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Inflammation – Acute vs Chronic

Inflammation – Acute vs Chronic

When people hear the term “inflammation” most people think of redness, swelling and heat like you would get after badly spraining an ankle.

This is acute inflammation and is:

  • Local (isolated to one area of the body)
  • Short lived (usually lasting only 4-14 days)
  • A normal (and essential!) part of the healing process. 

How we heal

Inflammation is often seen as “bad” and something that needs to be eliminated as quickly as possible. However, the reality is that acute inflammation is a vital first step in the healing process. When any tissue of the body is injured healing occurs in three phases:

  1. The Inflammatory phase
  2. The Repair phase. 
  3. The Remodelling phase.

Each phase of healing is necessary for the subsequent phase. In fact, it has been said that:

Inflammation can occur without healing, but healing cannot occur without inflammation

Leadbetter

So clearly, we don’t want to eliminate inflammation altogether. But we also don’t want to increase inflammation either, as excessive inflammation could increase total tissue damage, slowing down the repair process.

Instead, we want to encourage a healthy inflammatory response by creating an environment that supports the inflammatory process.

Managing acute inflammation

Chronic Inflammation

So ‘acute’ inflammation is a vital part of the recovery process, but ‘chronic’ or ‘systemic’ inflammation however, is a different story.

Chronic inflammation is not part of the body’s natural healing process. Chronic inflammation is defined as “a persistent and chronic inflammatory state which promotes ongoing tissue damage” [1].

Chronic inflammation:

  • Is widespread (affecting the whole or multiple areas of the body) 
  • Is ongoing (lasting several months to years)
  • Causes tissue damage

This chronic and widespread inflammation is linked with a host of chronic diseases including diabetes, cancer and cardiovascular disease. But it is also linked with muscle and joint problems such as disc herniation, arthritis and tendonitis [1].

Chroinc inflammation can cause multi-joint pain

Do I have Chronic Inflammation?

Unfortunately, chronic inflammation is not uncommon, in fact, 25% of adult Americans live in a highly inflamed state [1].  

Common signs and symptoms of underlying chronic inflammation include (2):  

  • Multiple sites of pain
  • Constant fatigue and insomnia
  • Depression, anxiety and mood disorders
  • Gastrointestinal complications like constipation, diarrhoea, and acid reflux
  • Weight gain
  • Frequent infections

The more of the above symptoms you have the more likely chronic inflammation may be part of your pain problem.

Blood tests (such as fasting insulin, HS-CRP, HbA1c, fasting triglycerides, HDL and LDL) can provide a more specific and detailed assessment for underlying metabolic dysfunction and chronic inflammation.

What Can I Do?

Many dietary and lifestyle changes can be helpful in removing inflammation triggers and reducing chronic inflammation [2]:

1) Weight loss

Weight loss has been found to be one of the most effective methods for reducing chronic inflammation.

2) Food

Some foods promote an inflammatory state (pro-inflammatory foods) whilst others reduce it (anti-inflammatory foods):   

  • Sugary foods and drinks: All sugars and refined carbohydrates (like cakes and cookies as well as refined grains like white bread), lead to a sharp upward spike in the blood sugar level after being eaten [3]. This increase in blood sugar leads to a rapid uptake of sugar by the cells of the body which causes an immediate inflammatory response. This response is proportional to the blood sugar elevation i.e. the more sugar you eat the more your blood sugar spikes and the greater the inflammatory response! ​According to the American Heart Association, the maximum amount of added sugars you should eat in a day are 37.5 grams or 9 teaspoons per for men and 25 grams or 6 teaspoons per day for women. For a little perspective, a single 330ml can of coke has 35 grams of sugar! ​That’s almost the entire daily male allowance and well over the daily the allowance for women!
  • Trans fats: Synthetic trans-fats are highly inflammatory. Trans fats are found in most processed foods so the best way to avoid them is to follow the rule – if it comes in a box or bag don’t eat it. That includes crisps, pastries and microwave foods.
  • Fruits and vegetables: A diet high fruit and vegetable intake has been shown to lower levels of inflammation. Fruit and vegetables provide important micronutrients and are also a good source of fibre.  Eating a variety of fruits and vegetables, in a variety of colours, will help to deliver a range of important micronutrients. For example, green leafy vegetables such as spinach are high in magnesium (Magnesium is listed as one of the most anti-inflammatory dietary factors, and its intake is associated with lowering many markers of inflammation.) Whilst citrus fruits are high in vitamin C. Both of these micronutrients are vital for healing and repair.
  • Green and black tea: Tea polyphenols are associated with a reduction in CRP (a marker of inflammation) in human clinical studies. 

3) Supplements

  • Curcumin: Curcumin has been shown to possess anti-inflammatory properties comparable to non- steroidal anti-inflammatories (NSAIDs) (e.g. ibuprofen) [4]. Read more about curcumin for arthritis and tendonitis here.
  • Fish Oil: Rich source of the omega-3 fatty acids. Higher intake of omega-3 fatty acids is associated with lowering levels of inflammatory markers.  

4) Exercise

Multiple human clinical trials have shown that exercise lowers multiple pro-inflammatory markers independently of weight loss [2].

5) Sleep and Stress

Lack of sleep and increased psychological stress have been shown to increase Inflammation [5,6]

References

  1. Seaman, D. R., & Palombo, A. D. (2014). An overview of the identification and management of the metabolic syndrome in chiropractic practice. Journal of chiropractic medicine, 13(3), 210-219.
  2. Pahwa R, Singh A, Jialal I. Chronic Inflammation. [Updated 2019 Dec 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/
  3. Atkinson FS, Foster-Powell K & Brand-Miller JC (2008) International tables of glycemic index and glycemic load values: 2008. Diabetes Care. 31, 2281-2283
  4. Perkins, K., Sahy, W. and Beckett, R.D., 2016. Efficacy of Curcuma for Treatment of Osteoarthritis. Journal of evidence-based complementary & alternative medicine, p.2156587216636747.
  5. Mullington JM, Simpson NS, Meier-Ewert HK, Haak M: Sleep loss and inflammation. Best Prac Res Clin Endocrinol Metab 2010, 24:775–784
  6. Motivala SJ: Sleep and inflammation. psychoneuroimmunology in the context of cardiovascular disease. Ann Behav Med 2011, 42:141–152

 

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