I'm sero-negative RA. I've been on Plaquenil and Maloxicam for 6 months and am in mid-titration of methotrexate to 20mgs. In the last month, I've had increased pain in both wrists, elbows, shoulders and even my neck. My question is this; how do I know if this is the RA getting more aggressive or is this a flare? I've had no remission since being diagnosed 6 months ago so I'm inclined to think that this is the disease ramping up. Anyone have similar experience?