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The pain that inflammation does not explain in SpA and PsA

Antoni Chan, MD, PhD

Clinicians often come across the scenario of a patient with well-controlled spondyloarthritis where the ASDAS in the low disease activity range, CRP normalised, joints clinically quiet. However, the patient returns to the clinic still reporting significant pain. Their rheumatologist adjusts the biological, waits, returns. The pain persists.

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Quiz Talk (5.22.2026)

Jack Cush, MD

Dr. Jack Cush talks of birthdays, Quizzes and journal articles this week on the podcast.

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Fatigue in SLE

Jack Cush, MD

An NIH lupus cohort study looked at fatigue in SLE and found associations with organ damage, obesity, but does not correlate with disease activity in systemic lupus erythematosus (SLE) patients.

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Fibromyalgia

Jack Cush, MD

Dr. Jack Cush reviews fibromyalgia.

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Chronic Low Back Pain Disappointments in a Randomized Trial

Jack Cush, MD

Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or mindfulness) may not be effective.

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More Comorbidity in Difficult to Treat RA

Jack Cush, MD

A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).

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Great Lectures; Great Presentations

Jack Cush, MD

Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.

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Day 2 of #EULAR2026 Studies to look forward today in #axSpA: new classification criteria performance, sex differences in disease progression, early disease treatment data, primary care education to reduce delays to diagnosis @RheumNow

Antoni Chan MD (Prof) synovialjoints ( View Tweet)

🥗 Does diet improve PsA? DIPSA RCT: Mediterranean/DASH/Standard all improved DAPSA in 92pts Weight loss drove outcomes OP070 #EULAR2026 @RheumNow https://t.co/k5y7bvDbDQ

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Nelly ZIADE 🍀 Nellziade ( View Tweet)
This retrospective cohort of NPSLE pts showed clinical assocs with MRI findings: Pts w/ focal symptoms - abn MRI Pts w/ diffuse symptoms - normal MRI except brain atrophy Interesting to know how this can aid in future mgt strategies for NPSLE OP093 @RheumNow #EULAR2026 https://t.co/omvdWk6EZK

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sheila RHEUMarampa ( View Tweet)
Curcumin in arthritis may have NSAID like clinical efficacy. But how? Metanalysis lays out the multiple potential effects for it to inhibit inflammatory signaling pathways (NF-κB, TNF-α, IL-1β, IL-6, COX-2, and PGE2) https://t.co/gSYVwpl41P https://t.co/0xZdyiF4QN

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Dr. John Cush RheumNow ( View Tweet)
Goofy study of the month! (pub in JAMA!) RCT 170 adults w/ chronic LBP + MRI disc herniation found that amoxicillin-clavulanate, 500 mg/125 mg bid x 3 mos did not improve pain at 3 or 12 mos (vs PBO). Whatha... https://t.co/njrw6itAP8 https://t.co/CW2ssNPxf1

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Dr. John Cush RheumNow ( View Tweet)
APR: Fibromyalgia Dr. Jack Cush reviews Fibromyalgia as part of the Advanced Practice Rheum video series. https://t.co/jq6dSXy6SU https://t.co/bDGRhhY2D9

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Dr. John Cush RheumNow ( View Tweet)
Depression screening (PHQ-8) equally accurate in pts w/ & w/o chronic pain. Depression screening is not biased by overlapping symptoms in depression and chronic pain. https://t.co/UWf97NDPAK https://t.co/7dvt35RT9E

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Dr. John Cush RheumNow ( View Tweet)
Meet the RheumNow #EULAR2026 Reporting Team Delivering real-time insights from the forefront of rheumatology: 🩺 Dr. Antoni Chan (@synovialjoints) 🩺 Dr. Mrinalini Dey (@DrMiniDey) 🩺 Dr. Jiha Lee (@JihaRheum) 🩺 Dr. Aurelie Najm (@AurelieRheumo) 🩺 Dr. Janet Pope https://t.co/zpIeGWpL6P
Dr. John Cush RheumNow ( View Tweet)
Advanced Practice Rheum: Fibromyalgia https://t.co/Wx09nPMA5n https://t.co/UAysDMGuFC

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Dr. John Cush RheumNow ( View Tweet)
JAMA Insights on Chikungunya (affects 35 million worldwide) - mosquito-borne alphavirus seen in tropics, also travelers. Dz char by fever, disabling polyarthritis; less rash, HA, myalgia, N/V, conjunctivitis; rarely myocarditis. https://t.co/Fa3cHygc4W https://t.co/jmh2WjOcI5

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Dr. John Cush RheumNow ( View Tweet)
Chronic Low Back Pain Disappointments in a Randomized Trial Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or https://t.co/17JObbXz5U
Dr. John Cush RheumNow ( View Tweet)
More Comorbidity in Difficult-to-Treat RA A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA). https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ

Links:

Dr. John Cush RheumNow ( View Tweet)
Knee pain: JAMA review - 5% PCP visits knee pain - Knee OA ~654 million worldwide - Patellofemoral pain: <40 yrs & physically active; pain on squat - Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/2fdpl464mb
Dr. John Cush RheumNow ( View Tweet)
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