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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can assess your joints by video, arrange blood tests and a referral, and help with flares; the diagnosis and long-term treatment are led by a rheumatologist.
- What it is: an autoimmune condition in which the immune system attacks the lining of the joints, causing pain, swelling and stiffness, usually in the hands, feet and wrists.
- Early signs: swollen, tender joints, often on both sides of the body, and morning stiffness that lasts longer than 30 minutes.
- Why speed matters: European guidance says new joint swelling should be seen by a rheumatologist within 6 weeks, and treatment should start as soon as the diagnosis is made.
- Emergency: call 112 or go to an emergency department for a hot, swollen joint with a fever, chest pain, or sudden breathlessness.
Do not book a video appointment if a joint is suddenly hot, red and swollen and you have a fever or feel unwell, or if you have chest pain, sudden breathlessness, or weakness of the face, arm or leg. Call 112 or go to an emergency department.
Can an online doctor treat rheumatoid arthritis?
Partly. A doctor by video can recognise the pattern of rheumatoid arthritis, look at swollen joints on camera, arrange the blood tests and the prompt referral to a rheumatologist that early treatment depends on, and help people already diagnosed with flares, pain relief and medicine questions. The diagnosis, disease-modifying medicines such as methotrexate and their monitoring are led by a rheumatologist in person.
How an online consultation helps with rheumatoid arthritis
- The pattern recognised early: Swollen joints on both sides, long morning stiffness and tiredness point to inflammation rather than wear.
- Tests and referral without delay: Blood tests for inflammation, rheumatoid factor and anti-CCP antibodies, and a referral that respects the 6-week window.
- Help with flares: Pain relief that suits your stomach, kidneys and heart, and when your specialist team needs to know.
- Medicines and daily life: Methotrexate and other treatments explained, vaccinations, smoking, pregnancy plans and work.
What the doctor checks in an online rheumatoid arthritis consultation
The doctor asks about the warning signs first, then about your joints and the rest of your health. The doctor asks about:
- Warning signs: a hot, swollen joint with a fever, chest pain or breathlessness, or feeling very unwell, especially if you take medicines that lower immunity.
- Your joints: which ones hurt or swell, whether both sides are affected, and whether you can make a fist.
- Stiffness: how long it lasts after you get up in the morning or after resting.
- The whole body: tiredness, fevers, sweats, weight loss, dry eyes and lumps under the skin.
- Risk factors: smoking, and rheumatoid arthritis in your family.
- Your medicines: what you take for your joints and other conditions, any side effects, and plans for pregnancy.
Before the call, note how long your morning stiffness lasts, and sit where you can show your hands, wrists and feet on camera.
What is rheumatoid arthritis, and what causes it?
Rheumatoid arthritis is an autoimmune disease: the immune system attacks the cells that line the joints, which become swollen, stiff and painful. Over time, the inflammation can damage the joints, the cartilage and the bone nearby. It is a long-term condition, and it can also affect other parts of the body, such as the lungs, heart and eyes.
What triggers it is not clear. The risk is higher in women, in people with a family history of rheumatoid arthritis, and in people who smoke.
Is rheumatoid arthritis hereditary?
Partly. A family history raises your risk, but it does not mean you will develop it. Smoking is the risk factor you can change.
What are the symptoms of rheumatoid arthritis?
The symptoms usually develop over several weeks, sometimes over a few days, and often start in the small joints of the hands and feet. The five main signs are:
- Joint pain: throbbing and aching, often worse in the morning or after rest.
- Stiffness: for example, not being able to bend your fingers fully or make a fist. In rheumatoid arthritis, morning stiffness often lasts longer than 30 minutes.
- Swelling: joints that swell and feel hot and tender to the touch.
- Both sides: the same joints on both sides of the body are usually affected, although not always.
- Feeling unwell: tiredness and low energy, a high temperature, sweating, poor appetite and weight loss.
Some people develop firm lumps under the skin near the joints, called rheumatoid nodules, dry eyes, or chest pain when the heart or lungs are affected. Symptoms often come and go in flares.
Rheumatoid arthritis or osteoarthritis?
