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nikipedia's avatar

How does reducing inflammation promote healing?

Asked by nikipedia (27333 points ) May 6th, 2010

The usual advice for two common running injuries, shin splints and tendinitis (which I think may actually be the same thing?) involves reducing inflammation by icing and taking ibuprofen.

I was under the impression that inflammation was evidence that your healing processes were at work. So why would you want to reduce it?

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20 Answers

jaytkay's avatar

My non-expert opinion is that it’s like healing a cut on your skin. If you pick or slice at it, it does not heal. Leave it alone to repair the damage.

ubersiren's avatar

Inflammation is okay initially because it rushes blood to the injury, but you want to get back to normal operation of the area asap. The more and longer inflammation is there, the longer you have to wait until you use that part of your body like you would normally. If you wait too long, you can develop an adhesion. That means a larger, less supple scar. Then you’ll have trouble moving it even after it heals. To promote healthy healing and better range of motion while healing, you can take an anti-inflammatory and apply heat, or wait 72 hours after injury and begin massage.

Seaofclouds's avatar

Inflammation is a sign of your healing process at work, but it is only helpful as an initial response. After that, the inflammation can put unnecessary pressure on the injury and prevent it from healing properly. If the tissue around the injury is inflamed for a prolonged period, it puts pressure on the blood vessels around the injury and can prevent the injury from getting what it needs from the blood. Also, the body will need energy to heal the injury, so if your body is spending energy on unnecessary inflammation, it has less energy to use on healing the injury.

OneMoreMinute's avatar

Exactly and I agree, I think the fluids that go to the site of the injury carry all kinds of natural healing stuff. It gets stiff for the reason, so you don’t move it.
I believe in the intelligence of the body to know what to do in this process.
Why the popular thing is to reduce swelling with ice, and take aspirin/ibuprofin.
Everyone I know who twisted their knee and did this ice and pill still has ongoing problems with their knee.
I think the body is saying NOT to move around on the knee while there is swelling and pain. But it’s popular to take something for the pain, then ignore what the body is asking and walk on it, further damaging. My friends did this, and now needs knee surgery.
I twisted my knee, and stayed in bed, I stayed off my knee for a week, and it healed all by itself. I did not take anything nor did I use ice. Yes, my knee was swollen, but I let my body do what it needed to do. I don’t need knee surgery.

netgrrl's avatar

My mom (who is a nurse) always said alternating heat & cold was best to reduce swelling. Always seemed to work ok.

Seaofclouds's avatar

@OneMoreMinute If you kept your knee elevated that whole week while you were in bed, that would have helped reduce inflammation as well (so you may not have needed to ice it). Some people heal better than others and generally it all depends on the exact cause of the injury.

OneMoreMinute's avatar

@Seaofclouds No no no! That’s not what I was trying to do! What I did goes against what modern medicine says to do. But think about this, it is modern medicine that benefits by selling you knee surgery down the road.

I was not trying to go against my bodys natural and automatic healing abilities. I wasn’t trying to stop/reduce/illiminate anything. That’s the whole idea, is simply to just stay off the knee, by staying in bed. Not elevating it. Just until my BODY says it’s ok to be on it again, and that happens when it’s not stiff from the inflamation. Yes it hurts a little for a few days or more. It’s stiff. That’s to remind me to stay in bed.
The healing magic mojo stuff is in the fluids. So my point is, leave it be. rest. it will heal by itself. Be patient. yes it hurts, you might get a little cranky.

My friend who did ice and pain pills and was walking on her twisted knee, had numerous doctor appointments, many more pain medicine refills, it never healed back right, then MRI, cortizone shots which made her whole body swell up retaining fluids, and now surgery. She took pills and was active on her knee right after the injury. Ignoring her pain signals as “Stop, stay off, sit down!”
My way healed in a week. With no after problems. No drugs or MRI or surgery. And I read and rested.
I know several other people with the same Wounded Knee story! An old war wound that never heals. Now they have laporoscopy, or what ever they call that knee surgery.
It never goes back to normal.

I agree with the questioner, and this is my experience.

Seaofclouds's avatar

@OneMoreMinute I wasn’t saying that it was your intention, just saying that by keeping it up, the inflammation would have been reduce. Just making an observation. I’m glad that yours healed well.

Also, some people aren’t able to lay in bed for a week, so they have to do other things to help their healing and maintain a certain level of functioning.

OneMoreMinute's avatar

@Seaofclouds Are you no not hearing me say I am NOT trying to reduce the swelling?
I am in complete agreement with the OP question, and telling my story of how I healed my twisted knee by not reducing the inflammation. not taking pills. and rest. staying off the injury.

