I frankly would start by finding a new rheumatologist. You may have to go through several, I did. The first one I had was good but he retired, then I had a NP who was great but she moved, the third one wasn't worth my trip to the office, and the one I have now is pretty good. But the good ones realized that you have to treat every patient as an individual and just a set of clinical statistics because everybody is different. For years I had a lot of pain but no swelling, especially in my hands and shoulders. A good rheumatologist will take the time to REALLY listen to you, do necessary testing (even if they don't think that you need it), try different medications (every medication doesn't work for everybody), and most of all they need to have compassion. RA is a tough disease and its hard on you, not just physically but mentally!

I have RA in my wrists and in the knuckles on my hands. Everything else is OA. I had a flare up last spring, I could not open bottles, cut meat, I even had trouble making a fist. I started on Orencia Infusions and the swelling in my wrists and hands went down. I got so excited to see that I had bones in my hands! No more pain, I have strength in my hands again. Not quite ready for arm wrestling yet ….

I frequently have mild swelling but also have pain and stiffness. Usually when on a medication that is working pretty well. Be your own advocate and stand firm until you find a dr. That will listen and treat appropriately

I have gone through EXACTLY what you are going through!
It is so discouraging! Do not back down. INSIST on pain relief. Request MRIS, maybe, as proof of damage going on. If you have the option, get a 2nd opinion.