Hello, lesliehawkinson, I also have advanced degenerative osteoarthritis. Reading your introduction I was impressed by your writing that you are "as active as I can be, have a puppy who keeps me busyand maintain my home." I'll briefly introduce myself (this is my first time here) so that my comments may be more meaningful. Pain , both chronic and acute are horrible things that I live with, get angry with because I love life and the pain often interferes with my quality of life. I have end stage arthritis in both shoulders, have had 3 surgeries on my right hip (2 were "revisions" -- the first orthopedist was negligent-- and discussion was had about a 4th surgery because the prosthesis, now about 20 years' old, is loose, not straight in the femur, and is hanging on to scar tissue only. I am 75, and like you, "otherwise healthy" (most of my joints, my back also -- herniated discs and severe stenosis-- are also affected. The prosthesis cannot be replaced mainly because there is nothing to hang it on to except scar tissue and atrophied muscles, so I have to walk and move carefully, not knowing what will happen next.Apparently, the greater trochanter was the bone the prosthesis was originally attached to, but it became "reabsorbed." I don't understand how a bone can be "reabsorbed." If that is so, (a touch of black humour!) then I may as well get a refund for my cremation plans!
Pain. Yes. Unlike you, I have always taken pain killers, though up till now, not NSAIDS as they gave me a stomach ulcer (now cured.) I have, in my arsenal against pain : lyrica,oxycodone,and.....I carefully use NSAIDS now, since the inflammation in my knee (only slightly arthritic) is unbearable due to the loose hip prosthesis, and the tibia is also involved -- the pain there is also unbearable. These medications have horrible side effects, but they take the edge off the pain, and I am able to sleep sometimes 4 hours a night. My coping strategies are distraction and laughter. Yes, laughter is the best medicine. Talking and listening to other people means I can't think of myself. I also know that when I MOVE, initially it may be agony, but stretching exercises, walking, keeping muscles from atrophying further is essential. When I stretch, (my arms, for example), I'm following physiotherapists on Youtube, as Physio clinics are expensive, and although pain is always present, I feel in control when I've successfully moved (with an ominous clicking of osteophytes) in baby steps, a little each day. I have a walker but don't often use it, as I don't want to be dependent on aids for movement.
Lesliehawkinson, you're not getting quality sleep, and sleep is important in reducing pain. If you can learn to relax fully, (with pain I automatically tense up) with calming teas, audio-visuel aids (listening to specialised tapes with hypnotic, kindly voices, white noise, soothing music etc.) then you might be able to sleep better and wake with less pain. I have written a lot, when I have flare-ups, I'm incapacitated for a few days, and have to lie down, but I do take prescription meds for the pain. They help. Replying to you has helped me strengthen my resolve that I refuse to let pain rule my life entirely. My joints (some of them don't exist anymore) have failed me but I find distractions help me regain a sense of control over my life.

Lesliehawkinson, I forgot to mention some things which you might not have thought about. In case you haven't, here are some suggestions : never, ever have sugar in your house--or in your diet! Sugar will bring on inflammation, and inflammation is pain. This means being drastic, looking at food labels to see if there's any sugar/glucides etc. in it, and researching and making a list (you can google foods to avoid like the plague for osteoarthritis "sufferers" -- such as those from the nightshade family, like potatoes, tomatoes etc....). There are also herbs which help against pain, like turmeric (I have turmeric gummies, and you can put turmeric (curcumin) on nearly everything.
I was a right pig at Christmas and ate 6 profiteroles (I love chocloate) and wham ! I was completely flattened in bed for two weeks. Then magically, the flare up ended and I had no pain at all ! I don't understand it ! The "no pain" lasted about 3 days and then came back....it's painful for me at the moment (end stage arthritis of shoulders) to even type so I must stop now, have something to eat to protect my stomach and take an anti-inflammatory , relax, meditate, and sleep. It helps to have a thick, soft mattress topper to sleep on.

I feel much compassion for you. I too have pain always because of the arthritis, fibromyalgia and torn rotator. I take only 4 tylenol 3 a day and 100mg of antibiotic once a day. Cold rainy days pain is extreme all over. warmer days I have to stay in but can walk in the house. I need temperature outside to be around 20 C.