Hi,
If you’re unable to use your NSAID then your doctor may need to change you on to a different class of anti-inflammatory drug to control your swelling. A stronger opiate may help to control the pain, but it won’t reduce the swelling and so this is something that your doctor would have to address. He may put you on a stronger dose of prednisolone or may alternatively put you on something like methotrexate or sulfasalazine, which are known as Disease Modifying Anti-Rheumatic Drugs (DMARDS). These are not painkillers, but will work to reduce the swelling and slow the progression of the RA.
If they do decide to put you on stronger painkillers then there are a few routes that they can go down. If they are increasing your opiates then they will likely stop your buprenorphine patches. They then could either give you a slow release preparation such as MST Continus (morphine) to be taken twice daily or fentanyl patches to be replaced ever 72 hours. With either of these options, an immediate release painkiller (such as morphine 10mg tabs) could also be taken if breakthrough pain is experienced. However, your doctor may decide to try a different treatment route depending on his/her own experience and your own symptoms.
Hope this helps,
Neldo

Upping yourself to stronger pain meds isn’t the answer. Believe it or not, you can learn to control some of your pain yourself. If you can, contact a dietitian. Alot of foods can cause pain flare ups. You also need to keep a journal. Write down when your pain is at its worst, the time of day it is, what you are doing at the time, and how long it lasts. Try to stay in a cool environment as humidity, stress and lack of sleep can cause pain to flare up also. Ice packs work good, or a bag of frozen veggies if you don’t have an ice pack. You could also try getting a body massage, going to a chiropractor, or soaking in a hot bath. I hope some of these tips help. Good luck to you. P.S…You might want to try out a pain management class.

The NHS has set up the odd specialist pain clinics.
I expect you have been desperate enough to look at this site already…http://www.britishpainsociety.org/patien…
You must be under stress and anxious (panic attacks/injections). A vicious circle pain-stress-tense up-pain worse.
Would it be worth your asking for a second opinion or to consider a doctor who is also qualified in homeopathy?
Treating the whole person does really come into it in your situation.
You say Tylenol (US name), mention UK drugs. If you are in the UK there might be an NHS doctor who specialises in homeopathy in your area. Below is a helpful link.
I am sorry not to have more helpful information, I know what living in constant pain can do to a person.
I hope you find something useful from the links and that your appointment tomorrow goes well