Sorry you are hurting! You may try calling your pharmacist or doctor to double check what is okay to take with MTX and any other meds you are on. As a general observation, I haven’t heard of pain meds being contraindicated with MTX. It may also depend on how your kidney and liver lab tests have been lately. For instance, some meds have raised my liver enzymes. When that happens I have to avoid any meds with acetaminophen in them. Hoping for less pain for you soon, Jo