@bwhitten01, sorry about your frustration. I have had an ANA that high myself but not for a long time. In my experience your CRP and sed rate may be even more significant indicating inflammation, as you know.

Does a diagnostic label change your treatment? That is another question. You said biologics don't help. Have you been put on Plaquenil, steroids or methotrexate (I ask from personal experience and am not suggesting anything)?

It seems rheumatologists mainly monitor for internal damage to kidneys, brain, heart, lungs, blood vessels etc. We get sent to PT and pain management for the pain. Are the meds for pain helping you?

I just wanted to comment sympathetically and don't have answers. It seems so many are dealing with ambiguous autoimmune disorders. I hope your doctors are confirming that you do have an autoimmune disorder (It seems like it!) and supporting you while diagnosis is pending for so long.