Pain in the acute stage of inflammation is widespread (not localized) and the area feels red, hot, swollen and painful.
Edema (swelling) is a hallmark of this stage, as white blood cells are streaming to the injured area and fluid follows along into interstitial (between the cells) spaces.
The goals of acute inflammation are:
Initially, blood vessels constrict in the area of injury: this helps slow metabolism. This Vasoconstriction is accompanied by clotting in the vessels, which seals off the wounded site. After 5 or 10 minutes, though, vasoconstriction is replaced with vasodilation (widened blood vessels), activated by chemical messengers like histamine, leukotrines, prostaglandins and cytokines.
Vasodilation allows blood to get to the damaged area quicker and increases permeability (so white blood cells (WBC's) and clot forming chemicals move in) to the site (diapedesis), Generally, within an hour after injury, phagocytes ("eating cells" - WBC's) move into the scene. Increased permeability also means that fluid and cellular debris can seep out of blood vessels more easily, The initial discharge lasts 24 to 36 hours. When vasodilation is complete, blood flow decreases and blood gets thicker, allowing leukocytes to slow down and adhere to vascular walls (margination). Platelets stick to this exposed collagen. Thrombin causes fibrinogen to change into very sticky fibrin which further cements the clot. Clot formation begins 12 hours after injury and is completed within about 48 hours.
Pain treatment in the Acute SOI focuses on keeping the inflammation response from running amok and causing more damage to the area.
The Symptom Picture is :
Treatment Plan (works to decrease the symptoms. Therefore
Treatment follows directly from the Plan, So
Self Care Recommendations follow the Plan too, so good recommendations include
Hydrotherapy: Ice or if the patient cannot stand the extreme temperature, Cool - to soothe the red, hot, painful, swollen area
Marian Wolfe Dixon
MA, LMT (OR #3902)
NCTMB Approved Provider
Continuing Education for Massage Therapists, CHt, TCMBB.