Hi MelMac,
Sorry that you’re going through all that! I’ve definitely had pain without noticeable inflammation. Sometimes I think it’s PsA pain, sometimes I think it’s more of a “chronic pain” issue - that the pain pathways have gotten really well worn. Muscle relaxants that my rheum prescribed for nighttime really helped with the latter. Even when things were at their worst for me, I would get some swelling in my fingers and wrist, but nothing too serious - though the pain level was high! I’m not sure the pain and inflammation always go hand-in-hand. Hope it all gets sorted out soon. Humira worked wonders for me, but it took a little while to kick in.