Hi BubblyMom, I have similar circumstances. I went the natural route, starting with Medical Marijuana Therapy. Awesome, not just to offset physical pain but to smooth out the mental issues, which were crushing me. I also use DoTERRA essential oils. I’ve used oregano, ginger, juniper Berry and other oils to ease foot pain. Another biggie was losing 60 pounds slowly and methodically over 2+ years. Gluten-free diet was also huge. Cut down on sugar intake. I’m on Enbrel (it totally cured the pitted fingernails and wiped out skin lesions) and methotrexate, with folic acid to aid the autoimmune system.