I’m not sure what you are asking. I had severe pain, swelling and weakness in hands elbows shoulders hips and ankles. Weakness to extent I couldn’t squeeze shampoo bottle without putting it between my knees. Much less open a door. Horrible onset and after one Rheumy that was after a gold star with the insurance company, taking me through multiple non-biologic options, I found a better one who put me on Humira and I was better in days.