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Swelling and tightness in left hand knuckles

Hello fellow community!
I’ve been experiencing swelling, tightness, and light pain in my left index and ring knuckles for ten months now. I’ve played guitar for ten years and believe the injury was caused from overplaying and incorrect playing (pressing down too hard on the fretboard, not warming up, and playing for hours straight) I had the same injury 4 years ago in the same knuckles but it was less severe and it healed itself in four months with rest, diet, ice, anti inflammatories, topical CBD oil, and lots of water.

I tried all of the things I had done in the past and they have helped but not fixed it. So I went to an orthopedist and had X-rays, MRIs, and blood work done. And they found no ligament damage, no tendon damage, and no broken bones. Been tested for rheumatoid, lupus, and Lyme disease and cleared all for that. One doctor said my uric acid was a little high and gout runs in my family but said it wasn’t high enough to diagnose it as gout, but could be uric acid levels. The MRI though showed a lot of swelling in my left knuckle and less swelling in my ring one, but like I said found no specific damage to anything around the joint.

The only drug has really helped is steroids. I took some orally and it knocked out the swelling til I stopped taking them and then it came back. And got a steroid injection in my index finger which helped so much (I couldn’t move my Index all the way down and now I can pretty much can) but it’s still swelling. No numbness or tingling in the tips of my fingers. My whole arm feels tight and weak from not using it for months.

So is it a sprain, a strain, arthritis? None of the three doctors I’ve gone too can diagnose me.

Wondering too if something in my lifestyle is causing this. I do smoke 2 packs a week, and work in a kitchen over a 400 degree grill. I have had heat exhaustion before and have a cold hands and feet a lot of the time. Besides all that, I eat very clean diet and drink lots of water.
And have been icing, resting, and elevating my left hand every day. I have no swelling in my other hand joints.

Not asking for a diagnosis but wondering if any one has any thoughts as to what this may be. Thanks for reading :)
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