Rheumatoid arthritis and musculoskeletal care
Updated: Oct 15
By Andy Duckmanton, BOst (Hons), GOsC registered osteopath.
Editorial update: 15 October 2026.
Rheumatoid arthritis is an inflammatory condition in which the immune system affects the lining of joints. It can also affect other parts of the body. It differs from osteoarthritis and needs medical treatment aimed at controlling disease activity and limiting harm.
Ask about persistent swollen joints
Persistent joint swelling, pain and stiffness, particularly in the small joints of the hands or feet or in several joints, should be assessed by a GP. Tell them about fatigue, stiffness after rest and difficulties with ordinary tasks. You do not need to wait for a joint to change shape.
Blood tests can help, but normal inflammation markers or negative rheumatoid antibodies do not rule out rheumatoid arthritis. NICE recommends urgent specialist referral for particular patterns of persistent joint inflammation even when these tests are normal or negative. Tests should not delay an appropriate referral.
Treatment of the underlying disease
Rheumatology care may include disease-modifying medicines, often called DMARDs, with monitoring and adjustments over time. The plan depends on disease activity, your health and your preferences.
Do not stop prescribed treatment because symptoms improve after a hands-on appointment. Discuss medication questions and possible side effects with your medical team.
Movement and everyday life
A physiotherapist can help with suitable exercise and maintaining function. Occupational therapy may help with daily tasks and practical adaptations. Advice should take account of current inflammation, fatigue and which joints are affected, and may need adjusting during a flare.
Useful goals might include fastening buttons, preparing food, walking to a shop or maintaining a hobby. Tell your team about changes in function so they can assess whether treatment and support are meeting your needs.
Considering osteopathy
Additional musculoskeletal care must fit your rheumatology plan. Tell Andy about your diagnosis, medicines, recent flares, fractures, joint replacements and relevant test results. Some techniques may be unsuitable.
Osteopathy does not control the underlying immune disease, prevent its progression or replace DMARDs. Evidence for lasting benefit from osteopathy specifically for rheumatoid arthritis is limited. If a supportive approach is considered, agree a concrete goal and review whether it helps.
Symptoms that should not wait
A hot, very painful or swollen joint can have causes other than a rheumatoid flare, including infection. Seek urgent medical advice through your GP or NHS 111, especially if you feel unwell; infection does not always cause a fever.
Rheumatoid arthritis can sometimes affect stability in the upper neck. New neck pain with weakness, altered sensation, clumsy hands or difficulty walking needs urgent medical assessment before neck treatment. Rapidly worsening neurological symptoms warrant emergency assessment.
For a suspected flare or worsening swelling, use the contact plan given by your rheumatology team or speak to your GP. A routine osteopathy appointment should not delay this.
The arthritis overview explains how rheumatoid arthritis differs from osteoarthritis and axial spondyloarthritis. Your medical team remains the main source of advice about disease management.
Sources and further information
Sources checked: 13 October 2026.