Inflammation: what causes it, cardinal signs, and natural approaches to deal with inflammation

What causes inflammation?

Inflammation is not as evil as its made out to be. It is completely natural! It is your body's way of protecting itself from anything harmful or irritating such as chemical irritants, any damaged cells, or pathogens. Inflammation is your body telling you that it's trying to heal itself from a harmful stimuli.

Of course, inflammation is only good to a limited extent. Acute inflammation is GREAT for your body to increase blood flow to the area and fight the harmful stimuli. However, chronic inflammation may prove to have negative consequences as the accumulation of chemicals and by-products of the inflammatory response may cause stress to your body, which may, in turn, impede in your immune function.

Cardinal signs of inflammation

The easiest way to remember the cardinal signs of inflammation is:  
Inflammation caused by a SHARP needle.

Source: http://en.wikipedia.org/wiki/Inflammation

Swelling
Heat
A loss of function
Redness
Pain

The more superficial the inflammation is, the more of the cardinal signs you will see. But remember, just because you don't see all of the signs does not mean that inflammation is not present.


Dealing with inflammation...naturally!

1. To decrease inflammation after an acute injury make sure you remember PRICE
• If you don't know or remember what PRICE is, check out "The Infamous Ankle Sprain" post to find out!
2. Contrast Hydrotherapy
• Simply alternating hot and cold applications to the inflamed area. 
• The cold application will decrease chemical reaction speeds thus slowing down the inflammatory response. 
• The hot application will increase blood flow to the injured area and help speed the healing process
3. Botanicals
• There are SEVERAL constituents that have anti-inflammatory actions, such as tannins, salicylic acid, and flavones. 
• Plants that have anti-inflammatory actions include Calendula (Calendula off.), Chamomile (Chamomilla recutita), and Turmeric (Curcuma longa)

Inflammation and Curcumin

Curcumin (the active constituent found in turmeric) has been the "up-in-comer" for the treatment of inflammation. According to Satoskar, a double blind, placebo-controlled clinical trial on post-operative patients found that curcumin was more effective than phenylbutazone and placebo in the treatment of post-operative inflammation (2004).

Recently, there has been extensive research in the biological activities and pharmacological actions of turmeric and its constituents (i.e. curcumin). Here are two papers that have been published about the anti-inflammatory action of curcmin:

• Anti-inflammatory Properties of Curcumin, a Major Constitutent of Curcuma Longa 
• Turmeric and Curcumin: Biological actions and medicinal applications

Sources:

1) Satoskar RR, Shah SJ, Shenoy SG. Evaluation of anti-inflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24(12):651-54.  Cited in Mills S, Bone K. Principles and Practice of Phytotherapy: Modern 

How do you deal with inflammation?
 
What are your thoughts about the anti-inflammatory actions of Curcumin discussed in the papers?

Comment below!

 

The Axillary Artery, Its Branches and Tips for Studying It

       As we all know, the flow of blood through the body plays a vital role. Without it, our cells would not receive oxygen and nourishment, metabolic waste would not be cleared out and our health would suffer because of it. When a patient is examined, it's necessary to have a good clinical understanding of the venous and arterial pathways. In cases of ischemia and hypoxia, it's important to know what tissues could suffer and what concerns need to be addressed. 

       Today, we'll take a closer look at the axillary artery, the pathways it branches off to, the areas served and a few good study ideas to learn, remember and understand this area. The axillary artery is a continuation of the subclavian artery and has three sections before becoming the brachial artery (after it passes the inferior border of teres major). The three sections can be broken down based on what branches off of them.

The Axillary Artery and its branches. The labels are in small font, try to pick them out and label them yourself! Picture from Gray's Anatomy. 

Section	Branches	Areas Supplied
One	Superior Thoracic Artery	Upper part of thoracic cavity
Two	Thoracoacromial Artery	Pectoral and deltoid regions
	Lateral Thoracic Artery	Lateral structures of thorax
Three	Subscapular Artery	Subscapular region
	Anterior Circumflex Humeral Artery	Proximal end of humerus
	Posterior Circumflex Humeral Artery	Proximal end of humerus

    Using this table is a start to good studying for remembering this area, but let me recommend a few more that I have found helpful. Visualizing yourself as a red blood cell and imagining your pathway through the body helps: starting in the aorta, moving through the subclavian artery, continuing down the axillary artery and then taking a sharp turn into the subscapular artery to supply the subscapularis as it is hard at work swimming or throwing a baseball.
     Secondly, use mnemonics! Med students have come up with all sorts of interesting mnemonics for remembering different sorts of information (the funniest in my mind have been for the cranial nerves). The axillary artery is no different: Screw The Lawyer Save A Patient moves you through sections one to three in descending order and the arteries that branch off. 
     There are a few more that you can find here but I encourage you to come up with some of your own. Be creative, be funny and maybe a little rude- those seem to stick the best. We'd love to hear some feedback from you with some of your favourites, so if you have any that come to mind jot them down in the comments section.
      And if you are looking for more ways to learn about or become more proficient with anatomy, physical assessment, physical medicine or clinical conditions take a look at our products, thanks!
     

