I have throbbing pain. Like someone hit me with a baseball bat, and I can feel my heartbeat pulsing in my veins. This happens from my knees to my toes, and elbows to my fingertips. Is this normal? So far this is causing the most pain and fatigue. Also with RA, is it normal to end up with gout? There is pain in my foot that feels like someone it using a saw to cut into my bones. So far I'm on plaquenil, I'm scared to have to get on Methotrexate. Any thoughts would be appreciated!