can anyone reccomend any good effective painkillers

Vicodin works great.  I took it once and my pain went away.  The bad news is a broke out in a rash and seem to be in the small pop. of people who are allergic to the stuff!  have you tried Prednisone?  That works great when you first take it.  I seemed to built up a tolerence for it though.  Your Meth. dose seems alittle low.  If you are in that much pain, you should be up to 6-8 pills a week.  Take to your Rheum. about it and see what he/she thinks.  Feel better

Provided that you are not allergic to morphine, Kadian is a wonderful medicine.  It is time-released so you don't have a "high" feeling, it just works wonderfully controlling my pain, and I take hydrocodone for breakthrough pain.  I like the fact that it (Kadian) has no acetaminophen in it.  I took Darvocet or Darvon regularly for the first 24 years I had RA and I realize that many medical professionals say it doesn't do any good, but it helped me more than any other analgesic, and for a  really long time, too!  But gradually over the years it lost its effectiveness for me and now I am on much stronger stuff.  I do not regret this AT ALL.  You do have to be careful who you tell about it though, because the population in general (even many doctors) are woefully ignorant when it comes to treating chronic pain and tolerance/dependence/addiction issues.  Don't be afraid or intimidated to EDUCATE YOURSELF and be your own advocate!

Since I wrote this answer last night, I read Lene Andersen's post about "Better Living through Chemistry".  You should definitely read that one.  And another thing...Back when I needed two replacements at the same time, but they could only do one, I was put on a Fentanyl patch.  It really was effective, so you might try asking for that, if you would rather not take anymore pills.  It, too, is a morphine derivative. 

There will always be some pain, though.  Pain in some measure is a protection.  If you had no pain at all, you would most likely be engaging in activities that would overwhelm your poor joints.  The goal with the "big guns" pain killers should be, as Lene said in her post, to reduce the pain to where it is manageable and in the background, not taking over and taking away your life.