Pain management for spouse

My wife has Rhumatoid arthritis, she is young ( 30) but she's also the glue to our home ( caring for our 4 children) and my full time caregiver as I'm in a wheelchair, she's been. Struggling for years and has finally this year gotten some answers , rhumatoid artharitis and possibly MS. We live in an area where all the pain management docs don't believe in pain meds, she's currently in a flare in the artharitis in her knees is restricting sleep/ activities and I don't know how to help other than look for information. who she should see for a referral to pain management, does she see her Rhuemetologist, or primary care? If they don't agree to write the referral then what's the next step? No doctors want to treat pain or flare ups and pain management for the most part in our area is a joke