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Hi there. I read your post. What question can I help you with?
RA is a good thought given the PIP involvement. It is easy to test for this, though in rare cases the RF is normal even when the clinical picture is pretty clear. (i.e seronegative RA). If it is RA, it typically responds pretty well, or very well, to NSAIDs. You could try ibuprofen or naproxyn if you tolerate them. That said, the nail marks in the palm make me wonder if you might be having occult seizures. They can sometimes occur only at night, and might be partial in nature. Either way, a sleep EEG would help to uncover this, or perhaps rule it out for now.