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Inflammation: What You Need to Know
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Figure 1. When
inflammation occurs normally, chemicals from the body’s white blood
cells are released to protect us from foreign substances. Sometimes,
however, the white blood cells and their inflammatory chemicals cause
damage to the body’s tissues. |
What is inflammation?
Inflammation is a process by which the body’s white blood cells and chemicals
protect us from infection and foreign substances, such as bacteria and viruses.
In some diseases, however, the body’s defense system (immune
system) inappropriately triggers an inflammatory response when there are no
foreign substances to fight off. In these diseases, called autoimmune diseases,
the body’s normally protective immune system causes damage to its own tissues.
The body responds as if normal tissues are infected or somehow abnormal.
What diseases are associated with inflammation?
Some, but not all, types of arthritis are the result of misdirected
inflammation. Arthritis is a general term that describes inflammation in joints.
Some types of arthritis associated with inflammation include:
- Rheumatoid arthritis
- Shoulder tendonitis or bursitis
- Gouty arthritis
- Polymyalgia rheumatica
Other painful conditions of the joints and musculoskeletal
system that are not associated with inflammation include osteoarthritis,
fibromyalgia, muscular low back pain and muscular neck pain.
What are the symptoms of inflammation?
Inflammation is characterized by:
- Redness
- Swollen joint that is warm to the touch
- Joint pain
- Joint stiffness
- Loss of joint function
Often, only a few of these symptoms are present.
Inflammation may also be associated with general "flu-like"
symptoms including:
- Fever
- Chills
- Fatigue/loss of energy
- Headaches
- Loss of appetite
- Muscle stiffness
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Figure 2. Inflamed Joint |
What causes the symptoms of inflammation?
When inflammation occurs, chemicals from the body’s white blood cells are
released into the blood or affected tissues in an attempt to rid the body of
foreign substances. This release of chemicals increases the blood flow to the
area and may result in redness and warmth. Some of the chemicals cause leakage
of fluid into the tissues, resulting in swelling. The inflammatory process may
stimulate nerves and cause pain.
What are the results of joint inflammation?
The increased number of cells and inflammatory substances within the joint cause
irritation, wearing down of cartilage (cushions at the end of bones) and
swelling of the joint lining.
How are inflammatory diseases diagnosed?
Inflammatory diseases are diagnosed after careful evaluation of:
- Complete medical history and physical exam
- The location of painful joints
- Presence of joint stiffness in the morning
- Evaluation of other symptoms
- Results of X-rays and other tests
Can inflammation affect internal organs?
Yes. Inflammation can affect organs as part of an autoimmune disorder. The type
of symptoms depends on which organs are affected. For example:
- Inflammation of the heart (myocarditis) may cause shortness of breath or
leg swelling
- Inflammation of the small tubes that transport air to the lungs may
cause an asthma attack
- Inflammation of the kidneys (nephritis) may cause high blood pressure or
kidney failure
- Inflammation of the large intestine (colitis) may cause cramps and
diarrhea
Pain may not be a primary symptom of the inflammatory disease,
since many organs do not have many pain-sensitive nerves. Treatment of organ
inflammation is directed at the cause of inflammation whenever possible.
How are inflammatory joint diseases treated?
There are a number of treatment options for inflammatory diseases including
medications, rest and exercise, and surgery to correct joint damage. The type of
treatment prescribed will depend on several factors including the type of
disease, the person’s age, type of medications he or she is taking, overall
health, medical history and severity of symptoms.
The goals of treatment are to:
- Avoid or modify activities that aggravate pain
- Relieve pain through analgesics (pain-relieving medications) and
anti-inflammatory medications
- Maintain joint movement and muscle strength through physical therapy
- Decrease stress on the joints by using braces, splints or canes as
needed
What medications are used to treat inflammatory diseases?
There are many medications available to decrease joint pain, swelling and
inflammation and hopefully prevent or minimize the progression of the
inflammatory disease. The medications include:
- Non-steroidal anti-inflammatory drugs (NSAIDs – such as aspirin,
ibuprofen or naproxen)
- Corticosteroids (such as prednisone)
- Anti-malarial medications (such as hydroxychloroquine)
- Other medications* including methotrexate, sulfasalazine, leflunomide,
anti-TNF medications, cyclophosphamide and mycophenolate
*Some of these medications are traditionally used to treat
other conditions such as cancer, inflammatory bowel disease or organ
transplants. However, when "chemotherapy" types of medications (such as
methotrexate or cyclophosphamide) are used to treat inflammatory diseases, the
doses are significantly lower and the risks of side effects tend to be
considerably less than when prescribed in higher doses for cancer.
When you are prescribed any medication, it is important to meet
with your physician regularly so he or she can detect the development of any
side effects and monitor the efficacy of the medication.
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