Hello Allan:
Reading your post I was struck as it is a carbon copy of myself all your ailments I live with right down to the numbness in the wrist but I have it in both my wrists
Myself I have had all the modalities plus 8 hours of spine surgery a 3 level laminectomy which did little to NO good
I tried the patch with no breakthrough med and found it not very effective at all and got very sick when I stopped it
I switched to Oxycontin which works wounder s for me I believe in your older posts you said your doctor will not perscribe it for you WHY I do not get these guy s sometimes but people like us pay for the abuse of these med s by other s
I also use a lot of heat mainly a waterbottle very hot and this helps a lot you might want to try that and ask for oxycontin and seriously contiplate any spine surgery mine help little to none and I went through a lot with it
Best Regards
Bob