Fibromyalgia/Pain

QD Clinic: Cellulitis Paradoxes Dr. Richard Conway, Dublin, discusses a case of cellulitis and gout. Presented as part of RheumNow's "Gout: More than Flares" campaign during the month of July 2026. https://t.co/ZeYyISJrrE https://t.co/2Ih4QRa7FK

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Dr. John Cush @RheumNow( View Tweet )
QD CLINIC: Senior Year Gout Daric Mueller, PA-C, discusses a case of difficult-to-treat gout in an individual first diagnosed at age 18 who is now in his early 30s. This QD Clinic is presented as part of RheumNow's "Gout: More than Flares" campaign. https://t.co/9GNk8ZqwyS https://t.co/hAFz6zPcay

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Dr. John Cush @RheumNow( View Tweet )
Weight loss helps gout, but extreme weight loss (bariatric surgery, ketogenic diets) may trigger gouty attacks. (Not seen with GLP-1 agonist weight loss) For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/LGEENexSZ6

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Dr. John Cush @RheumNow( View Tweet )
The Power of Self-Management with Chronic Low Back Pain Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the https://t.co/urZPsVwCV8
Dr. John Cush @RheumNow( View Tweet )
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The Power of Self-Management with Chronic Low Back Pain

EurekAlert!

Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce

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RheumIQ: True or False: In the NORD-STAR trial, failure to achieve early remission in RA was associated with a significantly increased risk of fibromyalgic RA at 48 weeks. Find out if you got it right at https://t.co/z8mLbcgE5D. https://t.co/vkusOYHcQj

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Dr. John Cush @RheumNow( View Tweet )
RT @rheumarampa "There’s more work to do” as Dr. Floris van Gaalen summarizes the challenges in peripheral SpA -pSpA has limited lab value testing like imaging, clinical diagnosis - few clinical trials to support tx guidelines - SPARTACUS trial: GOL vs. MTX in early pSpA

Dr. John Cush @RheumNow( View Tweet )

RT @aurelierheumo Failure to achieve early remission RA asso w/ non-inflammatory pain NORD-STAR 526 early RA pts) no remission at 24 wks increased risk of 48wk • unacceptable pain (OR ~6) • refractory pain (OR ~6) • fibromyalgic RA (OR ~16) Signal strongest w/ very early

Dr. John Cush @RheumNow( View Tweet )

Which is NOT a key feature of inflammatory back pain: relief with activity; morning stiffness; age under 40 years; unilateral pain? Test your knowledge in this week's RheumIQ quiz at https://t.co/z8mLbcgE5D. https://t.co/tOdPfEBJa4

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Dr. John Cush @RheumNow( View Tweet )
Self-Directed Cognitive Behavioral Therapy for Chronic Pain Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP? https://t.co/P2DDvCiLNL https://t.co/hyAArEG6V1

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Dr. John Cush @RheumNow( View Tweet )
U Maryland study found that 5-minutes of proximal intercessory prayer (PIP) — in-person prayer offered by a trained volunteer — significantly reduced pain and anxiety in primary care patients compared to a music control group. 180 pain pts (pain >4/10) w/ > 2 pt reductions at 2 & https://t.co/k4JiQvyC31
Dr. John Cush @RheumNow( View Tweet )
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Self-Directed Cognitive Behavioral Therapy for Chronic Pain

Jack Cush, MD

Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP?

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Retrospective study of 116 BL KOA (Kellgren–Lawrence I–II) pts rx w/ three PRP injx (n 58) or NSAIDs +/- IAhyaluronic acid (n 58). After 5 yrs there was no signif. difference in VAS, WOMAC, and SF-36, with both groups worsening. https://t.co/KDSMTvEl59 https://t.co/lgHOsppIU3

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Dr. John Cush @RheumNow( View Tweet )
JAMA Review on Low Back Pain A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain (nsLBP), drawing on 108 publications identified from a PubMed search (2005–2026) and the https://t.co/liEitQ2ACf
Dr. John Cush @RheumNow( View Tweet )
back, LBP, spine, AS

JAMA Review on Low Back Pain

Jack Cush, MD

A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain, drawing on 108 publications identified from a PubMed search (2005–2026) and the most recent guidelines from the WHO, ACP, and NICE.

