<s>[INST] Hello, I have been diagnosis with Rheumatoid Arthritis and I am taking Orencia and Prednisone I have been having shortness of breath and a pain in my back between my waiste and right shoulder blade. I have had the pain for 4 days and at time it is getting worse. When the pain hurts really bad I get really hot like a fever and when the pain claims down but never goes away the fever goes away. Is this something I should worry about, I have a doctors appointment on Monday but is it something I should take care of today. [/INST] I want to check your disease activity by ESR and CRP levels. If they are still high some adjustment in dose of DMARDS or need of some TNF alpha blockers will be required. At this time try taking tramadol, Paracetamol like drugs for symptomatic releif and apply some analgesic gels like flexabenz and go to physiotherapist </s>