When your doctor doesn't understand, I usually recommend crying in their office.  Sometimes, they don't get it until you fall apart in front of them - I'm not fond of crying in front of other people, but sometimes it's necessary. Tell your doctor exactly that. That you are in so much pain you want to cry all the time. Tell him how the pain limits you, that you can't work, be with your family, take care of your kids, whichever aspect of your life is affected. And if he still refuses, see your primary care physician to ask for help with painkillers while you look for a different rheumatologist - earlier this year, I wrote a post about what to look for in a rheumatologist and that might be helpful for you.  If you don't recognize your doctor in that post, find another one.