Hi, Sam,   Sometimes we have to stop our DMARDs, such as methotrexate, for a while because of changes in our blood work.  Your mom's rheumatologist should work with her if she flares.  If her hands start to swell and hurt more, she can call her RD.  IDK if the RD will prescribe a steriod or not, but her doc needs to be aware of any changes.  Once her bloodwork returns to normal, she may be able to resume taking MTX, or her doc my switch her to another DMARD ( disease modifying antirheumetic drug ).  In addition to that, she may want to wear gloves to keep her hands warm.  I have a pair of gloves with the ends of the fingers cut off of them that I used to wear when I was typing at work.   Hope this helps!   V