How can inflammation be detrimental?

If swelling is prolonged or extensive, this may actually result in excessive breakdown of injured tissue beyond that which is necessary for adequate healing. In addition, persistence of the inflammatory response means the continued release of pain-producing chemicals beyond the normal protective mechanism. Bradykinin, prostaglandings, substance P, and other, chemicals, mediate the response and produce pain. Furthermore, during the period of muscle spasm, there is little motion or function possible. The body's tissues need to return to motion and function if full healing is to occur. With lack of motion or usage, the muscles atrophy and ligaments and tendons can contract, that is, lose full flexibility.

In addition, persistence of inflammation results in lying down of scar tissue, which, without normal motion, may not be properly aligned and may not serve, an ultimately useful or practical purpose.

Why do people need treatment for sprains, strains and tears?

The reason for treatment is precisely to control the inflammatory response without totally suppressing it: This promotes the gradual reduction of pain, return of flexibility and strength, and ultimately the fullest possible return to function.

How does one treat inflammation in "the acute stage”?

For the first forty-eight to seventy-two hours the standard treatment is remembered by the acronym "RICE": Rest, Ice. Compression, Elevation.

Rest: This means that the involved region should be rested and its usage curtailed. This pertains both to the arms and legs as well as necks and backs.

Ice: In addition, in the acute stage, ice or cold compresses should be applied for fifteen to twenty minute periods every several hours. This results in reduction of undue swelling and inflammation.

Compression: Third, where possible, compression of the injured joint or region should be accomplished with an ACE bandage wrapped firmly but not tightly. One should be very careful not to "cut off" circulation below the level of the ACE bandage.

Elevation: Fourth, elevation of the leg or the arm, as feasible, should be done as often and for as long as possible for the first forty-eight to seventy-two hours. This again serves to reduce swelling and to limit the inflammatory response.

What else can be done in the acute stage?

In addition to the above standard measures, an assessment should be made of the nature and extent of the injury so that other possible treatments can be initiated. These might include medications to reduce inflammation (NSAIDs), muscle relaxants where there is undue muscle spasm, pain killers where pain is extreme and specific splints or braces in cases where there is instability or it is not possible to fully fest the involved structure. Other more serious conditions, such as complete ruptures or fractures, must also be diagnostically considered and ruled out. Cortisone and other steroid injections are reserved for specific cases, where they can be of great benefit in reducing inflammation and pain. In milder injuries, stretching and even isometric strengthening are started at the outset.