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Inflammation–Friend or Foe?

If you have ever been injured, or sick, then you will want to pay close attention to this eLetter. Chances are better than good that you have some sort of chronic pain in your feet, knees, back, shoulders, arms, hips, or legs. Further, you probably “tweak” your chronic condition from time to time. And when you do, you assume you did something that you should not have done (i.e. used your joint), and you were likely told to avoid certain movements. …Am I right? If this doesn’t apply to you, then by all means stop reading. However, for the rest of you, please read on.

Because I have had this conversation so many times, I feel it is time to put this in an eLetter. The first order of business is to say up front that

inflammation is definitely NOT bad! In fact, the acute inflammatory response is actually a GOOD THING!

I know, I know. You have been told otherwise by everyone (i.e. “The Man”) that has treated your injuries. Once again, I dissent. And here I explain why I believe what I believe. Please note that I am referring to acute inflammation. Chronic inflammation is NOT good!

So, let’s look at what inflammation is. In essence, inflammation is your body’s response to cellular injury. The role of inflammation is to clean up debris, destroy foreign bodies, and prepare the area for the second stage response, which is tissue repair.

Two examples of cellular injury are muscle strains and joint sprains. We have all injured ourselves. So, what happens following an injury? First, the injured cells release chemicals which, among other things, signal the brain that there is an injury and gives the location of the injury. One of these chemicals is prostaglandins. The body responds by dilating the local blood vessels, which increases the flow of blood to the area. Also, the capillary walls become more permeable, allowing antibodies and lots of nutrients into the area. The primary job of the phagocytes (Macrophages) is to engulf and digest foreign bodies like bacteria and dead cells. As the phagocytes do their job, they build up and sit in the affected area.

The prostaglandins also increase the sensitivity of the nociceptors, which alert you to the fact that you are injured. By the way, nociceptors are oftentimes mistakenly referred to as “pain receptors”.  They don’t send pain signals to your brain, as “The Man” would have you believe.  They simply send “status” signals (just as your scale simply tells you how much you weigh.  How “painful” the news of your weight is depends upon your interpretation).

The result is the 5 signals of inflammation: redness, heat, swelling, pain, and loss of function. Redness and heat because of the increase of blood flow locally. Swelling because the capillary walls become more permeable and allow large proteins (and more fluid) into the area, plus the phagocytes engulf the debris. Pain because the nociceptors become more sensitive and send signals to the Thalamus in the brain. And loss of function because of all of the above.

If you understand the unique role of inflammation, then you must understand that it is not only a good thing, but absolutely necessary for healing! If you agree with me that inflammation is a positive response to tissue damage (in fact, the ONLY way to true healing), then it follows that inflammation is no more a bad thing than the fire department. Remember, the fire is the problem. The city’s response to the fire is the solution!

So, if the inflammatory response is a good thing, then what is the role of anti-inflammatory drugs, such as NSAIDs? NSAIDs work by blocking the action of two enzymes (Cox-1 and Cox-2) which help to synthesize prostaglandins from Arachidonic Acid. By blocking the production of prostaglandins, NSAIDs reduce swelling and pain. Can you guess what this means? No swelling means all the nutrients which are needed to heal your injury do not make it into the injured tissue. So, let me ask you, if you have a bunch of garbage piled up in your yard, what happens to that garbage if it isn’t picked up and taken away? Yes, you have an injury that never quite heals. You have a chronic condition.

The only way to completely heal an injury is to allow inflammation to do its thing, and assist the inflammatory process using stretching, relaxation techniques, and deep massage therapy to flush out the exudates (cellular debris). In the west, we learn to stop inflammation using ice and NSAIDs (or steroids). In Chinese medicine, the idea is to actually promote inflammation using heat and lots of massage to flush the area. The result? Complete restoration of function. This method takes time and patience, but do you think the result is worth the effort?

Now I am not saying NSAIDs are evil. They definitely have their place, are quite necessary, and have served me well. I’m just sayin…

We will cover more on the topic. There is much more to be said. Until next time…

To Your Health!

Jeff Wooten, “The Body Mechanic”

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