Hello @bwhitten01, I see that you joined in April of this year and this is your first post so I would like to welcome you to Connect. 19 years is certainly a long time to deal with the pain and other symptoms and still not know the cause. While you wait for other members with similar experience to respond, here are a couple of discussions that might be helpful to scan through to learn what others have shared:

- Positive ANA: What might be the cause?: https://connect.mayoclinic.org/discussion/positive-ana/
- What can cause ANA titre of 1:2560?: https://connect.mayoclinic.org/discussion/what-can-cause-ana-titre-of-12560/

I know you mentioned seeing a lot of doctors. Were any of the doctors rheumatologists?