Quick answer: Most chest infections get better on their own in about 7 to 10 days, although the cough can last up to 3 weeks. The NHS advises rest, plenty of water, sleeping propped up on extra pillows and painkillers for a high temperature or aches. See a GP if you are over 65, have a weakened immune system (including from arthritis medicines such as steroids, methotrexate or biologics) or feel worse. Call 999 if you are struggling to breathe, suddenly confused or coughing up blood. Do not stop arthritis medicines yourself.
This guide is for the week you already have a chesty cough: what you can do at home, how arthritis medicines change the advice, how to protect sore ribs, back and joints while you cough, and how to get your strength back afterwards. If you want to plan ahead before you get ill, start with our winter viruses and arthritis medicines guide and the flu jab guide.
Is it a chest infection?
A chest infection is an infection of the lungs or large airways. It often follows a cold or flu. The NHS lists these main symptoms:
- a chesty cough, sometimes bringing up green or yellow mucus
- wheezing and shortness of breath
- chest pain or discomfort
- a high temperature, headache and aching muscles
- tiredness
Many chest infections are caused by viruses and clear up without antibiotics. Bacterial infections such as pneumonia may need antibiotics from a GP. Only a clinician can tell you which you have.
Looking after yourself at home
- Get plenty of rest, but get up for short walks around the house each day if you can
- Drink lots of water to loosen the mucus so it is easier to cough up
- Raise your head with extra pillows at night to make breathing easier
- Use painkillers such as paracetamol to bring down a temperature and ease aches. Only take ibuprofen or other anti-inflammatories if you have been told they are safe for you, and do not add them on top of a prescribed anti-inflammatory. Our painkillers and NSAIDs guide explains why
- A warm lemon and honey drink can soothe a sore throat
- Ask a pharmacist before buying cough medicine — they can check it against your arthritis medicines
- Do not smoke, and keep the rooms you use warm. See our cold home guide for heating help
If you take arthritis medicines
The NHS advises seeing a GP for a chest infection if your immune system is weak, you are over 65 or you have a long-term condition. Steroid tablets, methotrexate and other DMARDs, biologics and JAK inhibitors can all weaken the immune system, so contact your GP, NHS 111 or your rheumatology advice line early rather than waiting to see if it passes.
- Do not stop, skip or pause arthritis medicines yourself. Some teams advise pausing certain medicines during an infection, but only on their advice
- Never stop steroid tablets suddenly. If you carry a steroid emergency card, show it to anyone treating you. Our steroids and infection guide explains why
- If you are prescribed antibiotics, make sure the prescriber and pharmacist know every medicine you take, because some antibiotics interact with arthritis medicines. Finish the course as advised
- Keep a printed list of your medicines and doses by the phone so you or a carer can read it out
Coughing with sore joints, ribs and back
A heavy cough can strain the muscles around the ribs, back and shoulders, and joints often ache more when you are unwell. These steps may help you stay comfortable:
- Hold a cushion or folded towel firmly against your chest or tummy when you cough
- Sit upright in a supportive chair rather than slumping, so your chest has room to move
- Use gentle warmth on aching muscles, and keep moving stiff joints a little each day
- Pace your day: short spells of activity, then rest. Our pacing guide shows how
- If joints become hot and swollen while you are ill, read the flare-up guide and tell your team
Chest pain that comes with breathing or coughing is not something to manage at home. The NHS advises an urgent GP appointment or NHS 111 for it.
When to get help
See a GP if you have a chest infection and:
- you feel very unwell or your symptoms get worse
- your cough has lasted more than 3 weeks
- you are over 65, your immune system is weakened, or you have a heart, lung or kidney condition
Ask for an urgent GP appointment or contact NHS 111 if you are short of breath, coughing up yellow or green mucus, or have chest pain when breathing or coughing — these can be signs of pneumonia.
Call 999 or go to A&E if:
- you are struggling to breathe, choking or gasping and unable to speak
- your skin, lips or tongue look pale, blue or blotchy
- you are coughing up blood
- you suddenly feel confused, have slurred speech or uncontrollable shivering, or have not peed all day — these can be signs of sepsis
Do not drive yourself to A&E. Bring your medicines or your list with you.
For carers and older relatives
Older people may not get a high temperature with a serious infection, and the NHS says confusion is common in older people with pneumonia. Sudden confusion, a fall, being unable to get out of bed or chair, or not eating and drinking can be the first signs that someone is getting worse. Trust your instincts and contact NHS 111, or 999 if they are very unwell. If you care for someone, our carer's assessment guide explains how to ask for backup support.
Getting your strength back
The NHS says most people recover from pneumonia in 2 to 4 weeks, and tiredness can last longer. A week in bed or a chair can weaken leg muscles quickly, especially if you live with frailty.
- Sit out of bed for meals and stand up a few times every hour when you can
- Restart your usual walking or exercise at a smaller dose and build up over a week or two — see staying active in winter and the exercise hub
- Eat little and often, and keep drinking
- If tiredness lingers, our fatigue guide can help
- If you felt unsteady or fell while ill, read the falls prevention guide and ask your GP about a physiotherapy review
Lowering the chance of another one
- Ask about the yearly flu vaccine and the pneumococcal vaccine, which helps prevent pneumonia
- Check whether you are offered COVID-19 and RSV vaccines this season. Our vaccines on DMARDs and biologics guide explains which vaccines are not live
- Wash your hands often, and ask visitors with a cough or cold to wait until they are better
- Stop smoking if you smoke, and cut down on alcohol
Frequently asked questions
Should I stop methotrexate or my biologic if I get a chest infection?
Do not stop or pause it yourself. Some rheumatology teams advise pausing certain medicines during an infection, so contact your advice line, GP or NHS 111 early and follow their advice.
Will I need antibiotics?
Not always. Antibiotics only work for bacterial infections, and many chest infections are viral. A GP will decide, and may be more likely to treat you if your immune system is weakened.
Why do my joints hurt more when I have a chest infection?
Aching muscles are a common infection symptom, and being less active makes stiff joints feel worse. Keep moving gently. If a joint becomes hot, red and very swollen, especially with a fever, get urgent advice — a joint infection is an emergency.
Sources and further reading
- NHS: Chest infection
- NHS: Pneumonia
- NHS: Sepsis
- NHS: Pneumococcal vaccine
- NICE NG138: Pneumonia (community-acquired) — antimicrobial prescribing
- NICE NG120: Cough (acute) — antimicrobial prescribing
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Winter viruses and arthritis medicines — vaccines and a sick-day plan
- Flu jab and arthritis — free NHS eligibility and booking
- Vaccines on DMARDs and biologics — live and non-live vaccines
- Steroids and infection — signs to watch for on steroid tablets
- Painkillers and NSAIDs — which pain relief is safe for you
- Pacing — getting through the day while ill
- Staying active in winter — building strength back up
- Staying warm at home — heating help and moving more