Just take it to a 'decent' shop that does front end work and get a 'free' estimate, see what they think. Probably needs everything all the other guys suggested. I would hold off on the steering gear until all the other stuff has been replaced. It's probably not bad ..and there should be an adjuster on it to slightly tighten.
Really the only way to properly check/tighten (adjust) a steering box is to remove it off the vehicle, put it in a vise and use an inch/lbs torque wrench on it and measure the rotating force and check lower bearing play. 99% of the shops out there won't know how to deal with steering boxes other than to replace ad it's highly unlikely yours is bad, they're way overbuilt made to live the lifetime of your truck ..they need to be for safety. And most of the shops won't even have an in/lbs torque wrench either. Usually guys replce steering gears along with a bunch of other parts and think it was part of the problem when it was probably the 'other parts' which were worn! And plus, a lot of so-called reconditioned steering boxes are just cleaned and new top/bottom seals put in and repainted. Very few have new internal parts (those are the $400 ones!). Read the reviews on Amazon on replacement steering gears.
To check, I've kind of figured out that 18 in/lbs is about as much torque it would take to rotate a deep well 5/8" socket if you squeezed as tight as you could and rotated it with a regular length 3/8" ratchet. The rotating force is about 18 in/lbs. So as you rotate the steering shaft it should have about that much resistance. If it doesn't you'd need to adjust the tensioner a touch more. Most specs are between 18-21 so there's a fair amt of latitude. For reference, my GM truck has 265k mi on it. It was getting really loose and very annoying, probably like yours. Earlier in the year I removed the steering box with the intention of rebuilding it (I've done a few). I even bought a new kit prior to taking it off. Well, after having in the vise and checking it out, it didn't even need adjusting. The real problem was 'play' in the steering shaft between the steering gear and the steering column, which was not immediately detectable. Replaced that short intermediate shaft and she's tight as new now! All the other steering parts were still nice and tight too. So, another thing to check is that intermediate steering shaft. Some of them have 2-3 universal joints or even a rag joint which can wear. Mine had a rag joint that was worn, and a slip joint which also had play.
To check, put a large vise grips tight on the lower part of the shaft and hold it against the frame or something solid so only the area above the vise grips can move. Then have someone in the cab slightly rotate the steering wheel back/fourth and look for play in the joints. It only takes a small amount to make a big difference at the wheel. So, for now, forget about the steering gear and replace all the other bushings, joints and shafts which show excessive wear.
Good luck!
