Back pain can be a symptom of any number of problems, most commonly mechanical, or structural, in nature. Among the nonmechanical causes is ankylosing spondylitis, an inflammatory disease that involves the spine and sometimes other joints and extra-articular organs. Dr Escalante explains how to differentiate this disease from other causes of back pain, describes simple clinical diagnostic tests, and outlines current treatment. The condition's link with HLA-B27 is also discussed.