They are different conditions with different treatments, and the pattern of your symptoms usually tells them apart:
Swipe sideways to compare →
| Feature | Rheumatoid arthritis | Osteoarthritis |
|---|---|---|
| What it is | The immune system attacks the joint lining | The most common type of arthritis; joints become painful and stiff with age and use |
| Who gets it | More often women, smokers and people with a family history | Mostly people aged 45 or older |
| Joints | Small joints of the hands and feet first, usually on both sides | Knees, hips and the small joints of the hands |
| Morning stiffness | Often longer than 30 minutes | None, or less than 30 minutes |
| Swelling | Hot, tender, swollen joints | Sometimes swelling, and grating or crackling |
| The whole body | Tiredness, fever, sweats and weight loss | Not usually |
Neither is simply worse than the other: rheumatoid arthritis can damage joints if it is not treated, but early treatment controls it well. The arthritis page covers osteoarthritis and the other types.
How is rheumatoid arthritis diagnosed?
No single test proves or rules it out. The diagnosis comes from an examination of the joints, blood tests and sometimes scans, and a rheumatologist usually confirms it.
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| Test | What it shows |
|---|---|
| ESR and CRP | How much inflammation there is in the body |
| Rheumatoid factor | Raised in more than half of people with rheumatoid arthritis when it starts, but also in about 1 in 20 people without it |
| Anti-CCP antibodies | People who test positive are very likely to develop rheumatoid arthritis, but not everyone with it has them |
| Full blood count | Anaemia, which is common in rheumatoid arthritis, and other causes of the symptoms |
| Ultrasound, X-rays or MRI | Inflammation and damage in the joints; ultrasound can confirm joint swelling |
Testing positive for both rheumatoid factor and anti-CCP can point to more severe disease.
Why early referral matters
European guidance recommends that anyone with new joint swelling with pain or stiffness is seen by a rheumatologist within 6 weeks of the symptoms starting, and that disease-modifying treatment starts as early as possible, ideally within 3 months, because early treatment can prevent joint damage.
How serious is rheumatoid arthritis?
It is a long-term condition with no cure, but it is very treatable. Treatment aims for remission, or at least low disease activity, and early treatment can mean months or years between flares, so many people lead full lives and keep working. Left untreated, it gradually damages the joints, the cartilage and the bone, which is what scans track as it progresses.
Complications
- carpal tunnel syndrome
- inflammation of the lungs, the heart or the eyes
- a higher risk of heart attack and stroke
- anaemia
Good control of rheumatoid arthritis lowers the risk of these complications, including the risk to the heart.
Can rheumatoid arthritis be cured permanently?
Not at present. In sustained remission, specialists may lower the doses of medicines, but stopping them completely usually brings flares back.
Which rheumatoid arthritis treatment might the doctor recommend?
What happens next depends on whether you already have a diagnosis, how active the joints are, and how you feel. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| New swollen, tender joints, or morning stiffness over 30 minutes | Blood tests and a prompt rheumatology referral | Yes, to assess | A rheumatologist, ideally within 6 weeks of the symptoms starting |
| Joint pain without swelling, and stiffness under 30 minutes | Assessment for other causes, such as osteoarthritis | Yes | Not usually needed |
| Known rheumatoid arthritis with a flare | Pain relief that suits you, and contact with your specialist team | Partly | For a steroid injection or a change of treatment |
| Questions or side effects with methotrexate or other medicines | A review of the symptoms and your blood tests | Partly | For blood tests and specialist changes |
| Fever, sore throat or cough while on medicines that lower immunity | Assessment for an infection | Yes, to assess | Prompt examination in person if you are unwell |
| A hot, swollen joint with a fever, chest pain or sudden breathlessness | Emergency assessment | No | Call 112 or go to an emergency department |
Swollen joints and not sure whether it is rheumatoid arthritis? A doctor can tell you in one consultation which tests you need.
See available times →Treatment options for rheumatoid arthritis
What you can do yourself
- Stop smoking: it raises the risk of rheumatoid arthritis, and stopping is part of the recommended care.
- Keep active with regular exercise; physiotherapy and occupational therapy help you protect your joints and manage everyday tasks.
- Keep to a healthy weight, look after your teeth, and keep your vaccinations up to date.
- Learn about your condition: education programmes help with pain, work and daily life.