The Infamous Ankle Sprain

Now, we've all heard of an ankle sprain and if you don't have first hand experience, you for sure know or heard of someone who has suffered from this. But what does it mean when someone has sprained their ankle? How does one heal from it?

There are 2 types of ankle sprains: inversion and eversion ankle sprains. Inversion is twisting your foot inwards (where the sole of your foot is facing in) and an eversion sprain is twisting your foot outwards (where the sole of your foot is facing out). The first type is the most common.

It usually happens when you "roll" onto the outside of your foot and may have sensed a popping/tearing sensation.They can happen in so many different ways and at different severity's, as outlined below.

Grades of Ankle Sprains from Conditions Manual by Dr. M. Carnes and Dr. N. Vizniak

But now we know what it is, how do we heal from it? Up to 72 hours after injury, just remember PRICE.

1. P - Protect the ankle with splints, tape, or loose lace-up support. Don't want to injury yourself even more now, do we?
2. R - Rest by reducing any weight bearing activities, but try to return to activity ASAP (don't want to be resting too long).
3. I - Ice 20 minutes on with 1 hour intervals to control any inflammation and reduce secondary injury (this is especially important within the first 24 hours).
4. C - Compression. This can be done with elastic wrap or tape, or even keeping your shoe on while on the field (if injured in such a manner) to help with any swelling. If there's little room to swell, the swelling can only go so far!
5. E - Elevate your leg to allow you to rest up and help control swelling for the first 48 - 72 hours.

After the first 72 hours, you want to wean yourself off crutches and try to get back to pain free activities. Once you've mastered one activity pain free, try to challenge it a little more. BUT make sure you don't overdo it! We don't want to re-injure ourselves now do we?

A great way would be to start with alternating pointing toes and bringing the toes back while sitting. Once that no longer hurts, then try doing it while you're standing (stand on your tippy toes and back down). Once you've jumped that hurdle, let's go for a walk. It's great weather now, so why not go for a walk, barefoot, on the beach? The uneven surfaces of the beach really challenges those muscles and helps your muscles/ligaments heal much better. Besides, exercising and healing while having the sun shining on your face, breathing the fresh air, and hearing the waves crashing on the shore - can you think of a better way to heal yourself? 

Continue with these exercises and continue to challenge yourself once you've reached the "pain free activity" stage until you're pretty much back to your normal self! Now you're able to walk properly again and got a sweet tan, perfect.

To learn more about ankle sprains, how to manage them, or learn about other conditions that can afflict our fabulous bodies, click here to order the Conditions Manual. 

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is an issue afflicting many people every day, often due to overuse and repetitive movement of the wrist (specifically the flexor muscles). Actions such as typing, massaging and rock climbing are activities known to contribute to this problem. 

CTS is caused by entrapment of the median nerve between the flexor retinaculum (a ligament that acts as a pulley for the flexor tendons) and the carpal bones (the two structures making the tunnel). Both the median nerve and wrist flexors run between those two structures, so when inflammation occurs, and neither the flexor retinaculum nor the carpal bones are able to expand to help relieve pressure, the median nerve is ultimately compressed. 

Patients with CTS will often present with numbness, tingling, weakness and pain extending from the wrist, into the palm of the hand and up into the thumb, pointer, middle and lateral half of the ring finger. If compression is before the tunnel and the palmar branch is affected, patients will experience symptoms in the middle of the palm.  They may also present with the ‘flick maneuver’ to relieve pain which is exactly as it sounds, a flicking of the wrist as though they were trying to get some water off of it. 

Compression of the median nerve can occur in numerous other places and it is important to rule them out before confirming CTS. Compression can occur at the vertebrae as the nerve exits, between the scalene muscles, under the clavicle and between the heads of the pronator teres muscle. 

For more information on Carpal Tunnel Syndrome, the tests to confirm or rule it out, please refer to Professional Health Systems’ Conditions Manual. 

A section of the wrist displaying the carpal bones, flexor tendons, median nerve (black oval) just above the tendons, and the flexor retinaculum running above those structures.  

Hello! And welcome to Professional Health Systems’ new blog!

We’re excited to have this up and running and also to begin supplying you with new content covering both anatomy, clinical issues and links to any interesting articles we find that we think you may also enjoy.

Supplying the blog will be two students from The Boucher Institute of Naturopathic Medicine- Katherine Chung and Jordan Morton. 

To learn more about Professional Health Systems, check out the website! And please contact us with any questions or comments you may have, thanks.