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I'm so sorry you're having a rough time - this disease can really mess with your life.   The thing about blood work is that it doesn't always tell the story - e.g., you can have a negative RA factor and still very obviously have RA. However some doctors get very attached to tests and numbers and that doesn't always work for their patients. I am tempted to suggest that you try interviewing and other primary care physician - although RA can be tricky to diagnose and often cause people to go from doctor to doctor for a long time before they find me get the diagnosis, two years of tests seen a really long time before a referral to rheumatologist, especially considering your swollen hands.   When you have RA, pain comes from two things. Active disease with increased inflammation and swelling will cause pain - do you have visible signs of a flare? Are your joints read and swollen? If yes, then maybe the blood work is wrong. The second cause of pain when you have RA is damage to the joints. Untreated RA erodes the cartilage and when it's eroded enough, it hurts a lot. How long have you been on Paquenil? It takes a while to work, so if you've just started on that medication, it could be a matter of being patient to let it do its thing. While you're being patient, however, you should have better pain control - is completely unreasonable to expect you should just soldier on through this kind of pain - and I would suggest that minimum asking for an appointment with your rheumatologist to get bigger painkillers. If you're been on Paquenil for a while and it's still not working, you may want to discuss other treatment options with your doctor. In terms of whether you should be getting a second opinion from another rheumatologist, it's certainly something to consider. One of my recent post is called 5 Things to Look for in a Rheumatologist and you may want to read that to see if your doctor has potential. If not, interviewing another rheumatologist or two might be a good idea.