Table 1 The CaFaspA referral strategy

Applicable in patients ≥3 months back pain and age at oneset <45 years

Inflammatory back pain

Inflammatory back pain is considered present if at least four questions are answered with yes

 -Age at onset<40 years

 -Insidious onset

 -Improvement with exercise

 -No improvement with rest

 -Pain at night (with improvement upon getting up)

Positive family history

A positive family history is considered present if there is a first or second degree family member with axial spondyloarthritis, Crohn’s disease, psoriasis or uveitis anterior

Good reaction to NSAIDs

A good reaction to NSAIDs is present when a patient reports a relieve in pain perception within 48 hours after receiving a NSAID

CLBP ≥5 years

A long low back duration is present if the duration of the back pain is 5 years or longer

If at least two out of the four referral parameters are present → a referral to the rheumatologist is advised