Professor Rene Westhovens chaired an interesting session during EULAR 2024, where participants learned to recognise the range of pain and fatigue manifestations and impact in Rheumatic and Musculoskeletal Diseases and heared about options for managing different pain mechanisms in RMDs. State of the art and risks of opioid use are discussed and the role of self-management approaches to manage pain and fatigue and reduce opioid use are presented.