Fibromyalgia/Pain

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

Links:

Dr. John Cush @RheumNow( View Tweet )
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.

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

Links:

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

Links:

Dr. John Cush @RheumNow( View Tweet )
LBP.red_.jpg

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. 

Read Article
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

Links:

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

Links:

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

Links:

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

Links:

Dr. John Cush @RheumNow( View Tweet )
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.

Read Article
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

Links:

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

Read Article
DM Cover for Video

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

Daric A. Mueller, PA-C

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

Read Article
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

Links:

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

Links:

Dr. John Cush @RheumNow( View Tweet )
muscle%20aches.jpg

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

Jack Cush, MD

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.

Read Article
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

Links:

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 )

Recent Blogs

Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
Evaluation of MSK cover
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
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

×