I am sorry you’re suffering from so much pain at such a young age. I do have a suggestion however that might explore the reason for your new onset of intense joint pain, fatigue, hand symptoms and tremors. You are at an age when autoimmune diseases often start. Chronic migraines can be an initial symptom and then other symptoms can occur later. I would suggest asking your PCP to do some screening bloodwork for autoimmune disorders. There are many but lupus and Rheumatoid arthritis are the most common that affects joints and cause fatigue. Some screening bloodwork including CBC, metabolic panel, ANA. RA factor, sed rate and CRP are good screening tests and if abnormal levels show up, a referral to a rheumatologist would be indicated to identify the specific problem. It may be that your migraines are a part of a bigger problem that is developing. If that’s the case, ( I hope not), better to identify it early and get treatment started. Please let us know what transpires. I am glad the injections are at least helping your migraines. Good luck and I hope this gets figured out soon and you feel better!