I think others will chime in with good advice about dealing with flares, but let me just ease your mind about the injections if I can. The mtx injections are not a big deal, the needle is very thin, and it does not need to be deep at all. And I think a lot of people who hate needles find that when they're doing the injection themselves, it's not as bad because you're completely in control, and you can take a 'moment' if you need one. If you let your doctor (or the staff members, who were very helpful to me) know that you're not super comfortable with the whole thing, they can help you through it. When you know that you're doing it the right way, that takes a lot of the tension away. And if it works for you (as it did for me - switching to the injections REALLY helped) then it will be worth it. You can do this.

Sheltojl, you get used to those injections in no time. Have been on the Humira+MTX combination therapy for over six years myself. MTX can come either in tablets or injections as you know. I take the tablets once a week. Humira comes in 40mg injections. There are two types: what they call pen/sure-click OR pre-filled syringes. If you take the pre-filled pen, with one press of the butten you start the injection process and have no control over it. It is a matter of convenience/habit. I habe always preferred the pre-filled syringes. No issues with that. Since you are at the beginning of this whole therapy and it is new to you, you are bit nervous. My humble two cents: please please relax. Don't think too much about what will happen to you and how things will work out with this RA. We all know excruciating the pain can be especially at night. However, try to concentrate on other things.

Do not be afraid of injections because Biologics greatly reduced my pain. In fact today I need to inject my SIMPONI which is so very easy to use that I do not even feel the tiny needle because it does not go very far into the body, just a little way under the skin. I did Remicade infusions for years which did not work for me.

"Does anyone has any tips for their flare up pains?"

Yep. Go on biologics.

Trust me, you'll kick yourself in the booty for worrying about the needles once you see how easy and quick it is.

Mthx needles are diabetic needles, and those people really have to use a lot of needles, and have gotten virtually pain free needles. I did my shot this morning while talking on the phone to my sister. I didn't even feel it.

Years back I was in a daily needle, a biologic called Kineret. The needle was thick and so was the solution. The shots hurt and I had itchy injection site reactions!

But the RA was under control! A tiny prick every day, and to be 100% under control? You bet I got used to it! I do Orencia and mthx shots and I love them, because my RA is finally under control after a 2 year med failure, which increased my joint damage considerably!

As for getting people to understand, you can try educating them, showing them pictures, describing the pain and exhaustion. But likely, they won't get it. So, accepting that people don't understand is part of the disease.

I have a 4 year old grandson with autism, I swear he gets it more than anyone. I have never really explained it, but he us so careful and un-demanding with me. And if I play with him one day, chasing him, and the next day I can't he accepts it and gives me a hug!

So look for the people with compassion and empathy, and don't worry about the rest!

Flare ups...anti-inflammatory pills (over the counter) its not instant but it'll reduce the amount of time the flare up will last. my flare ups can last up to 4 days but can be reduced to 24 hours if i take advil/aleve every 4 hours. I know most people say its not good but if you are consistently getting lab work and all looks good then your not causing damage. Just make sure to follow the max amount on the label. Remember there is nothing that will be instant. You can try to apply heat/ice back and forth as well but with me its temporary and once i stop the pain and swelling comes right back.