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Fibromyalgia/Pain

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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )

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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
Inflammatory vs. Noninflammatory Pain https://t.co/ZZLMnT8IVO https://t.co/W0tVK75raN
Dr. John Cush @RheumNow( View Tweet )
Inflammatory vs. Noninflammatory Pain https://t.co/ZZLMnT8IVO https://t.co/dnZHqV1jcK
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )

Reefer Madness (12.12.2025)

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
Dr. John Cush @RheumNow( View Tweet )

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.

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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I Can't Believe it's Not Seronegative Rheumatoid Arthritis?!

In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. 

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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it? Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) https://t.co/RgRRHU9ZRo
Dr. John Cush @RheumNow( View Tweet )
JAMA Case Challenge - Painful Hand Swelling With Finger Contractures 56-yoF w/ BL hand contractures, 15 mos BL hand pain/swelling/stiffness. No or partial relief w/ ibuprofen, 30 mg prednisone, MTX 10-20 mg/wk. All labs were normal. Whats the Dx? https://t.co/lZ0NHX5Y56 https://t.co/JC04E3JUxB
Dr. John Cush @RheumNow( View Tweet )
Coccyx and Sacrococcygeal Joint Disorders Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/zrGDwULms5
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Inflammatory vs. Noninflammatory Pain https://t.co/3nJ2NZYTQY https://t.co/7FuSYzkX2G
Dr. John Cush @RheumNow( View Tweet )

Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?

Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.

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Turkey Tryptophan (11.28.2025) Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders? https://t.co/cnxxwqwyTE https://t.co/82zugQnp2Y
Dr. John Cush @RheumNow( View Tweet )
Coccyx and Sacrococcygeal Joint Disorders Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/u4w3b915my
Dr. John Cush @RheumNow( View Tweet )
BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/M0tI8wjzh4
Dr. John Cush @RheumNow( View Tweet )

Turkey Tryptophan (11.28.2025)

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

Read Article

Coccyx and Sacrococcygeal Joint Disorders

Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, anatomy, biomechanics, presentations, diagnostic evaluation,

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