I'm so glad that you have the internet to get input on how to help your daughter.  I was diagnosed with RA at the age of 17, but onset was around 14.  Back then (1974), they gave kids with moderate RA aspirin.  I never got aggressive treatment, even though I was pretty sick.  I take some responsibility.  I didn't complain much, and like most kids, I just wanted to fit in.  I alternated between feeling sorry for myself, and denying reality.  So much so that by the time I was in my 20's, I had significant joint damage.  I'm lucky, because I did have moderate RA, and responded pretty well to almost all treatments that have been tried. I'm going to join this forum - hope to see you post here. Stick with me, because I'm going to make a point that might help you. I just started Humira - have been on methotrexate and Relafen for about 15 years. Prior to that, on some combination of non-steriodal anti-inflammatories and plaquenil.  Never had oral prednisone until recently - after relative calm on my methotrexate and Relafen for many years, I went through menopause.  BIG increase in symptoms -started hormone replacement therapy, which helped a lot. Then my sister was murdered, and as a result, I had to move to a different state to help raise her kids.  It was a HUGE trauma for me, and I was "the strong one" for my entire family.  The stress really caused a major flare. So what does this have to do with you?  DON'T underestimate the role of hormones and stress on your daughter's RA.  Consider putting her on some kind of birth control pill to even out the hormone changes, and get her some psychological counseling, preferably with someone who specializes in teens who have illness. The local Cancer Society or the Arthritis Foundation might be able to recommend someone.