In our last article, we delved into the science behind pain and the difference between acute and chronic pain. All of us experience physical pain. It forms part of the human existence and whether it is due to injury or infection it is often accompanied by inflammation. Why is this and when does inflammation become unhealthy?
How Does Inflammation Aid Healing?
It is interesting to note that inflammation does serve a purpose – it is the body’s natural self-protection mechanism. The Oxford Concise Medical Dictionary defines acute inflammation as the immediate defensive reaction of tissue to any injury, which may be caused by infection, chemicals or physical agents. The aim of inflammation is to remove the harmful stimuli, damaged cells, irritants or pathogens in order to begin the healing process.
The 5 Cardinal Signs of Inflammation (PRISH)
- Pain: The central nervous system is triggered and the area is likely to be painful and sensitive to the touch.
- Redness: The blood vessels at the site become dilated to increase local blood flow.
- Immobility: There is a loss of function due to swelling or stiffness in order to limit the use of the injured area to give it time to heal.
- Swelling: There is increased capillary permeability and fluid leakage in tissue spaces. In some cases, production of pus or mucus occurs to push foreigners out of the body.
- Heat: Increased blood flow and dilation heats up the area. White blood cells, which form an integral part of the immune system, enter the scene to fight bacteria, remove and consume dead cells and unwanted particles in order to enable healing.
Chronic Inflammation and Modern Disease
Inflammation as part of the body’s immune response is initially beneficial but if it becomes continuous it can cause tissue damage, persistent pain and even disease as it no longer only affects the immediate area but can impact the entire body. In fact, ongoing research has shown that chronic inflammation is becoming increasingly common and it is strongly associated with most of our modern health problems.
Risk factors for chronic inflammation include:
The incidence of obesity continues to grow worldwide and researchers are studying the link between excess weight and inflammation. Research indicates that lean connective tissue assists with maintaining equilibrium within the body but obese connective tissue results in a decrease in anti-inflammatory proteins and an increase in inflammatory hormones within the cells. [1, 2] This can lead to chronic systemic inflammation and many associated health problems such as hypertension and high cholesterol.
Not only can lack of exercise increase the likelihood of obesity, it is also a risk factor for chronic inflammation. Both obese people and those who have low fitness levels have raised inflammatory markers. 
Poor Quality Sleep
A study by the Emory University School of Medicine found that poor quality sleep, whether it is too short or disrupted, increases the production of inflammatory hormones and causes changes in blood vessel function.  Researchers have found that people who have fewer than six hours of sleep generally have higher levels of three inflammatory markers and tend to have a higher incidence of heart disease and strokes.
Stress and Mood Disorders
Our modern high stress lifestyles have a ripple effect, not only on our psychology, but our bodies as well. Studies have shown that individuals under constant stress have increased levels of inflammatory hormone production.  At the same time, chronic pain and inflammation constantly trigger the nervous system which can eventually alter the transmission pathways, effecting the functioning of the brain. This may cause higher pain sensitivity, mood instability, lack of energy and focus and sleeping difficulties.  If left to fester this can become a vicious circle of anxiety and depression, sleep deprivation, increased pain and susceptibility to further health problems.
Common Health Problems Associated with Inflammation
Sadly, chronic inflammation left unchecked can lead to many serious and unpleasant health conditions including heart disease, rheumatoid and osteo-arthritis, osteoporosis, inflammatory bowel disease, asthmas, auto-immune diseases, diabetes, Alzheimer’s disease, macular degeneration, some cancers and allergies.
If you are suffering from chronic pain and inflammation, it is important to consult with the relevant medical professional. Early intervention is key to prevent irreversible tissue damage. Treatment options are varied and will depend on the nature of the condition but often include lifestyle changes such as weight loss and exercise, physiotherapy, surgery, counselling, pharmaceutical drugs and supplements.
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- Ping Jiao and Haiyan Xu. Adipose inflammation: cause or consequence of obesity-related insulin resistance. Diabetes, Metabolic Syndrome and Obesity 2008:1 25-31
- Kassi E, Pervanidou P, Kaltsas G, et al. Metabolic syndrome: definitions and controversies. BMC Medicine 2011,9:48
- Clarke J. Halfman, Ph.D., D.A.B.C.C. Laboratory Medicine and PathoPhysiology: Chemical Mediators of Acute Inflammation. August 1997
- Melissa R Meyers and Noyan Gokce. Endothelial dysfunction in obesity: etiological role in atherosclerosis. Curr Opin Endocrinol Diabetes Obes 2007 14:365-369
- Steven Simon. Opioids and Chronic Pain Management Paradigm: Time for a Change? http://www.medscape.org/viewarticle/478885
- Julio C. Fernandes, Johanne Martel-Pelletier and Jean-Pierre Pelletier. The role of cytokines in osteoarthritis pathophysiology. Biorheology 39 (2002) 237-246