In general, most orthodontic treatment for crowding is considered elective and cosmetic. An instance in which orthodontic treatment could be deemed medically necessary include crossbites causing trauma to other teeth, such that non-treatment can potentially lead to early tooth loss.
Crowded teeth do not usually push against one another to create forces high enough to cause pain. The discomfort you have been experiencing might be due to inadequate oral hygiene leading to gum disease. Hence, it may be helpful to go for regular teeth cleaning and to upkeep good brushing and flossing practices.
Malocclusions are, however, evaluated on a case-by-case basis. Thus, to determine if your malocclusion is considered medically necessary, it would be best evaluated with a proper clinical consultation by an orthodontist
