sounds like you've done mostly everything I have! Botox helped me quite a bit, trigger points and even cortisone. I hope you tried a variety of MFR peeps. I use a guy who doesn't take insurance but it is well worth it for the relief he gives. I tried several. Also, my heating pad and I are best friends for 35 years.
I went through a period of getting tendinitis and having connective tissue pain everywhere. Thank god it stopped. Have you tried Bioidentical Hlormone replacement therapy? I went into menopause early. So I was on for 10 years. Off for 10 years and now back on and it helps with a lot of things. Also I figured out I had gout (not my dang doctors!) after 30 years and the Allopurinol was a godsend. My joints moved again! And finally two days ago i asked to be put on medicine for prediabetes. I stopped being able to control my A1C with diet. I was lightheaded and STARVING all the time! I went on Metformin which has no consequences and it was 100% AMAZING even for my overall joints/OA/Gout -- I feel like someone just goosed and greased my movement. My fatigue dropped. Only a couple days but another miracle step for me. I have a couple of neighbors who wouldn't let the doctor remove their thyroid and they overcame their problems with walking (hyperthyroidism but not Hashimoto). I am about to start some strength training because I have lost all of my muscle tone (its scary!) and then you get connective tissue pain because the muscles glue together and tug on the connective tissue. I never say die! Good luck!