Have you tried cannibis? Heavy CBD topicals do wonders for my hands, a nice bit to smoke gives near-instant relief, and an edible or tincture helps the inflammation for a longer term. My wife uses hemp-derived salves and tinctures because she doesn’t like the feeling of being high, and has been a daily user since the first time she tried. It hasn’t cut the need for the rheumatoid meds entirely, but it’s helped delay an increase in dosage.