I feel for you. I do remember the methotrexate. I stopped taking it because of the horrible side effects. I stopped going to my rheumatologist and only go to pain management now to try to deal with the pain. We all must take our own path, but those arthritis treatments were not for me. I had severe side effects to all of it. The only thing I haven't done is the injectables and I just refuse. So, I am sorry to say, after 20+ years of dealing with this horrible disease (and a few others I just won't go into right now), my best advice is to take a pain pill, then a long hot bath, and relax. Stress will make anyone flare up. Meditation is also a great help. I must say though I've learned to really enjoy the good moments. Arthritis and fibro have a way of changing from one moment to the next, so while I do take life one day at a time (cause god knows some days are better than others) I also take it one moment at a time; because one moment you may feel great and the next you're as close to the fetal position as you can get and trying not to cry. And the fatigue is AWFUL. I have spent entire weekends asleep. I have found that if I get up for work at 4 or 4:30 I have a few hours to let my meds start working and wake up and get moving before I have to go to work. And I have also been known to spend a morning or 2 sitting straight up in my chair sound asleep. Thank goodness no one tells the boss. I usually wake up when my head hits my keyboard :) So good luck and god bless. And know that you are in great company ;) I have found those of us with these problems tend to be really strong folk. I hope you feel better soon and find that path that gives you the most relief.