What is Rheumatoid Arthritis (RA) and What is the Best Treatment?

Many of my patients come into my office with joint pain.  Some of them have been diagnosed with rheumatoid arthritis (RA). Some patients have been tested and told they don’t have RA, yet they have the same symptoms as patients with early RA.  Both patients are suffering with inflammation and both patients need solutions!  Learn more about what to expect from Dr. Sharon Borkowski, recommended Rheumatoid Arthritis Specialist In Naperville now!

Rheumatoid Arthritis Defined

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that primarily affects joints but can also involve other systems, including the skin, eyes, lungs, heart, and blood vessels. In RA, the immune system mistakenly attacks the lining of membranes surrounding the joints causing inflammation that can eventually lead to joint damage, pain, and immobility.

Causes of Rheumatoid Arthritis

The exact cause of RA is unknown, but it is believed to result from a combination of genetic, environmental, and hormonal factors:

• Genetics: Certain genetic markers, especially in the HLA (human leukocyte antigen) complex, are associated with an increased risk of RA.
• Environmental Factors: Smoking, exposure to certain bacteria or viruses, and other environmental factors may trigger RA in genetically predisposed individuals.
• Hormonal Factors: Hormonal changes, such as those occurring in pregnancy, menopause, and stress, can impact immune function and may play a role in the onset or progression of RA.

Symptoms of RA

• Pain and swelling in multiple joints, commonly the wrists, knees, hands, and feet
• Morning stiffness that lasts more than 30 minutes
• Fatigue, fever, and loss of appetite
• Joint deformities in later stages
• Development of rheumatoid nodules (lumps under the skin)

Rheumatoid Arthritis vs. Osteoarthritis

• RA is an autoimmune condition that causes inflammation primarily in joints but can also affect other organs.
• Osteoarthritis (OA), by contrast, is a degenerative joint disease caused by wear and tear on the joints, leading to cartilage breakdown.

The 4 Stages of Rheumatoid Arthritis

RA is susceptible to progression through four stages, each with distinct symptoms and different possible treatment approaches.

Stage 1: Early RA

Stage 1, or early rheumatoid arthritis (RA), is the initial phase of this autoimmune condition, marked by subtle joint inflammation that often goes unnoticed. At this stage, symptoms may be mild, such as slight joint stiffness, warmth, or tenderness, which might come and go. Internally, the body’s immune response begins attacking joint linings, potentially causing swelling but usually without visible damage on X-rays. Early diagnosis and intervention during this stage can significantly improve long-term outcomes by slowing disease progression and protecting joint function.

Characteristics

Inflammatory autoimmune reaction begins, affecting the joint lining.

Signs

Mild joint pain, swelling, and stiffness, often intermittent.

Treatments and Solutions

Medications

A traditional medical approach would include nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose corticosteroids.  However, this approach does nothing to address the cause of the inflammation.  There are also long-term consequences to the continued use of NSAIDs and steroids not the least of which can damage the gut and bone/joint health.

Lifestyle Adjustments

Conventional medicine recommendations include regular exercise, ‘balanced’ diet and joint protection strategies.

A functional medicine approach would include appropriate exercise strategies, proper nutrition, adequate sleep, stress reducing strategies as well as a low inflammatory, gut immune friendly diet.

Solutions

A conventional approach would be physical therapy to maintain joint flexibility.

A functional medicine approach would involve a holistic evaluation of the root cause of immune dysregulation.  Treatment would include the lifestyle adjustments mentioned above.  Proper evaluation and treatment would include a comprehensive history and functional testing to result in a proper treatment plan aimed to reduce the aggravating factors and optimize overall health.

Stage 2: Moderate RA

In Stage 2 rheumatoid arthritis, symptoms typically include more pronounced joint swelling, stiffness, and persistent pain, often worse in the morning. Cartilage damage can limit joint mobility, making movement more difficult. Affected areas may feel warm or tender to the touch, and fatigue is common, sometimes accompanied by low fever. Simple daily tasks may become harder due to joint discomfort and sensitivity.

