Lastly, I see an Interventional Pain Management Physician [Anesthesiologist] once every 4 weeks for pain management. This treatment not only includes medication but I have also received joint injections, albeit very rarely, and once a nerve block for a neurological condition I suffer unrelated to RA. My doc sees many RA patients in his practice, including JuvenileRA, and is extremely familiar with ALL of the medications I am prescribed from psychiactric to rheumatology. Not everyonre with RA needs to see a pain management doc, however, taking prednisone long-term is not recommended. And often, folks with RA May need help managing joint pain while they wait for their RA meds [DMARDS/Biologics] to “kick-in”; this can take as long as 3 months. Therefore it is helpful to have this kind of specialist as part of your medical team.

First and foremost, many bariatric surgeons and rheumatologists encourage RA patients who have undergone gastric bypass surgery to take OTC Prilosec [or similar] ,once daily, to help protect the vulnerability of our altered tummies. I take one tablet daily and have not suffered gastric ulcers or bleeding after 3 years so far. Please consult your Rheumatologist about this ASAP.
Celebrex is an NSAID (like Advil or Motrin). This medication is used to reduce symptoms caused by RA, such as inflammation and joint pain. Celebrex, however, is NOT a medication that helps to slow the progression of disease activity caused by RA or any other autoimmune disease for that matter. I also take Celebrex. Further, it is even more imperative that I take my OTC Prilosec everyday because NSAIDS, like Celebrex, can cause some to suffer stomach ulcers or stomach bleeds.
DMARDS (like Methotrexate and Plaquenil) and Biologics (like Enbrel and Xeljanz) are medications that ARE used to slow down the progression of disease activity caused by RA. However, not all “work” for all patients. Some may help and then stop working. Others may not work for some patients at all. This is very much a trial-and-error experience. These are immunosuppressant medications that lower our “faulty” immune systems to slow down RA, however, there is NO cure for RA.

It sounds as if your Rheumatologist started you on oral Methotrexate but has switched you to injectable Methotrexate? Typically any RA patient who has a compromised tummy like those you have had gastric bypass, injectable or IV infusion DMARDS and/or Biologics are recommended.
Lastly, I was prescribed prednisone when I was first diagnosed. I tried it for 4 days until I discovered an awful sensitivity to it and have not/will not take it again. That being said, prednisone helps MANY RA patients reduce pain and joint stiffness. Never discontinue prednisone abruptly; one should always taper off of it slowly if you have been taking it longer than approximately 7-14 days.
Feel free to take a peak at the treatments section under my profile and you can see what RA medications I have started and stopped, etc.

From my personal experience, having (RNY) gastric bypass in 2005 was definitely a factor in my 2015 RA diagnosis yet it was not the absolute cause. In other words, my “perfect storm” of factors: gastric bypass in 2005 [lost 120 lbs, maintained for 7+ yrs] > increased vulnerability for multiple vitamin deficiencies [low Vit D, B-12, Iron/Anemia] + a lifetime of stress, including multiple episodes of trauma = Dx w/ PTSD in 2014 = Dx w/ Rheumatoid Arthritis [plus additional autoimmune diseases] in 2015. There is no genetic/DNA influence in my particular diagnosis.

My goodness, you've been through it all, haven't you! I've got some of those things going, but not all. What type(s) of treatment are you on? I started out on oral, but the new Rheumy switched me to weekly injections as a precaution against stomach upset, and also to avoid liver problems. Each 6 week visit with him, he has increased the dosage, and now I'm on the highest he'll allow. It still is not enough, I've had to have prednisone along with it, and since I couldn't tolerate the side effects of the prednisone, I was put on Celebrex, but that is an oral med. It doesn't seem to help the pain nearly as well as the prednisone.

God Bless