Why not try a biologic? They really helped me get over a hump. I have a condition that is like Lupus and at times like RA, then it will go radio silent and then flare up. What I have is Undifferentiated Connective Tissue Disease. Now that I am 75 it is so much better than when I was in my 40's. I have used Prednisone, and the malaria medication used for Lupus. I finally got off of both medications after 15 years. The reason I mention where I am is that I have come through the worst symptoms you are mentioning and now at 75 I am managing symptoms that I can handle, I am not in the bed and going to the doctors several times a month. There is an upside to the condition playing itself out....