Characteristics

Continued inflammation damages cartilage, limiting joint mobility.

Signs

Increased pain, joint stiffness, and limited range of motion.

Treatments and Solutions

Medications

Disease-modifying antirheumatic drugs (DMARDs) like methotrexate and biologics.

Lifestyle Adjustments

Conventional medicine recommendations include weight management, physical activity, and stress reduction.

A functional medicine approach would also include proper nutrition, adequate sleep, stress reducing strategies as well as a low inflammatory, gut immune friendly diet.

Solutions

Conventional medicine solutions include occupational therapy and assistive devices for daily tasks.

A functional medicine approach would involve a holistic evaluation of the root cause of immune dysregulation.  Treatment would include the lifestyle adjustments mentioned above.  Proper evaluation and treatment would include a comprehensive history and functional testing to result in a proper treatment plan aimed to reduce the aggravating factors and optimize overall health.

Stage 3: Severe RA

Causes:

Inflammation damages both cartilage and bones, leading to joint deformities.

Signs

Visible joint deformities, persistent pain, significant loss of mobility.

Treatments and Solutions

Medications

Conventional medicine will include the addition of DMARDs, biologics, and possible corticosteroid injections.

Lifestyle adjustments

Conventional medicine offers no additional lifestyle recommendations for the stage of disease.

A Rheumatoid arthritis functional medicine approach would include appropriate exercise strategies, proper nutrition, adequate sleep, stress reducing strategies as well as a low inflammatory, gut immune friendly diet.  This is an important strategy for every stage of disease.

Solutions

Conventional medicine solutions include pain management strategies and mobility aids.  A more aggressive approach may be surgery to repair the joint or replacement to restore joint function.

A functional medicine approach would involve a holistic evaluation of the root cause of immune dysregulation.  Treatment would include the lifestyle adjustments mentioned above.  Proper evaluation and treatment would include a comprehensive history and functional health testing to result in a proper treatment plan aimed to reduce the aggravating factors and optimize overall health.

Stage 4: End-Stage RA

Causes

Joints become fused or nonfunctional due to severe damage.

Signs

Extreme pain, loss of joint function, reduced quality of life.

Treatments and Solutions

Pain Management

Palliative care, advanced pain management techniques.

Surgical Interventions

Joint fusion or replacement surgeries.

Solutions

Conventional medicine has emphasis on improving quality of life and maintaining mobility via the above-mentioned pain management and surgery options.

In addition to the traditional medical management, a functional medicine approach would involve a holistic evaluation of the root cause of immune dysregulation.  Treatment would include the lifestyle adjustments mentioned in the earlier stages.  Proper evaluation and treatment would include a comprehensive history and functional testing to result in a proper treatment plan aimed to reduce the aggravating factors and optimize overall health.

Functional Medicine Approach to RA

Functional medicine views RA as a systemic condition and seeks to identify underlying factors contributing to inflammation. This approach emphasizes diet, lifestyle, and personalized treatment plans.

Rheumatoid Arthritis Specialist in Naperville

Your Naperville rheumatoid arthritis specialist can help you to identify and treat the underlying drivers that may be contributing to your symptoms.  With this information you will be empowered to take action to create a better quality of life that is characterized by behaviors that can reduce your inflammation and pain. 

What to Expect with a Functional Medicine Consultation

When seeing a functional medicine doctor for rheumatoid arthritis, you can expect a comprehensive personalized approach that goes beyond managing symptoms.  The goal is to identify and address root causes of your inflammation and immune dysfunction.  With your rheumatoid arthritis specialist at Naperville Integrated Wellness, you can expect your initial visit to include an in-depth intake and history of health and present illness.  You will be guided next to obtain comprehensive blood testing and further functional testing (discussed below). This evaluation and testing will be used to guide us in the most appropriate treatment strategy.  Functional medicine solutions are discussed in a paragraph below.

Functional Testing for RA

At Naperville Integrated Wellness we use a combination of functional testing options to establish the presence and severity of autoimmune conditions such as RA.  Our Naperville rheumatoid arthritis blood tests include the following.

