Mark W. McFarland, DO
In the first article, I talked about inflammation, its causes and symptoms. In this article, I’m going to talk about the difference between acute and chronic inflammation and how as an orthopaedic physician, I treat those conditions in my patients.
Acute Inflammation
When your body suffers an injury (like a broken arm), has a wound (like a cut on your foot) or gets influenza from a virus, the inflammatory response immediately answers the call to action from the brain that there is something wrong. It rapidly deploys biological soldiers (neutrophils) in the form of immune cells to the site of injury or illness, followed up by the likes of cytokines, chemokines and prostaglandins, which are inflammatory mediators.
Together, these warriors take out bad guys, such as bacteria and viruses, mop up damaged cells and start the restoration of what tissues were damaged. Healing and recovery occur within a specific period of time. This process is vitally important to the human body.
Chronic Inflammation
When the above process doesn’t turn off, the brain kicks into a prolonged response where those soldier cells continue to be sent, but also other guerilla cells are added to the deployment, like microphages and lymphocytes. After a while, they get a bit crazy due to their long deployment. Instead of making things better, they start breaking down body tissues and causing disease. Here is list of just some of the diseases caused by chronic inflammation in the body:
- cardiovascular, gastrointestinal, lung, metabolic, neurodegenerative, kidney, non-alcoholic fatty liver disease
- Autoimmune diseases: Such as rheumatoid arthritis, lupus, psoriasis, psoriatic arthritis, and ankylosing spondylitis (AS)
- Mental health conditions
- cancer, obesity, diabetes
Treatment
As an orthopaedic physician, I see a great deal of pain and dysfunction caused by the inflammatory process. Most of the time, I can say that this is really good news for the patient because it is a sign that healing is occurring, just as it should. My job is to help manage that discomfort while allowing healing and the natural bodily processes to continue.
Acute musculoskeletal issues – low back strain, bone fractures, knee sprains, whiplash – these can all be quite painful. Our aim is to reduce your pain, swelling and dysfunction enough so that you can live your life, but not so much that we stop the body from healing. To do that, we lessen the inflammatory response with anti-inflammatory medications. Those can be NSAIDs (Nonsteroidal anti-inflammatory drugs) like ibuprofen or corticosteroids which can be taken orally or injected.
Post-surgically, we typically ask patients to avoid medications that interfere with the inflammatory process, such as NSAIDS and steroids, to let the body heal as naturally as possible.
Chronic inflammatory auto-immune diseases like RA and PSA are typically managed by a Rheumatologist with drugs called (DMARDs) disease-modifying antirheumatic drugs like Sulfasalazine or Otezla® or biologic injectable agents, like Cosentyx® or Humira®.