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What do you mean by “inflammation”?

As one of the UK’s leading London physiotherapists, I regularly write about injuries, treatment and assessment techniques.

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With patients, doctors, nutritionists, scientists and bro-scientists alike talking about “inflammation”, I decided it might be time to discuss exactly what inflammation is, what the implications are, and what you can do about it…

The first thing to say is that there are two main types of inflammation: acute local inflammation, and chronic systemic inflammation.

Acute local inflammation

Acute local inflammation is a response to a harmful stimulus – it’s what happens immediately after you sprain your ankle or stub your toe.  When you tear your ligaments or squash your blood vessels, plasma and leukocytes leak from your blood vessels into your tissues, attracting chemicals which stimulate the healing process.  Thus inflammation is the vital first stage of the healing process.  This is why doctors are starting to shift away from prescribing anti-inflammatory medication in the early stages of healing: research is increasingly beginning to suggest that anti-inflammatory medication, given too early in the healing process, can delay healing and impair its quality.  Instead, they’re recommending pain killers to help you move more normally (which promotes high quality healing), rather than anti-inflammatories.

Chronic systemic inflammation

Chronic systemic inflammation though, is quite different.  This happens for lots of different reasons – systemic disease such as rheumatoid arthritis, lupus or ankylosing spondylitis (conditions in which the body seems to misinterpret its own cells and think they are attacking it, so it ends up producing antibodies against itself); or bad habits such as smoking, a poor diet, lack of sleep, too little (or too much) exercise and excessive alcohol consumption; or emotional or physical stress (including poorly-healed old injuries leading to compensatory movement patterns).

What I think happens in these scenarios (and bear in mind that this is just my theory) is about tissue metabolism. When your body is inflamed, it effectively becomes a bit stagnant and blocked. Nutrients don’t reach the tissues they’re intended for (or not in the right quantities) and waste products don’t get flushed out as effectively as they should.  As this happens, tissues become dehydrated, which further blocks the nutrient/waste cycle, thus perpetuating the problem.  My suspicion is that, because oxygen (nutrient) is more alkaline than carbon dioxide (waste product) then over time, the pH of injured tissue decreases (becomes more acidic).  We know that low tissue pH is a stimulus for muscle pain, and we know that pain leads to poor posture and altered movement patterns… so if I’m right, then one pattern is that chronic inflammation causes pain, pain causes poor posture, poor posture causes physical (and emotional) stress, and stress perpetuates the chronic inflammation.  Similarly, a poor diet, lack of sleep and smoking etc will also feed into the cycle.

Chronic systemic inflammation, therefore – not helpful, and quite the reverse of local acute inflammation!

What to do about it?  Well, the short answer is to stop doing the things that cause it!  Stop smoking, cut down on the alcohol, sort out your sleep hygiene, reduce your stress levels, drink plenty of water, eat well, and exercise in moderation with good movement patterns… effectively, this is what my Health & Performance Pyramid is all about, especially the Foundation Layer.  So – next week, I’ll start getting into the specifics; but if you’re in too much discomfort and really can’t wait, then please do give us a call on 0207 175 0150 and book yourself a physiotherapy assessment.

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