Inflammation - good or bad, and when is too much?

[Taone]

This is something that began buzzing in my head a few weeks ago after a dislocated shoulder - physio wanted me on anti-inflammatories because it was rather swollen. Suprise :)

Question: Why are we trying to suppress inflammation?? Any physiology textbook explains inflammation as a natural response to increase blood flow and immune response in the area - ie faster removal of damaged tissue, faster rate of laying down new tissue, etc
But inflammation always seems to be looked upon as undesirable. Injury?? Ice it, pop some anti-inflamms and you'll have less swelling, and it will be less uncomfortable. Great. But wouldn't it heal better if the response was allowed to take it's course??

Obviously excessive inflammation, ie allergic response, or swelling in a potentially dangerous place needs to be dealt with. And chronic inflammation that ends up decreasing circulation and fluid just sits and stagnates, as well as less mobility... I can see that as being a problem.

But generally?? Good or bad, and when does the disadvantaged outweigh the benefits??

Comments?? :)
Peace

[bearpaw]

Natural inflammation is good but in our fast paced no pain world people don't want to deal with the swollen, painful bloated look of inflammation ... I prefer not to use anti-inflammation for all most anything (ear infections ... I have to use them or I become quite illtemptered). Besides dit jow work better then general anti-inflammation drugs ...

[Cody]

I'm making a guess. What tipped me off was the buzzing in the head. There is a major nerve group in the area of the shoulder, the brachial plexus. Whether the swelling is compressing a nerve there, or in another area is beyond me. But, I can see why physio would suggest anti-inflammatories. What does the doc say?

As for inflammation, my view is to lessen it, as the buildup can prevent or extend the time of healing. My experience and understanding, has been that when someone treats injuries (whether via anti-inflammatory meds; and/or, by rubbing the stagnant material out, hence, shortening the inflammatory process), the immediate goal is to reduce increased or static inflammation and the blockages associated with it as soon as is possible.

Thing is there are different kinds of inflammation. I know what you're referring to, and you are correct. You refer to "acute" inflammation, which doesn't last longer than necessary to heal.

This increases blood flow to the injured tissue, possibly lasting for hours, "with exudation of fluid from blood vessels into tissues with concomitant swelling, migration of leukocytes into the tissues, and gelatin of fibrinogen in intercellular spaces. Depending upon the severity of the injury, some red blood cells will escape into the tissue. If the injury is not too severe, these processes reach their maximum in six to eight hours, after which reparative processes begin to take place. Blood vessels return to normal size and normal blood flow is reestablished. Leukocytes degenerate or reenter circulation, ...................., and swelling disappears with resorption of tissue fluid and digestion of fibrin." and so on.

However, there are other inflammatory processes which are not as benign, and require intervention. If the swelling doesn't clear as it should, this is harmful. I can understand your point of view, as it does seem that anti-inflammatory meds can be overused, especially as a sole method of treatment.

Cody

[prana]

I thoguht inflamation was actually internal bleeding, and hence its best stopped ? hehe shows how much I know. :( :D

[Taone]

Cody - Thanks for the reply.

Yeah I know the issue with the nerve there - that's why you should never just 'pop' a dislocation back in like they do in movies. You can compress the nerve and such if you don't know what you are doing. There is a story (the 'it happened to a friend of a friend of mine' type :) ) where a dislocated hip was put back in on the field by friends... compressed one of his testicles :eek:

But it was fine, no problems there - tingling, numbness, etc. - physio and doc said it was fine. Funny thing is, when I asked the physio why I should take anti-inflammatories the main answer he could give me was to make it less uncomfortable. When I pushed him for an answer relating to recovery, he said *sometimes* inflammation can reduce mobility and affect rehab. But that was hardly likely after only 2 days when it was still in a reasonably acute phase. I understand the potential danger with the nerves, but it wasn't mentioned.

Good points about the different types of inflammation - and there I suppose is my real point. In acute inflammation directly after an injury - why ice it?? It isn't a problem right then - if it becomes excessive or after 3+ days it hasn't really gone down at all, yes, take steps. But why in the acute phase??

I think bearpaw has a point - it's the age of convenience, image and comfort. Noone wants to deal with it :) I share the same view bearpaw. Don't need it unless it's really necessary. Same with fevers - natural response. It's there for a reason.

Prana :) - no, that's haemorraghing (sp?), a hematoma or bruising. Inflammation is when it puffs up because your body directs a lot of circulation and fluid to the site of injury. This way it can actually stop any bleeding faster, clean up debris, kill foreign bad bits, and start repairing.

Looking forward to any further input.
Peace

[Cody]

quoting from a book I have on sports injuries. What does RICE stand for? It's athletic first-aid.

Rest. Ice. Compression. Elevation.

"Ice. Ice decreases the bleeding from injured blood vessels because it causes them to contract. The more blood that collects in a wound, the longer it takes to heal."

It is important to do this as soon as possible to prevent excess inflammation. After 3 days, it's a done deal.

prana.
There is such a thing as "hemorrhagic inflamation". That is when there are many red blood cells in the fluid buildup. So, in this sense, there is some internal bleeding. I've had this happen and hematoma grows and spreads and might travel down a limb until it dissipates. Can be quite impressive.

speedy healing, Taone
Cody

[Taone]

Actually that's a good point.
Whenever RICE and icing is mentioned, it's generally reasoned that it's for decreasing inflammation, not bleeding.

But one to think about is that part of the process of inflammation is to cause swelling about the site, thus putting pressure on and constricting blood vessels - *decreasing* bleeding.

Many thanks Cody :) I intend it to be a short and one-off ordeal :)