Fibromyalgia/Pain

Longitudinal study of 1761 US military service pre- & post-deployment. The prevalence of fibromyalgia in Males/Females was 2.%/2% (sames as civilians) but post-deploy incr to 8%/11% (P < 0.001). PTSD incr from 21% /18% to 23%/26%. PTSD predeployment lead to a 3 fold risk of FM. https://t.co/XTjuhjx0zd
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DARWIN study ADHD med use among children and adults in Europe (Belgium, Germany, Netherlands, Spain, UK) more than doubled betw 2010 to 2023. IN UK use went up 20X in females, 15X males. (Ed. note: ADHD meds-->poor sleep-->fibromyalgia-->MSK pains) https://t.co/KlvUF1vhhj https://t.co/yEWXwM0WBL

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What Is Restless Legs Syndrome? JAMA Patient Education handout. https://t.co/fCqArVxrSu https://t.co/WjFNWyr9Q2

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Are JAK Inhibitors Better at Pain Relief in RA? Among rheumatoid arthritis (RA) patients who responded to upadacitinib (Rinvoq) or adalimumab, those receiving upadacitinib had significantly less residual pain with treatment, according to a post hoc analysis of phase III trial https://t.co/QrbwlxIm3d
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Acupuncture in SpA metanalysis of 35 RCTs (2,591 AS pts) showed statistically significant improvements BASDAI score, BASFI score, ASDAS, VAS score, CRP level, and ESR level. Findings imited by high heterogeneity & the lack of large-scale, high-quality RCTs. https://t.co/gznAiNo0k4
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Are JAK Inhibitors Better at Pain Relief in RA?

MedPage Today

Among rheumatoid arthritis (RA) patients responding to upadacitinib (Rinvoq) or adalimumab, those receiving the former had significantly less residual pain with treatment, according to a post-hoc analysis of phase III trial data.

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restless.legs.feet.spasm

Review of Restless Legs Syndrome

Jack Cush, MD

JAMA has published a full read review of RLS - restless leg syndrome - a frequent, but often unrecognized, cause of poor sleep and the resultant hazards of insomnia.

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Emergency Department Visits by Rheumatoid Patients

Jack Cush, MD

A Canadian population study shows that rheumatoid arthritis (RA) patients have 30% higher emergency department (ED) visit rates for Ambulatory Care Sensitive Conditions (ACSCs) compared to age- and sex-matched population controls.

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Metanalysis of 21 clinical trials, 2,100 adults, shows cannabis-based medicines (vs placebo) over 2-26 weeks are not effective in treating chronic neuropathy nerve pain, regardless if given as THC of CBD. https://t.co/ZOJrcMGZkr https://t.co/nqCWoFmaWp

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2025

The 2025 Rheumatology Year in Review

Jack Cush, MD

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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Metanalysis of Tramadol included 19 PBO-RCTs, 6506 pts, showing a very modest benefit on chronic pain (low certainty of evidence), but a doubling of risk for serious adverse events (OR 2.13); including nausea (NNH 7), dizziness (NNH 8), constipation (NNH 9), somnolence (NNH 13) https://t.co/0ZEIoy1gqC
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Data from NHIS surveys show in the USA 24.8 million adults with arthritis reported having an activity limitation AND that the arthritis attributable work limitations in US adults 18-64 yrs affects 38.8%. https://t.co/Ul2GjrFqfp https://t.co/Ul2GjrFqfp https://t.co/qzJQwBYDWT

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Obesity and Low Back Pain A large patient population study finds weight gain, increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. https://t.co/EZQwhLpNjg https://t.co/tIlEQmedp7

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Obesity and Low Back Pain

EurekAlert!

A large patient population study finds weight gain,  increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. 

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Best of 2025: Targeting Obesity in Rheumatic Disease Patients Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese. https://t.co/aPGuYFCWLo
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Comprehensive review of the management of knee osteoarthritis - topicals, analgesics, narcotics, intraarticular, metabolic, nutraceuticals, TENS, acupuncture and biologics. https://t.co/3UjPQeZut9 https://t.co/z0dzENSbtX

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Inflammatory vs. Noninflammatory Pain https://t.co/ZZLMnT8IVO https://t.co/W0tVK75raN

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Dr. John Cush @RheumNow( View Tweet )
Inflammatory vs. Noninflammatory Pain https://t.co/ZZLMnT8IVO https://t.co/dnZHqV1jcK

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APP Pearls “You must assess sleep and mood- without this, even if you control all inflammation, you will not control pain and fatigue!” - Christine Stamatos, NP, DNP, RN

Dr. John Cush @RheumNow( View Tweet )

Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://t.co/73yIyvwRtL
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QD Clinic: Weakness with Fibromyalgia ack Cush, MD and Leilani Law, APN, Dallas, TX, discuss a case about weakness with fibromyalgia and how to best treat the complaints she presents with. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" https://t.co/OHeTdemtra
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Medical Cannabis for Pain Management Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients. https://t.co/kxTDqbzpgg https://t.co/fBumEAgISU

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RheumNow Podcast square

Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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Dr. John Cush @RheumNow( View Tweet )
cannabis,weed,marijuana

Medical Cannabis for Pain Management

Jack Cush, MD

Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.

Chronic pain affects more than one in five American adults, yet practitioners are limited in treatment alternatives. Even if we exclude the

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Recent Blogs

Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
Eval of Rheum Complaints Cover Image
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice. Read Post

From DNA to PGA

David Pisetsky, MD, PhD
dna
I have been investigating the mechanisms of antinuclear antibody (ANA) expression in SLE since 1978. In this pursuit, I have followed the advice of my first division chief, Dr. Ralph Snyderman, a great academician.  Ralph told me to identify a research focus and make it mine. I think I have done reasonably well in my mission so you can imagine my surprise (and excitement) when, for the Lupus 2025 meeting in Toronto, I was asked to conduct a Meet the Professor session on the Type 1 & 2 model for SLE. Read Post
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Rx Updates (filtered for Topic)

Therapeutic Updates

The Impact of Obesity on Psoriatic Arthritis

Sponsored by Lilly Medical Affairs
Lilly February 2026
Obesity is common in PsA and may worsen disease activity and reduce treatment effectiveness through shared inflammatory pathways. Weight intervention may improve outcomes and support achievement of targets of disease control.
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