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Genicular artery embolization (GAE) in knee OA? Multiple open label studies & metanalyses suggest a clear pain benefit; BUT 3 sham-controlled RCTs have not demonstrated a statistically significant benefit over placebo. GAE is not addressed by ACR or EULAR guidelines. https://t.co/amIN6kzY74
Dr. John Cush @RheumNow( View Tweet )
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EULAR 2026: Updated Recommendations for Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases

Jack Cush, MD

This update includes new pandemic era evidence, recombinant zoster vaccine data, and new perspectives on vaccination in patients taking novel immunosuppressants. Five overarching principles and 10 vaccine recommendations follow.

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MTX: SC vs Oral? Metanalysis of 9 RCTs, 974 RA pts. Compared w/ oral, SC MTX signif. incr odds of ACR20 (RR=1.15), ACR50 (RR=1.14) & reduced GI adverse events (RR=0.58), diarrhea (RR=0.42): BUT no difference in ACR70, DAS28-ESR, bioavailability AUC, or other AE https://t.co/tQeQz7H7do
Dr. John Cush @RheumNow( View Tweet )
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EULAR 2026 Rheumatology RoundUp

Jack Cush, MD

It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.

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Understanding Comorbidities in RMD People with rheumatic and musculoskeletal diseases (RMD) are at risk of a number of comorbidities, from cardiovascular diseases to cognitive impairment and fractures. EIULAR 2026 showcased new data and ideas around various comorbidities and https://t.co/twr0EiMp9f
Dr. John Cush @RheumNow( View Tweet )
#OP0159 #EULAR2026 Multimodal study in D2T RA identified altered brain connectivity patterns linked to pain, psychological features & peripheral transcriptomics. Supports neuroimmune component in D2T RA & need for personalised approaches beyond inflammation control. @RheumNow https://t.co/qMQbkiMCwX

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Mrinalini Dey @DrMiniDey( View Tweet )
Does #RA accelerate age-related functional decline in older adults? STAR study (n=421, age 55-85): RA with worse HAQ, grip strength, but aging's effect on function similar in RA vs controls. Geriatric syndromes like sarcopenia may matter more than RA @RheumNow #EULAR2026 POS0360

Jiha Lee @JihaRheum( View Tweet )

Do GLP-1 agonists achieve meaningful weight loss in patients with RMDs? RISE registry Retrospective N=60,206 Tirzepatide: lost 8% Semaglutide: list 6% At 12 months PsA had the highest usage OP0112 #EULAR2026 @RheumNow https://t.co/P3CTgiwqCr

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
Machine learning identifies a “vulnerable” phenotype in older RA patients n=275 -51% “vulnerable” -Worse grip strength, gait speed & SARC-F -Higher disability (HAQ 1.56 vs 0.64) -More fatigue, poorer QoL -Higher DAS28 despite greater biologic exposure Suggests we should assess https://t.co/bv1FbTxGKR

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Aurelie Najm @AurelieRheumo( View Tweet )
Failure to achieve early remission RA asso w/ non-inflammatory pain NORD-STAR 526 early RA pts) no remission at 24 wks increased risk of 48wk • unacceptable pain (OR ~6) • refractory pain (OR ~6) • fibromyalgic RA (OR ~16) Signal strongest w/ very early remission wk8 https://t.co/H8iyhIrsJw

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Aurelie Najm @AurelieRheumo( View Tweet )

Recent Blogs

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Fibromyalgia

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Dr. Jack Cush reviews fibromyalgia.
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Evaluation of Rheumatic Complaints

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Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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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.
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