The prevalence of rheumatic diseases is high, and in some cases, such as osteoarthritis, may increase as the population ages. The degree of tissue damage, disease activity, and/or imaging findings often do not explain the degree of self-reported pain and pain-related disability. Similarly, pain may be best conceptualized through a biopsychosocial framework that includes a complex interplay of biological, psychological, and social factors that together determine pain severity, pain-related distress, and pain-related disability. For example, the ability to deal with pain, thoughts about pain misery, lifestyle choices, family and social factors all play an important role in the experience of pain. These factors may greatly influence the patient’s pain and functioning, and may even be the course of the disease itself. Therefore, the consideration of non-pharmacological interventions should be a fundamental component of comprehensive treatment. I. Cognitive Behavioral Therapy (CBT) and other psychotherapies CBT is a structured self-management intervention that emphasizes cognitive (distraction, intentional guidance, cognitive adjustment methods) and behavioral (activity pacing, enjoyable activities, relaxation training) strategies for patients with rheumatic diseases to improve coping abilities, increase function and relieve pain. CBT has been shown to be effective in treating psychological grief, given the difficulty of dealing with persistent pain and the increased mood and anxiety problems of patients with rheumatic diseases.CBT may be a uniquely beneficial approach. Coping skills in CBT, such as relaxation strategies, can also be used with biofeedback, which uses computer-assisted instructions to reduce sympathetic arousal, such as reducing muscle tone or increasing body temperature in the terminal areas, with the goal of further relaxation and pain relief. In recent years, Acceptance and Commitment Therapy (ACT) has been used in the treatment of chronic pain, which expresses an active willingness to accept existing pain rather than trying to control and avoid it. At the same time, by continuing to engage in worthwhile activities and by “exposing”, ACT focuses on reducing the effects of grief on pain. Many studies on the use of ACT in adults with chronic pain have found improvements in emotional, social and physical functioning compared to controls, with effects lasting up to 3 months with treatment. II. Physical exercise For adults with rheumatic disease pain, exercise and regular physical activity are generally recommended. The American College of Rheumatology and the American Pain Society recommend aerobic exercise and physical therapy (including flexibility and muscle conditioning exercises) for patients with rheumatic diseases, including OA, RA, and FMS. consider ① flexibility and range of motion; ② muscle conditioning and resistance training; and ③ aerobic exercise. Each of these exercises is considered to play an important role in the physical intervention of patients with painful rheumatic diseases. In addition to improving strength, joint protection, mobility and aerobic metabolism, exercise regimens are effective in reducing fear-related avoidance of activity and in reducing pain-related disability. It is recommended that exercise programs should be slow and gradual, otherwise patients may be at increased risk of pain and injury, which can lead to non-adherence and program interruption. A common problem mentioned in the literature is that exercise is very effective in reducing pain and disability, but the benefits appear to be relatively short-term because patients are not easily able to adhere to an exercise program over time. Patient education programs are a fundamental part of multidisciplinary treatment for children and adults with OA, RA, and FMS, and based on the guidelines of the American Pain Society, patient education is recommended as the first step in the foundation of pain management, over medication and other forms of intervention. Pain education programs for patients with rheumatic diseases include: the specific rheumatic disease, how biopsychosocial factors influence the pain experience, possible co-occurring condition effects (e.g., depression, headache, inflammatory bowel disease), pain management options (e.g., education-based self-management programs, CBT, physical activity, alternative therapies), and symptomatic medication use. The goal of such programs is to improve patients’ ability to self-manage pain and reduce impairment, and for RA, OA and related rheumatic diseases, one of the best known patient education is the Arthritis Self-Management Program. A meta-analysis of the impact of patient education on patients with RA and OA found that moderate support for the use of educational interventions was more effective for patients with RA. Overall, patient education may be an important component of interventional approaches for patients with rheumatic diseases, but the use of patient education alone as an approach is not supportive in terms of prognostic outcomes. IV. Complementary and Alternative Therapies CAM The use of CAM interventions for patients with rheumatic disease has generally increased in the United States, with estimates ranging from 18% to 94% of CAM use. A recent review of CAM interventions for patients with rheumatic diseases concluded that as of now there are no adequate studies of acupuncture, osteopathic medicine, massage, and chiropractic therapy, although patient satisfaction with chiropractic therapy is high.