Question: I'm a 50 year old female with chronic pain (chronic, not constant) in the right scapular area & lower back pain when walking. Pain is possibly caused by what should have been a fatal car wreck 22 years ago & possibly from years of improper lifting & physical activities that did not cause me pain until I was about 40. I had a total abdominal htsterectomy at age 27. I have osteoporosis and can't take medication due to recurring stomach ulcers. MRI's don't show enough compression of the vertebra to cause the intensity of pain I have. May have fibromyalgia also. Tried pregabalin but side affects were intolerable. Have been through physical therapy & had epidural cervical & lower back epidural injections of Kenolog. The Kenolog slightly helped pain the 3 months. Kenolog caused huge mood swings, but I did not fit the criterial for bipolar. I have a psychiatrist who manages my medications ordered by sleep medicine doctor. He put me in the hospital a month after my steroid injections to keep an eye on me. I also have SAD & major depressive episodes a few times a year. Saw a really good psychologist for over 3 years hoping that by resolving & coming to terms with current & past issues might help reduce pain. Therapy was psychologically beneficial but it didn't reduce my pain. I've tried every medication for depression including meds used off label or as add-on meds. My psychiatrist considers me treatment resistent. My bad experiences with doctors telling me my "pain is psychological" and then after the psychiatric problems I had after receiving Kenolog injections that the pain management doc couldn't have caused has kept me away from doctors for a few years. I have an appointment next week with a new PCP & hope she can figure out why I have chronic pain & how to treat it. I got some medical marijuana from a doctor while out of my state last week to see if it would help with the pain. Marijuana isn't legal in my state. I will tell my new PCP I tried marijuana because I believe in being completely honest with my doctors. I also have narcolepsy & take Vyvanse. The "dreams" were not like hypnopomic hallucination. It helped with pain but caused what seemed to be 5-8 minute dreams. Did not like marijuana. It affected my thinking for 3 days. I've asked many people if they ever experienced "dreams" after smoking marijuana & no one said they experienced anything like what I did. I also have B12 (pernicious) anemia. I saw a neurologist when I was about 38-39 fearing I had some type of dementia. My EEG & MRI were normal. The neurologist checked me for B12 & sent me to hematologist. My B12 was 998. Cancer was ruled out. Weekly, then monthly cyanocobalamin injections control my B12 now. I apologize for my scattered thinking & writing. This is a lot of information to give you. Two of my adult children are doctors. Both are anesthesiologists & might have some insight, but I'm uncomfortable discussing my health issues & ethically neither could treat me for any condition. I guess my main questions are what can be done for my pain when medical imaging is unremarkable, steroid injections, antidepressants & pregabalin don't work or cause serious, unacceptable side effects?

I have done everything you suggested.
What auto-immune disorders & tests can be done to diagnose or rule out conditions that can cause or increase the perception of pain?