Hello, If these r already done ,no need to repeat esr, crp, cbc, rf, acpa levels, moreover causes are viral and immunity generalized guidelines for both 1.exercise[yoga], diet,massage,councelling,stress reduction,physical theraphy, [ these all are included in online ombw course of art of living or wellness course join it] 2.dmard theraphy [as u already on those meds follow the theraphy or he may shift you to biologic agents] 3.prevention of diabetes is recommened [blood glucose levels should be checked , u may start using jaggery or brown sugar instead of white sugar] 4.healthy balanced diet include fruits,vegs, salads.. avoid alchol caffeine ,smoking pollution area,, use instead intake lemon ,c, , basil,ginger,turmeric,black pepper, rose petals 5. methy salicylate/menthol topicalcan be applied at joint pain use it when pain not daily [not to exceed more than 2 patches for 3 days or 1patch / 24 hr. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sunny Madar