Often, there is a delay in the diagnosis of inflammatory
back pain (
IBP) in the primary care setting. This may be attributed to the inability of healthcare providers to distinguish between inflammatory and mechanical
back pain. This study aimed to evaluate primary care physicians' current practices for assessing patients with
IBP using clinical, radiographic, and laboratory tests. A questionnaire-based survey was emailed to all primary care physicians in the western region of Saudi Arabia by the Saudi Commission of Health Specialists from February to May 2021. The questionnaire included data about axial
spondyloarthropathy based on the
Calin, Berlin, and European
Spondyloarthropathy Study Group criteria. A total of 103 primary care physicians responded who represented around 24% of primary care physicians at primary healthcare. The most often perceived
IBP symptoms include a response to
NSAIDs, morning stiffness lasting >30 minutes, age of onset <45 years old, duration of
back pain >3 months, and improvement with exercise. The most frequently questioned patient or family history conditions were peripheral
arthritis (92.2%), family history of spondyloarthritis (83.5%), and
inflammatory bowel disease (97.6%). The most-reported investigations were CRP/ESR (86.4%) and spinal radiography (66%). For treatment of
IBP,
NSAIDs were most prescribed (48.6%), followed by physiotherapy (45.6%) and disease-modifying
anti-rheumatic drugs (41.7%). Primary care physicians were more confident in management of mechanical
back pain than
IBP (Pā
<ā
.001). Primary care physicians have good knowledge of
IBP symptoms but not of disease-specific features and modest confidence in evaluating patients with
IBP, indicating the need for educational programs and a more effective, feasible referral strategy.