• Comprehensive Blood Panels: To assess inflammatory markers like CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate).
• Autoimmune Testing: Tests for antibodies such as rheumatoid factor (RF), Anti-nuclear antibody (ANA) and anti-CCP.

Additionally, we utilize other functional testing to identify concomitant factors that may be contributing to a patient’s health.

• Gut Health Testing: Since gut health can influence immune response, tests for gut microbiome balance or leaky gut are common. 

Types of Medications for RA and Long-Term Effects

• NSAIDs: Reduce pain and inflammation but can cause gastrointestinal issues and cardiovascular risk with long-term use.
• DMARDs: Slow disease progression; however, long-term use can impact liver function and bone marrow.
• Biologics: Target specific immune pathways but may increase infection risk.
• Corticosteroids: Provide fast relief from inflammation but are associated with osteoporosis, weight gain, and diabetes risk when used long-term.

Functional Medicine Solutions to RA

1. Anti-Inflammatory Diet: Emphasis on whole foods, with an anti-inflammatory approach that includes omega-3 fatty acids, fiber-rich vegetables, and low sugar intake.
2. Lifestyle Modifications: Stress reduction techniques, regular physical activity, and sleep optimization.
3. Supplements: Targeted supplements, such as omega-3 fatty acids, vitamin D, and probiotics, may help reduce inflammation.
4. Mind-Body Practices: Practices such as meditation, yoga, and acupuncture can reduce stress and improve immune balance.

Rheumatoid Arthritis and Gut Health

Although Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation that primarily affects the joints, its origins may lie far beyond the musculoskeletal system, specifically in the gut. Research increasingly shows that the gut microbiome, the vast community of bacteria, viruses, and fungi living in the digestive tract plays a significant role in immune system regulation. In individuals with RA, studies have consistently found signs of gut dysbiosis, or microbial imbalance, with certain bacteria like Prevotella copri being more abundant in early RA. This imbalance can contribute to an overactive immune response, potentially triggering or perpetuating the autoimmune attack on joint tissue.

So, does gut dysbiosis cause RA? While dysbiosis alone may not directly “cause” RA in every case, it is considered a significant contributing factor—particularly in genetically susceptible individuals. The gut lining, when compromised, can become more permeable (a condition sometimes called “leaky gut“), allowing microbial fragments or toxins to enter the bloodstream and activate systemic inflammation. This may lead to immune dysregulation and the development of autoimmunity, including RA. Addressing gut health, therefore, becomes a key strategy not only in preventing progression but also in managing symptoms and supporting remission.

Best Diet Strategy for Rheumatoid Arthritis

The best diet strategy for gut health and RA focuses on reducing inflammation and nurturing the microbiome. An anti-inflammatory, whole-food diet can help restore microbial balance. This type of diet will emphasize fiber-rich vegetables, omega-3 fatty acids, antioxidant-rich fruits, and the elimination of common triggers like gluten, dairy, and processed sugars. By targeting the gut, many patients experience improved joint pain, reduced flare frequency, and better overall health.

Schedule A Rheumatoid Arthritis Appointment in Naperville

If you have rheumatoid arthritis or any autoimmune disease, you may now agree that it is in your best interest to care for your body as a whole.  If you are interested in a root cause medicine approach to rheumatoid arthritis, then functional medicine may be the next step in your health journey. This blog was not meant to diagnose or prescribe treatment of any kind.   This information should not be used to self-diagnose or treat rheumatoid arthritis or any other disease.  Contact our functional medicine rheumatoid arthritis specialist in Naperville to schedule an appointment!

Functional medicine focuses on understanding the body’s natural processes, identifying the root causes of health issues, and taking a targeted approach to resolve them.

This involves in-depth investigation, interpreting key findings, and crafting a personalized plan to restore balance and enhance overall wellness. My goal for you is a healthier, happier life with a greater sense of vitality.

For more information on functional and integrative medicine, or to learn more about Dr. Borkowski, visit napervilleintegratedwellness.com.