How to Manage Inflammation

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There are many ways to manage inflammation, depending on the kind and severity of the condition.

by Fiaz Jaleel, M.D.

Inflammation, as I mentioned in my initial article, is an important part of the healing process. The early features of the inflammatory response generally include increased blood flow, warmth, redness, swelling, and pain. These clinical features are all part of the early response to injury, infection, antigen exposure etc.

How to Manage InflammationThe treatment of acute versus chronic inflammation has many similarities, but also has significant differences. For example, an acute asthmatic attack can be treated with a short course of corticosteroids such as prednisone, while long-term chronic autoimmune disorders, such as rheumatoid arthritis and multiple sclerosis, may require chronic low dose corticosteroids, along with biologics to try to modulate disease progression.

At Absolute Injury and Pain Physicians, we mainly see acute inflammatory conditions associated with physical trauma, like those seen in motor vehicle accidents, falls etc. As such, we do not normally treat chronic inflammatory conditions associated with autoimmune diseases.  I, however, have interest and expertise in autoimmune disorders, metabolic syndrome, obesity, gut disorders, and hormonal balancing.

The management of acute inflammation has several aspects. Modalities such as cold compresses, are helpful in reducing pain and swelling. Massage is also beneficial in mobilizing excess fluid in the tissues, soothing tense muscles, and helps with pain reduction and mobility. Heating pads and heat generating modalities such as ultrasound, are also beneficial but should be applied after the initial inflammatory response subsides.

The use of anti-inflammatory medications such as ibuprofen and naproxen may be used for a short period of time. These non-steroidal anti-inflammatory drugs (NSAID) may be associated with gastrointestinal upset, gastrointestinal bleed, elevated blood pressure, swelling of the legs, impaired kidney function along with an increased risk for strokes and heart attacks. Although NSAIDs may reduce inflammation and pain, they may also impair healing due to suppression of key inflammatory markers associated with tissue repair.

Anti-inflammatory MedsAnother class of drugs that are commonly used includes muscle relaxers. These are generally centrally acting and are associated with drowsiness, dry mouth, urinary hesitancy, constipation etc. A short course of oral prednisone can be considered if therapy and treatment with NSAIDs and muscles relaxers are not sufficiently helpful. Due to the host of potential side effects of the common medications used, I prefer the use of targeted joint and soft tissues injections along with occipital nerve blocks for headaches. Injectable medications use include: lidocaine, corticosteroids such as methylprednisolone acetate, magnesium, etc.

As an adjunct to medical management, active and passive physical therapy has benefits along with chiropractic and massage therapy. These interventions are best supported by a nutrient dense diet along with restorative sleep. For acute inflammatory responses associated with infections, one must consider the associated pathogens, and treat accordingly.

At Absolute Injury and Pain Physicians, the use of targeted medical interventions, supported by chiropractic care and physical therapy, increases the likelihood of swift resolution of symptoms and improvement in function and quality of life.

I do stress that patient compliance is key to functional progress; no significant gains can be made without the patient strictly adhering to medical advice.

See Related Article: Inflammation by Fiaz Jaleel, M.D.

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Dr. Fiaz Jaleel

Author: Dr. Fiaz Jaleel

Fiaz Jaleel, MD, joined the team at Absolute Injury and Pain Physicians as Medical Director in 2007. He is Diplomate at the American Board of Physical Medicine and Rehabilitation, and at the American Board of Pain Medicine.

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