Fibromyalgia/Pain

Cross-sectional study of Joint hypermobility (JH) in 256 young adults (75% female) found JH in 42%, females w/ signif. higher Beighton scores. 88% had chronic MSK pain; 38% had acute MSK pain. MSK pain was signif higher in students with mild JH (BS 4–6/9 pts; P < 0.009) https://t.co/QZwJ9zHfEj
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Shoe.blue

Supportive vs Flexible Footwear in Hip Osteoarthritis

Jack Cush, MD

Do shoes make a difference in osteoarthritis (OA)? Common advice often suggests that stable supportive shoes can improve arthritis symptoms in the knee, but does this apply to hip osteoarthritis?

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GLP-1s are known to improved knee OA. Using a mouse OA model w/ obesity, semaglutide yielded less pain, osteophytes & had strong chondroprotective effects, fia a wt loss-independent way. Changing from glycolysis to oxidative phosphorylation resulted in cartilage restoration. https://t.co/YySGDHX9KO
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Population survey of 21 000 US adults, 62.3% reported recent use of any OTC or prescription meds. Past-7-day prevalence of any OTC medication was equal to RX med use (46%) and increased use with age among both male and female individuals. https://t.co/xeWBQ0DnlB https://t.co/c8lqXOmAaT

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Comorbidity & Health Management https://t.co/cSwCEDKL28 https://t.co/WP7yIdWPVY

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Maui Potpourri (2.13.2026)

Jack Cush, MD

Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.

  1. Diet & Obesity Management in Rheumatology - Uzma Haque, MD
  2. Mitigating risk for Rheum patients undergoing orthopedic surgery - Susan Goodman, MD
  3. Paradoxical skin reactions – Joseph
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#RNL26 Haque @HopkinsRheum 1/2 of Americans will be obese by 2030 "Obesity is common &amp; obesity is expensive" Adipose tissue - active endocrine organ -&gt; cytokines, chemokines, adipokines Leads to inflamm axis - risk factor similar to 🚬, higher activity, worse response https://t.co/yQLTpE7reY
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RT @Gibson_RheumPAC GLP-1 receptor agonists do more than promote weight loss. They impact insulin resistance, inflammation, cardiovascular risk—and may influence musculoskeletal disease. #RNL26 https://t.co/ypKnOJojAm
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RT @Gibson_RheumPAC Nearly 50% of U.S. adults may meet criteria for obesity by 2030. For rheumatologists, it directly impacts disease activity, outcomes, and treatment response. #RNL26 https://t.co/cpy4LBBPHc
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Study of 90 adolescents (46 w. Juvenile fibromyalgia (JFM) & 44 controls) finds that JFM pts have greater sensitivity to non-painful sensory stimuli, such as sounds and bright lights; such hypersensitivity is closely related to the severity of the disease and brain function https://t.co/KGqzRK6e4a
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ANA Pollution (2.06.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com

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Which Fibromyalgia Drugs are Cost-Effective? A cost-effectiveness analysis compared FDA approved fibromyalgia (FM) drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives. https://t.co/5NZeYquGxs https://t.co/rhcwH2yLEm

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Dr. John Cush @RheumNow( View Tweet )
Pain,FM,fibromlyalgia,Trigger

Which Fibromyalgia Drugs are Cost-Effective?

Jack Cush, MD

A cost-effectiveness analysis compared FDA approved fibromyalgia drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives.

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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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
joint.pain_.hand_.PIP_.jpg

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.jpg

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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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.
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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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From the Archives: Rheumatology Dead Word Cemetery

Jack Cush, MD
CTD.jpg
I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say?
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