Dr. Mohammad Khudadah — Consultant Rheumatologist · Al Seef Hospital
Specialist Back Pain & Rheumatology Programme

Years of back pain.
Still no answer?

If your back pain has been dismissed, misdiagnosed, or simply not explained — this programme is designed for you. We follow every back pain case to its precise cause.

Book an Assessment Check Your Symptoms
Our structured programme
History Labs & MRI Diagnosis Care Plan
2–6
years average diagnostic delay in axial SpA
Most patients see multiple specialists first
85%
of patients see more than one specialist before diagnosis
The right diagnosis changes everything
ASAS
Gold standard globally endorsed classification
We apply the most current diagnostic framework
Symptom Checker

Do any of these
sound like you?

Tap every symptom that applies — then see what your pattern means.

Morning stiffness over 30 minutes
Stiffness that improves with movement — not rest — is a key inflammatory signal
Back pain starting before age 45
Young-onset back pain is the hallmark of inflammatory spinal disease
Night pain that wakes you up
Nocturnal spinal pain is strongly associated with sacroiliac inflammation
Alternating buttock pain
Shifting pain across both sides of the lower back — a classic pattern of sacroiliitis
Pain that improves with exercise
Inflammatory pain gets better with movement — mechanical pain does not
Back pain with no clear cause
Unexplained, recurrent or treatment-resistant back pain deserves a proper workup
Worth a specialist review
Even one inflammatory symptom is a reason for a proper assessment. Back pain is rarely "just" back pain — a high-quality evaluation can rule out or diagnose a serious cause early.
Book a Quality Assessment — 1881122
These symptoms warrant specialist assessment
Two or more of these symptoms together significantly raise the likelihood of inflammatory back pain. This pattern is precisely what the ASAS criteria are designed to identify — you should be seen by a rheumatologist.
Book an Assessment — 1881122
Inflammatory back pain criteria: ASAS/IBP criteria · Sieper et al. Ann Rheum Dis 2009
ASAS
Gold Standard
Gold standard diagnosis — internationally validated
We use the ASAS classification criteria — the most current and globally endorsed framework for diagnosing axial spondyloarthritis. Your diagnosis is built on evidence, not guesswork.
Assessment Framework

A structured pathway.
No guesswork.

01
History & Clinical Assessment
Detailed inflammatory back pain history. Duration, character, pattern, age of onset, family history, response to treatment. ASAS criteria applied.
02
Investigations
HLA-B27, CRP, ESR and relevant blood tests. Results are interpreted in full clinical context — not in isolation.
03
State-of-the-Art MRI
Advanced MRI protocol designed to detect early sacroiliac inflammation and structural damage with high sensitivity.
04
Personalised Care Plan
A clear diagnosis. A realistic treatment plan. Targets agreed with you — not decided for you.
Book Assessment — 1881122
Imaging Excellence
State-of-the-Art MRI Protocol

Our MRI protocol is specifically designed for axial spondyloarthritis — using sequences and parameters optimised to detect both early sacroiliac inflammation and established structural damage. This is not a standard back pain MRI.

STIR Sequences T1 Sequences Sacroiliac Joint Protocol Early Inflammation Detection Structural Damage Assessment
HLA-B27
Genetic marker strongly associated with axial SpA. Present in up to 90% of patients with radiographic disease. Interpreted alongside clinical findings — not used alone.
CRP & ESR
Markers of active inflammation. CRP is used directly in the ASDAS disease activity score. Elevated levels support diagnosis and guide treatment.
ASDAS Score
Ankylosing Spondylitis Disease Activity Score. Combines patient-reported symptoms with CRP. Most clinically validated monitoring tool — endorsed by ASAS-EULAR 2022.
X-Ray & CT
Plain radiographs to assess established structural changes. CT used when additional bony detail is required.
ASAS-EULAR 2022 (Ramiro et al.) · BSR 2025 (Zhao et al.)
Book Diagnostic Assessment — 1881122

Management combines non-pharmacological and pharmacological treatment from day one. No medication doses are listed — all decisions are made individually with you.

