Sorry to hear you're having so much difficulty finding the medicine that will really help with minimal side effects. One standard option is to go on prednisone for a few weeks until the Arava has a chance to really kick in. Or stay on a good NSAID continuously for a while if you aren't already on one. Your doctor may be willing to prescribe other pain control medications as well - have you talked to your doctor yet about the trouble you're having making this switch and asked for some options yet?