I am on mtx & feel like all i am doing is complaining to my rheum about the side effects. my cheek is twitching. is that serious enough to tell her?

Neuropathy: from Methotrexate can cause focal muscle twitching and numbness. Have your Rheumatologist check you for neuropathy or better yet have her send you to a neurologist who can perform a nerve conduction test. I recently had a patient develop polyneuropathy on MTX for Psoriatic arthritis. He was switched to Embrel (Enanercept) and the neuropathy resolved (as did his skin lesions and arthritic pain)