Hey lady, and twin, Do you have a rheumatologist? I think that I would ask them what to do. It just so happens that I have come back from my rheumy today, and he told me that there are hundreds of types of arthritis, and different treatments for them all. As coincidence, of course,( maybe we really are twins), I have severe arthritis in my hands and fingers also. (Geez, something else to deal with) but anyhow instead of putting me on another systemic medication, he has ordered a fairly new med from the Optional Pain Control, compounding pharmacy, which specialize in topical pain creams. They mix together these ingredients, including NSAIDs (which I cannot ingest), a pain med, and other things that you can rub into your hand when the pain is bad. You can use it two to three times a day, but the beauty is that it is not ingested, therefore, it does not affect your other meds. My doctor is so impressed with this company (he thought that they were just looking to make a buck, and didn't trust them), until his patients started coming back to him claiming that is works so well. He has over 100 patients on this med, and he is so impressed with their work. If your doc has never heard of them, the number is: 888-482-3972. It's worth a try, and certainly you want to know what is causing this pain before you start taking internal meds, that have side effects even though they are over the counter, if you don't have to do that.
Good luck, and I hope that I helped you. I'm very excited about this cream (and they carry other compounds too), because some days I can't even hold a pen to write.