Hi Rae and welcome to the boards.
I hope you are able to come to a meeting of the minds with your rheumy.
Something that helped me was to give my pain levels a rating, ie 1-10, and rate it during the day. Keeping a symptom journal often helps to identify what is going on on a day to day basis. Either take copies of this to your doctor visit, or take it with you and go over it with your doctor.
Have you and your rheumy tried to use prescription NSAIDS? There are a lot more out there now than when I started this journey. If you have asthma issues, make sure that your doctor is aware. The list of safe NSAIDS for asthmatics is more limiting, but there are several that if one doesn't help, try another. Often getting relief is a case of trial of the different meds. No one drug works for all.
Even after 20 years, I have found it helps my doctors and I to identify problems by taking a list of current updates for my doctor. When I don't see that doctor but 4 times a year, it helps to keep him/her updated by this means.
I found that at a point along the journey of living with lupus, I was not getting pain relief with the nsaids I was prescribed. I was having major migraines and standard meds weren't working. I hated the feeling that I found when I was seeing my doctors and found I was out of my narcotic pain meds. I felt like I had to beggar myself to explain why the meds were needed, etc.
My solution was to talk to my primary doctor, and asked him if he would be comfortable being the only doctor who wrote narcotic pain meds. Fortunately, he agreed and it has worked very well for us for years. So, you might talk to the doctor you see most often and ask about this for yourself.
A few years after we had started this, I saw in the AMA newsletter that this is now recommended for people who are dealing with chronic/long term health issues. It helps if there is ever a review of meds prescribed to have the narcotic pain meds done only by one physician. It avoids "doctor shopping" and prevents abuse.
Good luck, and I hope that you are able to get relief with your next visit.
Sally