TOPLINE:

Chronic overlapping pain conditions (COPCs) affected 57.5% of adults with autoimmune rheumatic diseases (ARDs), with 22.7% experiencing multiple conditions. Chronic low back pain was the most common condition among these patients.

METHODOLOGY:

• Researchers analyzed 2008-2021 data from a US database of medical and outpatient pharmacy claims for adults.
• A total of 149,742 adults (mean age, 48.2 years) with ARDs were identified using diagnostic codes for ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, Sjögren disease, systemic lupus erythematosus, or systemic sclerosis.
• The COPCs assessed included fibromyalgia, irritable bowel syndrome, urologic chronic pelvic pain syndromes, migraine, chronic tension-type headache, temporomandibular disorders, chronic low back pain, chronic fatigue syndrome, and endometriosis and vulvodynia (for women).
• The proportions of patients with ARD having one, two, or at least three COPCs were calculated, and the prevalence of each individual COPC within each ARD subtype was estimated.

TAKEAWAY:

• Overall, 57.5% of the patients had at least one COPC, and 22.7% had multiple COPCs. Rheumatoid arthritis was the most prevalent ARD in both groups, accounting for 53.9% of patients with COPCs and 55.5% of those without COPCs.
• Chronic low back pain was the most common COPC across all ARD subtypes, affecting 67.7% of patients with ankylosing spondylitis, 42.7% of those with Sjögren disease, 40.1% of those with psoriatic arthritis, and 39.8% of those with rheumatoid arthritis. Fibromyalgia was the second most common COPC.
• Fibromyalgia and chronic low back pain co-occurred in 11.8% of patients, with an observed-to-expected ratio of 1.35 (95% CI, 1.34-1.36); migraine and chronic low back pain co-occurred in 6.2% of patients (observed-to-expected ratio, 1.42; 95% CI, 1.40-1.44).
• Patients with urologic chronic pelvic pain syndrome were more likely to have vulvodynia (odds ratio [OR], 10.46; 95% CI, 7.88-13.42), and those with irritable bowel syndrome were more likely to have pelvic or urologic pain (OR, 4.43; 95% CI, 3.83-5.09). Patients with migraine had a higher likelihood of having chronic tension-type headache (OR, 6.37; 95% CI, 5.98-6.78).

IN PRACTICE:

“Identifying these patterns can help flag patients at risk for escalation to opioids and support earlier use of multimodal or nonopioid strategies,” the authors of the study wrote. “Integrating these evidence-based approaches across care settings could mitigate opioid-related harm while addressing the shared central sensitization mechanisms underpinning pain amplification in rheumatology populations.”

SOURCE:

The study was led by Di Lu, MS, Stanford University School of Medicine, Stanford, California. It was published online on May 18, 2026, in Arthritis Care & Research.

LIMITATIONS:

Data were obtained from administrative claims, which lacked information on pain severity, duration, or functional impact. The findings may not be generalizable to the uninsured, publicly insured, or those outside employer-based systems. Individuals without documented prescription drug benefits were excluded, which may have introduced selection bias.

DISCLOSURES:

The authors did not cite any source of funding for the study, and they said they had no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.