This summer something happened to me. As I was walking down a scenery path, something hit me. It happened so quickly that I felt as if I had been hit by a drop of burning oil that I could not manage to wipe away. Turns out that the culprit responsible for my pain was a bee, or a wasp, I never actually saw it so it could really be either one. What I was certain of, however, was the amount of pain I was experiencing. My body didn’t like it one slightly bit. I was also very confused, why did this insect decide to sting me? Why me? Why on my hand? I had to find answers. I actually had never been stung before. That was my very first encounter and I really didn’t know what to do.
My fiancé, having been stung many times before, was kind enough to inform me to raise my hand above my heart line until we reached home. Once there we would finally be able to put some ice to soothe the pain. Thinking about it now, I realize there were actually two actors at play in this scenario: pain and inflammation. They were interrelated. Inflammation caused pain and pain caused inflammation. It’s a truly terrific vicious cycle we got there. As previously mentioned in the Bring Up Pain article, pain is an adaptative mechanism that forces us to take an adequate action to free us from danger or from something the body interprets as potentially harmful. Where inflammation, also an adaptive mechanism, is there in contrast to provide an ideal environment for healing. One way it achieves this is by sending chemicals to the skin to increase sensitivity. This is the component responsible for the pain we feel when dealing with an inflamed body part. This is also why just the mere rubbing of our clothes after a sunburn is nearly unbearable. We call this increased sensitivity, allodynia. This is meant as a way to keep us from making the injury worse.
Apart from the aforementioned insect sting and sunburns, there are many more events that can lead to development of inflammation. Think about blemishes (pimples), injuries, headaches, arthritis, only to name a few. All of us at one point or another has, or definitely will, experience inflammation. There is absolutely no way around it. Well, not naturally at least. So I believe it’s essential to know how to recognize it. To do this, experts rely on a principle called the five cardinal signs of inflammation. Here, even though you might not know them in terms of their names, you know them at least from experience. So there is really no need to get scared!
The first sign, you guessed it, is pain. This is a necessary step, but still a dreadful step. This is the most obvious sign. It’s a major warning that signals us to pay attention to what’s actually going on. Without it, we would probably carry on with our days with absolutely no knowledge that something wrong is happening. This is also the main, if not only the only sign that transpires when we get a headache. Not that all headaches are signs of inflammation, it’s still a common source. We often get them when we don’t get enough oxygen to our brain cells. That could be caused from a bad sitting position, anxiety or even other health problems. You can discover that the only act of massaging the back of your neck can prove itself sufficient to relieve a headache. This happens because you are restoring blood flow by relaxing muscles that can compress the blood vessel walls. By putting a stop to the compression, enough blood can finally reach your neurons and deliver the oxygen it so dearly wants. Now that your brain cells get enough oxygen, there is no more need for inflammation and thus no need for pain.
The second sign is redness. This is a visual cue that you probably got to experience last time you got pimples. I’m talking about the one that hurts, the one that seems all perky and purulent. They are not only painful, they are also obviously visible by their coloration, red. If you want an additional example of this, think about sunburns. The lobster shade that you adopt after taking that extended sunbath is definitely a manifestation of inflammation. This should be taken as an unquestionable warning sign to get the Fick out of the sun, or pursue at your own peril. Taking in too much ultraviolet rays (mostly from the UVB type) will cause damage to your outer skin layer which will lead to inflammation. To avoid this, it’s really easy, use a proper sunscreen. This tiny bit of advice is so well known that I don’t even know why I bother repeating it here. We know that we should do it, but we don’t. Thus, I am here taking a pledge that I will, from now on, use sunscreen before lengthened sun exposure. Are you brave enough to join me?
Now if you fail to protect your skin after it has turned red, by running away from the sun to the shade, you will probably see soon enough blisters appearing. These are also called edema, which is the third cardinal sign. They contain something we call the inflammatory soup. That soup contains pain mediators, hormones, chemicals, and immune cells. They all contribute to different functions of inflammation, which some of them were mentioned earlier. The immune cells are the one responsible for protecting and defending the affected site against outside invaders, think about that venom from the insect bite I spoke of at the beginning. Some chemicals and hormones will be involved in stimulating cell reproduction (or multiplication). This will help heal wounds, like the skin you damage with the sunburn.
As a fourth sign, we get increased heat. This is not only really obvious when we touch ourselves after a sunburn, it is also really evident when we get a fever. That fever appears because the body, or more precisely your immune cells, perceived a widespread infection with an external agent. It could be from toxins, bacteria, parasites or viruses. By itself, a slight fever is often sufficient to kill living organisms like bacteria and parasites, but it’s completely useless against things that are not alive, like toxins and viruses. This is why fever that gets really intense is frequently associated with viral infection or toxin exposure. If we fail to care for the fever in these cases, it might cause us harm and this is why medical experts give us medication to quench the fever. In most cases, it actually targets inflammation directly which ends up also alleviating pain.
At last there is the loss of function that marks the final signs. This takes the longest to settle in but is, nonetheless, one of the major drivers for hospital visits. This is the less evident sign, as it bears somewhat of a very confusing title. Don’t worry this will be made very clear with examples. If you consider sunburn, the skin is so damaged that it can’t serve as the ultimate barrier anymore; therefore it has lost function. The hypersensitivity we experience is actually a testimonial to that. It is screaming to you that you have to keep all things away from it as it can no longer protect you by itself. Now if you consider a twisted ankle, the loss of function manifests itself through the near inability to walk over it. Your ankle which normally allows you to perform a walk, now pains you anytime you use it. This pain prevents you from performing the exact action it was meant to accomplish.
Now that you’re familiar with the five cardinal signs of inflammation, you may feel comforted in knowing that there exist some ways to help reduce the inflammation responses. Probably none of them will come as a surprise to you. When the inflammation is localized (only in your foot, for example), external (not in your airway or other internal organs) and acute (not a long-termed response), you can refer to the acronym RICE for treatment. “R” stands for rest. Reducing movement will prevent more stress from damaging the tissues further and help the healing process. “I” is for ice, placing ice indirectly (not straight on your skin) on the affected area will slow down the immune response. This will reduce swelling and pain. “C” corresponds to compression, by exerting pressure on the skin you are reducing the volume available for the inflammatory soup to occupy. This should lead to reduced swelling and increase mobility. Finally, the “E” refers to elevation, by lifting your body part slightly above your heart you are improving blood circulation in the area, leading perhaps in the loss of swelling and increased mobility as well.
If ever you are faced with a situation that is so bad that none of these helps, you may require medication. Ibuprofen, commonly known in North America as Advil, is an over-the-counter openly available anti-inflammatory medication that you may want to use or at least keep in your cabinet. If Ibuprofen fails to help, there are more anti-inflammatory medications, some of them even stronger, that require a prescription for procurement. In these cases, you will need to set a visit with your family physician or go through an emergency clinic to obtain the prescription.
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