| What We Treat
Rheumatoid Arthritis
Rheumatoid arthritis needs early medical treatment. Alongside it, exercise protects joints rather than damaging them.
Overview
What It Is
Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the lining of the joints, typically the small joints of the hands and feet, symmetrically. Early treatment substantially changes the long-term outcome, so prompt referral matters. Exercise was once discouraged and is now known to improve function and strength without accelerating joint damage.
Symmetrical Small Joints
Hands, wrists and feet on both sides, with morning stiffness lasting more than an hour and soft, boggy swelling.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
Prolonged Morning Stiffness
More than an hour, which distinguishes it from osteoarthritis.
Symmetrical Small Joint Swelling
Hands, wrists and feet on both sides.
Soft, Boggy Swelling
Rather than the bony enlargement of osteoarthritis.
Fatigue
Often profound, and frequently the most limiting symptom.
Better With Movement
Symptoms ease as the day goes on, then return after rest.
Systemic Features
Low-grade fever, weight loss or general malaise.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Autoimmune Process
The immune system targets the synovial lining of joints.
Genetic Susceptibility
Certain genetic markers substantially increase risk.
Smoking
The strongest modifiable risk factor, and associated with more severe disease.
Sex and Age
Considerably more common in women, typically presenting between thirty and fifty.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- A single hot, swollen joint with fever — infection must be excluded urgently
- Neck pain with arm symptoms, or a feeling of instability — the upper cervical spine can be involved
- Breathlessness or a persistent cough
- New numbness or weakness
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Will exercise damage my joints?
No. This was standard advice for decades and is now clearly contradicted. Progressive strength training improves function without increasing joint damage on imaging.
How is it different from osteoarthritis?
Rheumatoid is inflammatory, symmetrical, affects small joints first, and produces morning stiffness lasting over an hour. Osteoarthritis is usually asymmetrical, affects large or end joints, and stiffness eases within thirty minutes.
Should I exercise during a flare?
Reduce rather than stop. Gentle range of movement maintains what you have and makes the return afterwards much easier.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.