Friday, February 7, 2014

The Inflammation Puzzle

In July I posted a blog discussing the overuse of cryotherapy. The controversy surrounding the topic made it one of the most popular blogs I’ve written. What is surprising to me is that a controversy exists at all. Why, where, and when did this notion of anti-inflammation start? Ice, compression, elevation and NSAIDs are so commonplace that suggesting otherwise is laughable to most. Enter an Athletic Training Room or Physical Therapy Clinic nearly all clients are receiving some type of anti-inflammatory treatment (ice, compression, massage, NSAIDs, biophysical modalities, etc). I evaluated a client the other day and asked what are you doing currently – “Well, I am taking anti-inflammatories and icing.” Why do you want to get rid of inflammation and swelling? I ask this question for both chronic and acute injury!

The Stigma of Inflammation
Editor in Chief of The Physician and Sports Medicine Journal (Dr. Nick DiNubile) once posed this question: “Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?” Much like a fever increases body temperature to kill off foreign invaders; inflammation is the first physiological process to the repair and remodeling of tissue. Inflammation, repair, and remodel. You cannot have tissue repair or remodeling without inflammation.  In a healthy healing process, a proliferative phase consisting of a mixture of inflammatory cells and fibroblasts naturally follows the inflammatory phase (1).

"Why do you want to get rid of inflammation and swelling?"

I have stopped taking NSAIDs - unless I take one.  An example of when I might take them is if I have too much pain to sleep, or too much pain to enjoy being with my family/friends.  What I have found is that sometimes a dose of NSAIDs just shuts down some inflammation cycle that I'm suffering from.

Overall, though, I think many folks take NSAIDs because the standard american diet leaves us in hyper-inflammatory conditions, so that a normal ache or pain becomes a day after day painfest which we might need an NSAID to turn off.

That said, I think the point above is valid.  I feel healthier now that I don't rely on NSAIDs to turn off pain every day.

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