In long-standing Rheumatoid Arthritis, medicines like Metrotaxet and Zy Q help, but long-term control often needs a structured plan with a rheumatologist. This may include optimizing methotrexate dose, adding other DMARDs or even biologic therapies if symptoms persist, along with regular physiotherapy and joint care. Please consult a specialist to adjust treatment and prevent further joint damage while improving quality of life.