First let me say thank you to the group. I don't always get online to see updates daily but I try. The members of this site are all very supportive of each other and it's wonderful read the posts and know that everyone genuinely cares about each other. I wish you all a good night's rest tonight. Now to my question..I have been taking Plaquenil since February, along with Mobic (maximum allowed) which I have been on for several years. I am being treated for Sjogren's, Lupus, and recently UCTD. Within the past month I have noticed the Sjogren's symptoms of dry mouth, eyes and overall body have improved dramatically, which I think is from taking the Plaquenil. The joint pain and swelling in my hands have not improved yet. In fact I now have pain in my feet, elbows and occasionally knees. I take Xtra Strength Tylenol during the day when the symptoms interfere with my abilities to work and I take Flexeril and sometimes Norco at night when the pain wakes me up. I saw my rheumatologist 2 weeks ago and the nurse called me this week to give me results of my blood tests. The Lupus is stable and the test for inflammation shows normal. I have low vitamin D and a low Complement C3C. I protein in my urine, I always seem to have that. Since I still have pain my my joints and my hands swell at night and are stiff in the AM and PM, I expected the blood test to indicate inflammation. Is it possible that the medications (Plaquenil, Mobic etc) can be lowering the levels AND I can still have pain, swelling and stiffness? I am hoping that some of you can help me to understand how I can have pain but yet blood work doesn't indicate it. Thank you for your help and many blessings to you all!