Decent because I take several meds that sedate. Neurontin was the most effective because I no longer wake up with arm pain.

How do you sleep?

Sounds like you had Hashimoto’s thyroiditis and burned your thyroid out. The progression of your TSH suggests that. Now you are hypothyroid. Not the end of the world . Have you heard of CREST. Sjogrens is only a part of the picture, hence SYNDROME. You may only have one of the pontentia Five but with your pain ,I would think there may be others going on, like joint inflammation. You need a good rheumatologist who will look at all of your sx. I personally would get off “pain killers”. The alternative acetaminophen, Tylenol. I knit till my thumbs scream at me. If you can walk or swim….get as physical as you can comfortably do. I am a nurse as well 1967 class. But I still cannot know your whole story.