I, too, have been on Arava for a month with nothing but worsening pain and symptoms. I have been told, as drbob992 said, that it can take quite some time to begin to help, if it is going to help. Usually, when it fails to help much or takes longer than "expected" a biologic will be added. You may want to discuss this with your rheumatologist. Aggressive treatment is needed to slow down progression of disease activity and erosion. I'll be starting one in January 2013.
I don't know what else to say and I know this is an older post, but I do want you to know you are NOT alone in this fight! Hang in there! I know it feels impossible some days, but things can and will be done. It's just a crummy process, to wait and see and then wait and see again. ♥
Unfortunately it can take up to 4 to 6 weeks before you notice any effect from the drug; and in some patients it can take up to 6 months before any benefits are noted /pain relief.
Thi may not be the drug for you; consider talking about using a biologic drug (Humira, Enbrel, Simponi or Remicade) when this drug fails to help you.
Your comment is over two years old, but hopefully this can help someone else.
Dr. Bob
Bumping this up so someone who knows can answer.