Well without doing a full exam on you I'd say surgery is sounding like a strong possibility.
If the cortical / steroid shots only helped for 3 days...that's not good...that means you have some severe inflammation going on in the joint. Nothing to get too worked up about, it is an indicator of your injury.
While Satanus' comment of: There is this stuff that a lot of wieght lifters take for joints. It's called glucosamine. All drug stores sell it. I haven't tried it myself, but it is popular. Also, maybe some natural antiinflamitories, like ginger, a daily dose of aspirin (85mg). But, avoid the suppositories.
His/Her advice is ok but...this would be for everyday osteo / arthritis not an acute injury like yours.
Depending on the injury the small incision needed, you would heal very quickly. But you would need to keep the arm immobilized for a good 6 weeks.
But you should not be living in pain. Tell the doc's your meds are not touching your pain and you need something stronger. Without sleep you can't heal. And I'm not a big proponent of pain meds as I know what long term exposure to them due to the nervous system but there is no reason to be in pain losing sleep.
So I'd get to the doctor and discuss the alternatives, medical recommendations he suggests...let me know how it turns out.