inflammatory back pain?

• A. Morning stiffness lasting more than 30 minutes.
• B. Pain worsens with activity.
• C. Onset after age 60.
• D. No morning stiffness.

Answer: (A)

Morning stiffness lasting more than 30 minutes signals inflammatory back pain because inflammation in the spine causes stiffness after a period of rest that gradually eases with movement. This pattern—stiffness after waking that improves with activity—helps distinguish it from mechanical back pain, where stiffness is typically brief and pain tends to worsen with activity. Onset after age 60 and no morning stiffness are less consistent with inflammatory back pain, which more often begins earlier and presents with morning stiffness.