Chronic low back pain, defined as back pain lasting for more than three months, can be divided
into mechanical or inflammatory back pain (IBP). IBP typically starts in patients below the
age of 40, is improved with activity and worsens with rest. IBP is strongly associated with axial
spondyloarthritis. Early recognition of IBP among primary care physicians is essential for timely
diagnosis and intervention to ensure the best outcomes for patients with axial spondyloarthritis.
This paper describes the Malaysian Society of Rheumatology’s recently developed Inflammatory
Back Pain Referral Algorithm for primary care physicians, which aims to facilitate the early
identification and referral of IBP patients to rheumatologists.