Shoulder pain: is there anything short of surgery that I haven't tried?

Pain seems to be centered in the right shoulder blade but also includes the areas of the cervical vertebrae and upper arm.

It used to happen occasionally when I was a youngster after prolonged periods of writing or typing. It didn’t become very troublesome until about 20 years ago. Since then it has steadily increased over time. Now it is constant, throbs in the night, interferes with sleep, and worries me because nearly everything I do depends on the use of my right arm. Sometimes my right arm is cold. My hand is also increasingly stiff, but that could be from a lot of things.

I was diagnosed with degenerative disc disease, especially C5-C6, in my forties. More recently a “big spur” was seen in Xrays.

A physical therapist also asked me if anyone had mentioned thoracic outlet syndrome to me, but no one has besides her.

Treatments so far:
— pain medication – side effects of Ultracet and Tylenol 3 worse than the distress; discontinued
— Lidocaine pain patches – 10% benefit at best
— exercises – virtually no effect
— physical therapy—helps a lot for about 45 minutes afterward, then reverts until the next session
— cortisone injections – taken twice: #1 significantly reduced pain temporarily, but sharp headache followed treatment; never had it before, have been troubled by it ever since; #2, 5 weeks later, reduced pain by about 70%, but not for long

All this took about a year and a half. Eventually I gave up hope and stopped seeing the spine doctor. I was not willing to have surgery without confidence that it would help. Now things are enough worse that I have to think again about seeking treatment, but I don’t know why the useless previous efforts would work any better now.

What else is there to do? What am I missing?