Know When to Go to the Emergency Room  

Learn the scenarios when it’s best to just call your doctor and when it’s better to head to the ER or dial 911.  

By Linda Rath | Updated Feb. 14, 2023

You’re feeling sick but your doctor is booked and the nearest urgent care center is 45 minutes away. There’s always the hospital emergency room — more accurately called the emergency department — but your symptoms aren’t that bad. Should you just tough it out?

Figuring out how and where to handle an illness isn’t easy. It’s even harder for people with inflammatory types of arthritis because complications related to the disease and its treatment can be serious, says Uzma Haque, MD, an assistant professor of medicine at The Hopkins Bayview Medical Center in Baltimore. Here’s what she suggests.

Primary Care Provider or Rheumatologist

Patients on immunosuppressive medications, especially biologics, should understand the side effects, especially an increased risk of serious infections. Call your doctor or other health care provider if you have signs of an infection, such as fever and chills. (Learn more about arthritis drug side effects here). Other reasons to call your doctor:
  • Flu or flu-like symptoms, such as fever, headache and body aches
  • Rash
  • Acute joint pain and swelling not typical of a flare
  • Mouth sores
  • Bruising and easy bleeding
Urgent Care

Can’t get in to see your doctor? Go directly to urgent care if you have these symptoms:
  • High fever with rash
  • Red, hot, swollen joints
  • Unusual pain and swelling in a joint, especially with a fever, that could be septic arthritis
  • Severe and sudden abdominal pain
  • A severe, atypical disease flare
  • Sudden spine pain, which may signal a vertebral fracture (Rheumatoid and psoriatic arthritis are risk factors for both osteoporosis and fractures; corticosteroid use raises the risk.)
Emergency Department

The emergency department is meant for life-threatening events — severe chest pain, stroke, sudden vision loss, uncontrolled bleeding or trauma. JAK inhibitors such as tofacitinib (Xeljanz) put you at higher risk of serious blood clots, heart attack and stroke. Other arthritis drugs can cause an infusion reaction or a severe infection that may need emergency treatment. If you experience any of these, go to the hospital or call 911. Call your rheumatologist’s office, too; it’s helpful for your doctor and emergency providers to communicate. A trip to the hospital will cost a lot more than a doctor or urgent care visit and the wait can be lengthy, depending on the severity of your condition. Still, some symptoms need immediate attention.

When to Ride It Out

Most health problems aren’t emergencies and may not require medical help. Dr. Haque says patients usually can handle mild arthritis flares by resting and pacing themselves. Colds and allergies aren’t cause for alarm unless they take longer than normal to go away.