Fibromyalgia/Pain

tylenol,acetaminophen,pills,tablets

Prenatal acetaminophen linked to increased autism and ADHD

EurekAlert!

Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children. The study, published today

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Sjögren's Graduates (8.22.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.

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RCT of 2331 chronic MSK pain pts showed that telehealth Cognitive behavioral therapy (CBT) (health coach) superior to self-care (Pain trainer) or usual care at achieving a >30% reduction in pain (32% vs 26.6% vs 20.8% respectively) & benefits were sustained at 12 months. https://t.co/a69zPsJslH
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FDA Approves 1st new Fibromyalgia drug in 15 yrs - Tonmya (cyclobenzaprine HCl sublingual) as treatment of fibromyalgia in adults. Based on 2 phase 3 trials and 1400+ pts. Dose 2.8 mg tabs 1-2 SL qhs (peak concentration 4.3 hours; t1/2 life = 36 hrs, longer w/ elderly, liver dz) https://t.co/8DVRet5sjU
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Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/csbHtiEglp
Dr. John Cush @RheumNow( View Tweet )
Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/twI6wcxKf7
Dr. John Cush @RheumNow( View Tweet )
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Teaching You How to Think… (8.15.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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PT in RA - Metanalysis of 17 RCTs, 1362 pts Rx w/ aerobic/resistance exercise, hydrotherapy, manual Rx, electrotherapy, multimodal Rx. 5 RCTs (n 307) signif reduced pain (SMD −0.347; interpreted as a small to medium effect favoring PT. https://t.co/UJGSGrgMV0 https://t.co/n4DzMSm9iJ

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Repurposing & Pipeline (8.8.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.

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Survey of 39 Spanish rheumatologists (mean age 50 yrs, 9.6 yrs in practice) finds that while 79% agreed on the importance of using Patient-Reported Outcome Measures (PROMs), only 28% use them routinely (mostly pain, VAS, HAQ) - reason? Time! https://t.co/YnZBXlK24M https://t.co/a8W52XO8jh

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Mild cognitive impairment (MCI), (a reversible precursor to dementia) is increased in elderly RA (n=378) and is signif. assoc w/ course of disease(OR 1.07), DAS28 (OR 1.31), high CRP (OR 1.01) & osteoporosis (OR 1.88) as independent risk factors. https://t.co/45DY03sD23 https://t.co/kdX9TnykVK

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Plant extracts, C. longa & B. serrata extracts (CBTIL) studied in hand OA in 3 mos, DBRPCT of 162 HOA pts given CBTIL (n83) or PBO (n 79). Also signif were decreased Pt global, acceptable symptom status (PASS), SF-36 pain, SF36 health change (no AE diff) https://t.co/vqhqnEZIsz https://t.co/XuCX0zc4qD

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NHANES, Numbers, & Risk (7.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".

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Americans choose short term relief for neck and back pain

EurekAlert!

New survey data from the Orlando Health Spine Center reveals a significant difference among Americans on how to manage neck and back pain. Respondents were split between relying on rest and reduced activity (44%), turning to over-the-counter pain

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Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/wC2dPvVR7x https://t.co/HCFSXBfVGM

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Rheums! Question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. https://t.co/HsqM9xLNtP https://t.co/voONsOLeSK

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Hmmm Really? (7.11.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?

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Diffuse idiopathic skeletal hyperostosis (DISH)is a structural cause of dysphagia due to anterior cervical osteophytes. Retrospective study 208 dysphagia pts w/ head/neck CT. DISH was Dx in 39%; predicted by low serum albumin, COPD, & chronic pain https://t.co/zrn4dnCtLc https://t.co/svE6khmUEm

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Dr. John Cush @RheumNow( View Tweet )
Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/NMtiQPICpw https://t.co/gVJ0TyuY01

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ICYMI: ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine. https://t.co/mQI2g4W4hX https://t.co/BhfQtI792M

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ICYMI: Consensus Against Interventional Injections for Chronic Spinal Pain

Jack Cush, MD

BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or inflammatory arthropathy. This is a chronic (not acute) spine pain guideline.

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ICYMI: ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain

Jack Cush, MD

The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.

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TONIX pharm presented two phase 3 RCTs at #EULAR2025 demonstrating efficacy of sublingual cylcobenzaprine at bedtime in w/ significant reductions in Fibromyalgia pain scores. TNX-102 SL could be the 1st new FM drug to be FDA approved in >15 yrs. PDUFA (decision) date is 8.15.25. https://t.co/XNd8uYLQsJ
Dr. John Cush @RheumNow( View Tweet )
Resilience or Resignation? Rethinking Pain, Aging, and Quality of Life Dr. Jiha Lee reports on abstract POS0402 - THE ROLE OF AGEING IN THE RELATIONSHIP BETWEEN CHRONIC MUSCULOSKELETAL PAIN AND HEALTH-RELATED QUALITY OF LIFE: THE MAASTRICHT STUDY - presented at the 2025 EULAR https://t.co/AiP57hXIRB
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Simple Measures are Effective in Knee Osteoarthritis

EurekAlert!

Knee braces, water therapy and exercise are the most promising non-drug therapies for treating knee osteoarthritis, according to a new meta-analysis publishing June 18, 2025 in the open-access journal PLOS One by Yuan Luo of the First People’s Hospital of Neijiang, China.

Knee

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Recent Blogs

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

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? Read Post
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