Late Night Finger Pain in Swollen Joint

I hit the indoor boulders a bit too aggressively in my teen years and developed a set of lumpy fingers pretty early on, around 18. Now that I am 35, my fingers are very lumpy, and my middle finger on my right hand is very prominently swollen. I have seen a couple of hand PTs, and have been doing the exercises that they recommended with little success.  The main issue that is causing me to post is in my most swollen finger, my right middle finger, where I have started to develop low levels of pain at night. 

The hand PT that I was seeing referred me to Dr. Mark Wagner, M.D., who determined through X-Ray that I have a bit of osteoarthritis in my most swollen finger, the one hurting at night, but he didn't think that I had it in my other fingers. He was concerned that it might be lupus because my hands are in rough shape for a 35-year-old. The rheumatologist determined that it was pure sports-induced wear and tear. I returned to Dr. Mark Wagner, and he recommended PRP injections into my fingers. I held off on doing this for a handful of months, mainly because it costs $2,000 out of pocket to get these injections, and the consensus online seems to be that it's super duper experimental. I ended up getting them done three weeks ago and am seeing a climbing PT at Union Physical Therapy in Seattle. 

This feels like an inflection point. I don't want to do irreversible damage to my hands.  But I love climbing. Are there other treatments besides PT and PRP worth looking into? My diet is good. I am open to supplements. Is hangboarding potentially a solution? Are there other doctors, like a hand surgeon, who are worth talking with? I understand that full crimping and bouldering are out of the question moving forward. 

had the exact same thing — finger would be fine during climbing and then throb at night with visible swelling around the joint. turned out to be capsulitis (inflammation of the joint capsule) rather than a pulley issue. worth getting checked if it keeps up because the treatment is different. what helped me in the meantime: contrast soaks (warm water 3 min, cold water 1 min, repeat a few times) before bed made a noticeable difference with the nighttime swelling. also light rubber band extensions before and after sessions — sounds too simple but theres actually research on it improving finger circulation for climbers specifically. the bigger fix was backing off volume for a couple weeks. not stopping, just fewer hard sessions and more rest days between. the swelling went down pretty quick once i stopped overloading it

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