Seaofclouds's avatar

@OneMoreMinute I understand you were not trying to reduce the swelling. I get what you are saying. I’m just saying that, medically speaking, elevation reduces swelling, so it could have been an unintended effect of your lying in bed for that week and staying off your knee.

Pandora's avatar

Swelling also aids in keeping you from re-injuring yourself till you are fully healed. However the process can take a lot longer. When I was in Japan I was trying to hit a switch that would reverse the rotation of the blade. Only I didn’t know that their switch was to release the fan from the ceiling. I moved quick enough to keep it from crashing on my head but it caught my leg and scraped it on the way down. Instantly I started to see it swell and turn dark. I quickly put ice on it till the swelling went down. It froze the busted cappillaries and kept them from bleeding more and getting worse. I bruise easily and it can take months for a bruise to go away. The bruise was the length of my whole thigh but it went away in a few weeks, vise months. It was sore the next few weeks but if I did nothing, the pain would’ve been worse and I would’ve been laid up for days. Instead, after taking it easy for two days, I was able to walk around with little pain and that was gone within a week.

nikipedia's avatar

@OneMoreMinute: If you cannot explain how reducing inflammation promotes healing, please do not answer a question asking how reducing inflammation promotes healing.

I am glad that you found a way to relieve your personal, individual knee pain. However, I am not asking about your personal, individual knee pain. Nor do I think it was ambiguous what I was asking. To clarify, I am asking about the mechanism of action behind a treatment that appears to be pervasive throughout the sports medicine community.

I am not interested in hearing any kind of complementary or alternative medicine explanations for real biological phenomena unless they can be backed up with empirical evidence.

Seaofclouds's avatar

@nikipedia The wikipedia about inflammation has a lot of correct information. It states that “Prolonged inflammation, known as chronic inflammation, leads to a progressive shift in the type of cells which are present at the site of inflammation and is characterized by simultaneous destruction and healing of the tissue from the inflammatory process.”

The cells that initially respond to an injury are present, but then at a certain point in the process some other cells come to the injury that can actually break down the healthy tissue. When this happens, you get tissue destruction and fibrosis (thick collagen scars).

There is no definite point to know when the cells will change and become destructive, so getting rid of inflammation sooner rather than later helps prevent that from happening.

Rarebear's avatar

Well, in normal situations reducing the inflammation really doesn’t promote healing—it just makes it hurt less.

nikipedia's avatar

@Rarebear: So is running on iced/ibuprofened tendons etc. good or bad?

Dr_C's avatar

Reduction of swelling does not promote healing. It promotes comfort and ease of use which (specifically in the sports medicine community) is the more pressing concern for injuries that are not considered debilitating or serious enough to refrain from the specific activity that caused them.

Someone on the thread earlier mentioned swelling as blood rushing to the affected area; this is inaccurate.

The process of acute inflammation is initiated by cells already present in all tissues, mainly resident macrophages, dendritic cells, histiocytes, Kuppfer cells and mastocytes. At the onset of an infection, burn, or other injuries, these cells undergo activation and release inflammatory mediators responsible for the clinical signs of inflammation.

Vasodilation and its resulting increased blood flow causes the redness] and increased heat. Increased permeability of the blood vessels results in an exudation (leakage) of plasma proteins and fluid into the tissue, which manifests itself as swelling.

Some of the released mediators such as bradykinin increase the sensitivity to pain. The mediator molecules also alter the blood vessels to permit the migration of leukocytes, mainly neutrophils, outside of the blood vessels into the tissue. The neutrophils migrate along a chemotactic gradient created by the local cells to reach the site of injury.

The repair process involves the regeneration of tissue or neo-genesis when tissue is destroyed. Once the repair process is finished swelling tends to dissipate on it’s own due to a lack of production of the chemotactic response.

So while reducing the swelling may make it easier to resume your activities, it won’t speed up or promote healing. Giving your body the opportunity to heal can be a good thing.

Response moderated
ubersiren's avatar

@netgrrl Yes, I should’ve said to alternate heat and cold instead of just heat… Cold is good for the swelling itself, and heat is good later, to help the scar form more smoothly. I wasn’t very clear about that. The RICE method will help in the first 72 hours. After that, heat and friction will aid against adhesion.

frienemies0113's avatar

Well if someone had severe allergies and got stung by a bee or near a cat, their airways can swell up so much they can die from suffocation. an epi pen reduces the inflammation enough so the sick person can manage to breathe.

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