Hi. I'm newly diagnosed as well and have been on MTX for about a month now. I experienced your exact description (popping) in my knees before I started on MTX and steroids. Once I got on the MTX and steroids that sensation has gone away and I have only had minor pain in my knees since starting. Additionally, today is a bad day for me and I took the MTX yesterday. So yes - I have also experienced where I had great improvement and then a setback today. Not sure why. I see my doc in 3 weeks and we will evaluate everything at that time. I have also not been able to get back into exercising. I'm too fatigued that I've only been walking. I hope this will improve the longer I'm on MTX.

I am on MTX for about 2 months now. I have mostly good days, but still have swelling in my feet every day. My exercise regime has not changed, though I do feel I get tired more easily. No popping joints (except the occasional 54 year old knees that popped occasionally before RA anyway). :)

Scoates....I'll write tomorrow when i have time. In the meantime...what dose of mtx are you on and for how long?

Second week at the full dose of 15mg. I can't tell if it's even helping. There were times when I could use my hands and thought the mediation basically allowed me to function, but maybe I just wasn't doing anything with my hands. I'm talking about little things like using a mouse and holding a tablet.

My understanding is that MTX takes around 12 weeks to take effect, so youre not likely feeling any benefit yet.
I've been taking it for 18 weeks, and overall symptoms are now less, but not gone by any means. "little things" like mouse and tablet use tend to be repetitive movements for hours at a time, and I find this causes me a fair bit of pain too.
Re exercise, seems that it's important to keep the joints moving even when they flare, but move only as far as is comfortable, and it can be short bursts of movement, often...probably much much less than you would normally consider to be exercise.

Finally, a chance to respond.

First, I was diagnosed in 1992. I've been on MTX since then. I started at low dose, then titrated upwards as needed. Over the years MTX isn't as effective unless you increase the dose over time. In my case, I was maintained on about 12.5 for some time, then as I noticed flares, the dose went up about 2.5mg a year. Utlitmately I reached 25 mg, which is generally considered the max dose for RA. When that dose helped for a while, I had to resort to Kenalog intrajoint injections and eventually Humira was added [6 years ago]. I currently am stable on 7.5 mg MTX + Humira bi-weekly.

It took, if I recall correctly, about 3 weeks or so before I noticed improvement after starting RA. Since they caught it early in my case, it doesn't surprise me that it could take up to 3 months for good improvement to occur. [Most people aren't as lucky as I was with an early diagnosis.]

If after say 60 days on MTX if you feel you're worse, you still need to titrate the dose higher [your doctor should do this, not you]. Remember, you've probably forgotten what it feels like to feel good and have learned to adapt to pain.

Exercise: cut back to about 25% of what you used to do. Are you able to do that without pain the day later? If so, add maybe 10% more of the same exercise and keep checking. Gradual change is key here. Anytime you hurt after [or the next day] exercise you need to cut further back. Don't push it. You'll get there.

There's no clear textbook case that we all follow. Hah! If only it was that simple. It's different for all of us.

I know too well the pain when mousing with the computer. I managed to partially relieve that situation by getting a true ergonomic mouse. It's become pretty pricey, but here's the link:

http://www.rakuten.com/prod/microsoft-natural-wireless-laser-mouse-6000-metallic-gray-microsoft/203452190.html?listingId=506554047&sclid=pla_google_PCMONDE&adid=29963&gclid=CjwKEAiAmJvBBRDKpP724LigwngSJAAYRJXB4TBi_FKTG8p0KLJ5eTYGHiPcoUds0cd9TMeuXr5QoRoC_Ijw_wcB

I swear by it.

Pace yourself in anything that requires joint movement.

Scoates, is the plan to add a biologic to your treatment? Or is your rheumatologist just trying to see how well the MTX works?

My insurance won't cover a rheumatologist, so my doctor is doing the best he can. If I get a referral for a rheumatologist, it's a three month wait to get an appointment anyway.

Is it possible to change your insurance?

Not reasonably.

Swimming is probably the best thing you can do. Because you can go at it gently. Can you just walk leisurely? That's pretty good too. It will keep you cardiovascular wise until you can do more.

That said, I think you've got the idea here already that your RA has to be under control first. My MTX works pretty well. I lift weights and walk on tread or swim. But there weight I lift is 15-20 lbs where it used to be 70-100. And I have still a few days of stiff fingers afterward.

On medication, I'm lucky I have a nonerosive form. I started with plaquenil and sulfasalazine. The sulfasalazine after 2 yrs have me itching and was stopped. The plaquenil after three years started to damage my retinas and was stopped. Those two together actually made me feel normal like before this whole mess.

Now I'm on methotrexate. It works mostly. I still get stiff and flares but they aren't so bad that i can function. They're just annoying. Can't exorcise with any vigor. My dose was 15 which did almost nothing. Now I'm on 20mg

I can identify with your concerns. My exercise has varied greatly depending on my medication. Before RA I was a avid runner and did kickboxing as exercise. On Enbrel I had a high level of mobility and was able to at least jog a mile if I wanted to. Humira and Xeljanz were both flops for me, any excercise aggravated me to much, I would try to put in some time with the elliptical when I had energy but it was difficult. Now I am on Orencia Infusion and Injection, I am ok now, I have a high level of activity, able to bike ride, play raquetball, jog, lift weights, etc. I hated the process of trying so many meds, it took 6 years to get to the right one. When you get to the best one, you really know. My quality of life is pretty high but I still suffer pretty bad during cold and humid days. Hope that helps some and best wishes with your excercise.