1
Education, Exercise & Physiotherapy
The foundation of axSpA management. Regular supervised exercise reduces pain and stiffness independently of medication. Smoking cessation is strongly advised.
2
Anti-inflammatory Medication (NSAIDs)
First-line pharmacological treatment. Taken at the optimal dose for symptom control. For patients who respond well, regular use is preferred.
3
Biologic & Targeted Therapies
For patients with persistently high disease activity despite conventional treatment.
TNF InhibitorsIL-17 InhibitorsJAK Inhibitors
4
Monitoring & Follow-up
Regular review using validated disease activity scores. Treatment adjusted based on your response.
Advanced Therapy Details
Biologic and targeted therapy options are discussed during your consultation — personalised to your case.
Book a Consultation — 1881122
ASAS-EULAR 2022 · BSR 2025 · All prescribing decisions are individualised

Every patient leaves with a clear plan — not a list of possibilities. A personalised roadmap agreed with you at the first visit.

Diagnosis can take years — it doesn't have to
Average diagnostic delay is 2–6 years. Early diagnosis changes outcomes.
axSpA is treatable — not just manageable
With the right treatment, most patients achieve significant improvement in pain, stiffness and quality of life.
Exercise is medicine — not optional
Regular exercise is as important as medication in axSpA. The physiotherapy programme is a core part of your treatment plan.
The rheumatologist coordinates everything
axSpA is a multisystem disease. One specialist. All the pieces together — spine, eyes, bowel, skin, joints.
ASAS criteria — the global standard
Our diagnostic approach uses ASAS criteria — the most current, globally endorsed framework for axial SpA.
ASAS-EULAR 2022 (Ramiro et al.) · BSR 2025 (Zhao et al.) · Non-pharmacological review (Yeo et al., Korean J Intern Med 2025)
Start Your Care Plan — 1881122
Beyond the Spine

axSpA affects more than
your back.

Extra-musculoskeletal manifestations occur in a significant proportion of patients. Recognising them early changes outcomes. Tap each condition to learn more.

Uveitis — Eye Inflammation
Affects up to 25% of patients with axSpA

Acute anterior uveitis presents as a sudden, painful red eye — often unilateral. Episodes can be recurrent and require prompt ophthalmological assessment within 24 hours to prevent vision loss.

The rheumatologist plays a central role: the choice of biologic therapy is significantly influenced by the presence of uveitis. Monoclonal TNF antibodies are specifically preferred for patients with recurrent uveitis.

Book at Al Seef — 1881122
Enthesitis — Tendon Insertions
Pain at the points where tendons meet bone

Enthesitis is inflammation at the sites where tendons insert into bone — a defining feature of axSpA that frequently goes undiagnosed.

Plantar Fasciitis — heel pain on the underside of the foot, worst with first morning steps
Achilles Tendinitis — pain and swelling at the back of the heel where the Achilles tendon inserts
Epicondylitis — elbow pain driven by enthesitis, not overuse

If you have been treated for these conditions repeatedly without lasting relief, inflammatory enthesitis should be considered.

Book at Al Seef — 1881122
Inflammatory Bowel Disease
IBD + joint pain — book now

IBD and axial SpA are closely linked. If you have IBD and develop back or joint pain — a rheumatologist needs to be part of your care team. The choice of treatment is directly affected by the presence of IBD.

Book at Al Seef — 1881122
Psoriasis
Psoriasis + joint pain — book now

Psoriasis affects approximately 10% of patients with axSpA. Back pain or joint pain alongside psoriasis has specific treatment implications. A rheumatologist can coordinate your care with dermatology.

Book at Al Seef — 1881122
Book at Al Seef — 1881122
Important Signs

When to seek urgent help.

The following symptoms alongside back pain require prompt medical assessment. Do not wait for a routine appointment.

Fever with back pain
New fever alongside back pain may indicate infection or a serious systemic cause
Neurological symptoms
Weakness, numbness or tingling in the legs — or loss of bladder or bowel control — requires emergency assessment
Sudden red eye
Acute painful red eye — see an ophthalmologist within 24 hours
Unexplained weight loss
Significant unintentional weight loss alongside back pain must be investigated promptly
Trauma with known axSpA
Even minor trauma in patients with a fused spine can cause fractures — seek assessment immediately
Rapid change in symptoms
A sudden significant worsening of established back pain may indicate a new cause — not just a flare
Call Al Seef Hospital — 1881122
Ready to find out what's causing your back pain?

Book a specialist assessment at Al Seef Hospital. Walk away with a clear diagnosis and a plan.

1881122
Al Seef Hospital · Salmiya, Kuwait · Saturday to Tuesday
drkhudadah.com 1881122
Dr. Mohammad Khudadah | Consultant in Internal Medicine & Rheumatology
Farwaniya Hospital · Al Seef Hospital, Salmiya · This programme is for health education only and does not replace a personal medical consultation
© 2025 Axial SpA & Back Pain Programme · Based on ASAS-EULAR 2022 · BSR 2025