- Adapt how you do daily tasks when joints are painful or stiff.
Prescription treatment
A prescription is never issued without a consultation. Disease-modifying medicines, such as methotrexate, are started and monitored by your specialist team. For pain and stiffness, the doctor may prescribe an anti-inflammatory such as naproxen at the lowest dose that works for the shortest time, after checking your stomach, kidneys and heart, and may continue an established medicine when it is right for you. Opioid painkillers such as codeine and tramadol are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
Treatments led by your rheumatologist
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| Treatment | How it is used |
|---|---|
| Methotrexate | The usual first disease-modifying medicine, started as soon as the diagnosis is made |
| Leflunomide or sulfasalazine | Alternatives when methotrexate is not suitable |
| Steroids | A short course when treatment is started or changed, stopped within about 3 months; injections into a single inflamed joint |
| Biological medicines and JAK inhibitors | Added when the target is not reached; JAK inhibitors are weighed carefully in people with heart or cancer risk factors |
| Physiotherapy and occupational therapy | Exercise, joint protection and help with everyday tasks |
| Surgery | To correct joint problems that develop |
While the disease is active, it is checked every 1 to 3 months, and treatment is changed if there is no improvement within about 3 months, or if the target is not reached by 6 months.
What does not help
Waiting to see whether swollen joints settle on their own. Relying on painkillers alone, when disease-modifying medicines are what slow the disease. Stopping treatment without your specialist, which usually brings flares back. Smoking.
Special situations
Taking methotrexate
Tell a doctor straight away if you get yellow skin or eyes, a persistent cough, chest pain or breathlessness, swollen hands, ankles or feet or a change in how often you pee, a high temperature, muscle aches or a sore throat, or bleeding gums, blood in your pee or unexplained bruising.
Planning a pregnancy
Methotrexate is not recommended in pregnancy, because it can cause birth defects. Talk to your specialist before you stop contraception, so that your treatment can be changed in good time.
Heart health
Rheumatoid arthritis raises the risk of heart attack and stroke. Keeping the disease well controlled lowers that risk.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When rheumatoid arthritis is treated online, and when you need in-person care
Treated online: recognising the pattern, arranging blood tests and a referral, flares in diagnosed rheumatoid arthritis, pain relief, medicine questions and side effects, and advice on exercise, smoking and pregnancy plans.
In-person care: diagnosis by a rheumatologist, examinations and scans, starting and monitoring disease-modifying and biological medicines, joint injections, surgery, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- a hot, red, swollen joint with a fever or feeling unwell
- chest pain, or sudden breathlessness
- weakness or drooping of the face, arm or leg, or slurred speech
- a calf that is swollen, hot and painful
Get medical advice the same day for:
- a high temperature, sore throat or muscle aches while taking methotrexate or other medicines that lower immunity
- yellow skin or eyes, bleeding gums or unexplained bruising while taking methotrexate
- a persistent cough or breathlessness while taking methotrexate
- a sudden flare with many swollen joints and feeling unwell
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your joints: show any swollen joints on camera, say how long your morning stiffness lasts, and have recent blood tests to hand.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s rheumatoid arthritis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Arthritis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about rheumatoid arthritis
What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the lining of the joints, causing pain, swelling and stiffness, usually in the hands, feet and wrists. It is long term and can also affect the lungs, heart and eyes.
What are the five signs of rheumatoid arthritis?
The five signs of rheumatoid arthritis are joint pain, stiffness that often lasts longer than 30 minutes in the morning, swollen joints that feel hot and tender, the same joints affected on both sides of the body, and tiredness, fevers or weight loss.
What causes rheumatoid arthritis?
In rheumatoid arthritis the immune system attacks the joint lining, but what triggers it is not clear. Being a woman, a family history and smoking raise the risk.
Is rheumatoid arthritis hereditary?
Partly. Rheumatoid arthritis runs in some families, and having a parent or sibling with it raises your risk, but most people with a family history never develop it and many with no family history do, so genes are only part of the picture. Smoking is the strongest avoidable risk factor and also makes treatment work less well.
How is rheumatoid arthritis diagnosed?
From an examination of your joints, blood tests for inflammation, rheumatoid factor and anti-CCP antibodies, and sometimes ultrasound, X-rays or MRI. No single test proves it, and a rheumatologist usually confirms the diagnosis.
