Arm pain from shoulder to fingers, with swollen finger

[redkim]

For about eight years my middle finger on my right hand has been swollen.  I went on workers comp (secretary) for a few weeks and started physical therapy.  Since then my arm pain is worse.  My finger has been swollen for eight years, my shoulder, and wrist hurt (a lot).  My wrist crackles, my arm pops and crackles when I move it.  I have lost range of motion in both the wrist and shoulder.   If I bend my wrist up or down it hurts a lot and can't move very far.

I was tested for CT, negative.  Went to physcial medicine she said my case is complex and thought I had Complex Regional Pain Syndrome...the doctor at pain management doesn't think I have that and gave me a list of stretches to do.  I have had a bone scan which also came back normal.   She told me she didn't think physical therapy would work.

Sometimes my arm hurts so much I am in pain!  I am only 28 years old, so I have been dealing with this pain since I was 20.  I did message my doctor to today about seeing a hand specialist about my swollen finger...

Anyone have any suggestions on what this might be?

[redkim]

I wanted to add I have a warm feeling in my arm and have loss of sensation.  I have Chiari Malformation, a pineal cyst and had brain surgery 1.5 years ago.  I thought Chiari could have been the cause because it damages the nerves...but after surgery there wasn't improvement.  I was on Nortryptyline for a few weeks and I think it helped a little, but it also caused me to have more severe headaches, so I stopped it.

[redkim]

I sent my doctor a message and she is referring me to an othopedic doctor.  I called and they said their surgeon will review the request and will decide to either make an appointment or to send the request to pain management.  I have already been to pain management, they were the ones who told me to see an orthopedic (hand specialist).  

I asked for the request and my doctor asked for my symptoms.  Then she told me she was sending me to get an x-ray and would submit the referral to the orthopedic department.

Does this mean I might need surgery?  The woman on the phone seemed to imply that you see the orthopedic "surgeon" or they send you to pain management...