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Battling RA often requires a number of different treatments. It is rare that a disease modifying drugs (like methotrexate) will work so well that no other medication is needed. Sometimes it needs to be supplemented with an additional disease modifying drug or with painkillers and/or anti-inflammatories. Depending on the painkillers you're prescribed, you may not be "loopy all day". Even if you are prescribed a narcotic kind of drug, you may not be loopy and if you are, it probably won't be for long - over time, often as quickly as a few weeks, your body will adapt. The medication will be going to treat your pain - it has something to do other than make you feel loopy.   FuzzyQBall is right, it's important to get a flare on the control as quickly as possible to hopefully avoid it causing permanent damage and anti-inflammatories can help with that. If you have concerns about the type of pain medications your doctor is suggesting, given her/him a call and discuss your concerns. There are many different painkillers out there and together, you and your doctor will be able to find one that works to address the pain and the flare, as well as allow you to function in your daily life.   Good luck!