What is the difference between rheumatoid arthritis and osteoarthritis?
Rheumatoid arthritis is an autoimmune disease that causes hot, swollen joints on both sides and long morning stiffness. Osteoarthritis is the most common type of arthritis, mostly after 45, with pain on use and stiffness of less than 30 minutes.
How serious is rheumatoid arthritis?
Rheumatoid arthritis is a long-term condition that can damage joints and raise the risk of heart attack and stroke if it is not controlled. Early treatment brings it under control for many people, with months or years between flares.
Can rheumatoid arthritis be cured permanently?
Not at present. Rheumatoid arthritis cannot be cured permanently, but treatment aims for remission, in which the inflammation is switched off and the joints stop being damaged, and many people reach it with modern disease-modifying medicines started early. Doses may be lowered once remission has lasted, but stopping treatment completely usually brings flares back, so most people stay on some treatment long term.
What is the long-term outlook with rheumatoid arthritis?
Far better than a generation ago: with disease-modifying medicines started early, many people with rheumatoid arthritis reach remission or low disease activity, keep working and avoid the joint deformities that used to be common. The course varies, with flares and quieter spells, and some people need to change medicines over the years to keep control. Because rheumatoid arthritis raises the risk of heart disease, osteoporosis and infections, regular checks of blood pressure, cholesterol and bone health are part of long-term care.
What are the stages of rheumatoid arthritis?
Doctors describe how far rheumatoid arthritis has progressed, from inflammation of the joint lining to damage to the cartilage and bone seen on scans. Treatment started early aims to stop it before damage happens.
How soon should I see a specialist?
European guidance says anyone with new joint swelling with pain or stiffness should be seen by a rheumatologist within 6 weeks of the symptoms starting, with treatment ideally within 3 months.
What can I do myself to manage rheumatoid arthritis?
Take your disease-modifying medicine exactly as prescribed, even when you feel well, and keep the blood-test appointments that go with it; stay active with daily range-of-motion exercises and low-impact activity such as swimming, cycling or walking; rest during a flare but do not stop moving altogether; use heat for stiffness and ice for a hot swollen joint; stop smoking, which drives rheumatoid arthritis and blunts treatment; and eat a Mediterranean-style diet and keep to a healthy weight.
Can rheumatoid arthritis be prevented?
Not with certainty, because genes and chance play a part, but the risks you can change matter: not smoking is the most important, since smoking raises the risk and makes it more severe; keeping to a healthy weight, good dental health, and a diet rich in oily fish, vegetables and olive oil may also help. What can be prevented is the damage: new joint swelling seen by a rheumatologist within weeks and treated early often stops rheumatoid arthritis before it harms the joints.
Can I take ibuprofen for rheumatoid arthritis?
In rheumatoid arthritis, anti-inflammatories such as ibuprofen or naproxen ease pain and stiffness at the lowest dose that works for the shortest time, if they suit your stomach, kidneys and heart. They ease symptoms and are used alongside disease-modifying treatment, which slows the disease.
Can an online doctor treat rheumatoid arthritis?
Partly. A doctor can assess your joints by video, arrange blood tests and a referral, and help with flares and medicine questions. The diagnosis and long-term treatment are led by a rheumatologist.
- Rheumatoid arthritis, NHS, National Health Service (UK), reviewed 8 March 2023.
- Rheumatoid arthritis: symptoms, NHS, National Health Service (UK), reviewed 8 March 2023.
- Rheumatoid arthritis: diagnosis, NHS, National Health Service (UK), reviewed 8 March 2023.
- 2016 update of the EULAR recommendations for the management of early arthritis, Combe B, et al. Annals of the Rheumatic Diseases, 2017.
- EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological DMARDs: 2022 update, Smolen JS, et al. Annals of the Rheumatic Diseases, 2023.
- Osteoarthritis, NHS, National Health Service (UK), reviewed 20 March 2023.
- Side effects of methotrexate, NHS, National Health Service (UK), reviewed 14 March 2023.
- Pregnancy, breastfeeding and fertility while taking methotrexate, NHS, National Health Service (UK), reviewed 14 March 2023.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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