Inflammatory spondyloarthropathies (SpAs) include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis/spondylitis (PsA) or inflammatory bowel disease (IBD). It is a chronic inflammatory disease of the mesial skeletal system characterized by back pain, progressive spinal stiffness, onset/stop disease, arthritis, and peripheral extra-articular manifestations, and it usually causes loss of function. The prevalence ratio is 3-4 in men and women: and it tends to occur in younger men. The pain can be severe, persistent and disabling and is the main reason for seeking treatment for rheumatic diseases. It may be due to active inflammation, previous inflammation and joint damage due to tissue destruction, but is often multifactorial in origin and contains both central and peripheral causes. Although treatment with DMARDs and NSAIDs may reduce inflammatory pain symptoms, many patients actually continue to have moderate pain, indicating the presence of a non-inflammatory cause with a different etiology and/or altered central pain modulation mechanisms. Disease activity indicators are commonly used in patients with SpA, and self-reported indicators (including the Bayesian Ankylosing Spondylitis Disease Activity Index BASDAI) correlate well with the presence of CWP or FM, implying that women with inflammatory rheumatic disease often complain of CWP, and women with mid-axis SpA may also often have CWP. It may also partially explain why women self-report more severe functional limitations than men, regardless of the level of imaging damage. However, women with FM have much higher BASDAI scores than women with AS, and BASDAI may not be a good way to assess inflammatory disease activity in patients with SpA. BASDAI is based on a subjective assessment of fatigue, stiffness, and pain, as these symptoms are also characteristic of CWP, and it is difficult to determine disease activity and functional capacity in patients with AS with FM. If their painful symptoms remain untreated, those with inflammatory arthritis are more likely to develop CWP and disability, and have a poorer quality of life. In spondyloarthritis, because of the involvement of the spine, NSAIDs are commonly used with classical DMARDs to control peripheral clinical symptoms. Cases that do not respond to first-line therapy are often switched to anti-TNF-α drugs, but this can make treatment more difficult because patients with concomitant secondary pain syndromes complain of pain, and they may even have to endure unnecessary treatment changes or dose increases when inflammation is poorly controlled. Pharmacological treatment for pain relief includes analgesics such as NSAIDs, opioids, and neuromodulators (including antidepressants, anticonvulsants, and muscle relaxants) for patients with persistent pain, with each type of medication used either alone or in combination. Because of the superimposed effect or synergistic mechanism, the combination of different types of drugs is more effective than single treatment for persistent pain, so that the final effect is better than the sum of the effects alone. On the other hand, combination therapy may be associated with increased risk, and the advantages of pain combination therapy are expected to be similar to those of neuropathic pain, and a recent review of drug therapy for NP showed better pain relief with combination therapy compared with monotherapy.