Inflammation

Inflammation is the process by which your body's white blood cells and the chemicals they produce protect you from infection by outside invaders like bacteria and viruses. However, in some disorders, such as arthritis, your body's defence mechanism, or immune system, causes inflammation even when there are no invaders to fight. In autoimmune diseases, your immune system reacts as though normal tissues are infected or otherwise unusual, causing damage.

Inflammation types:
Inflammation can be either acute or chronic in nature (chronic). Acute inflammation resolves in a matter of hours or days. Chronic inflammation can last for months or years after the initial cause has passed. Chronic inflammation is associated to the following conditions:

• Cancer
• Heart disease
• Diabetes
• Asthma
• Alzheimer’s disease

Inflammation and arthritis:
Some types of arthritis are the result of inflammation, such as:

• Rheumatoid arthritis
• Psoriatic arthritis
• Gouty arthritis

Other painful joint and musculoskeletal disorders that aren't caused by inflammation include osteoarthritis, fibromyalgia, muscular low back pain, and muscular neck pain.

What are the symptoms of inflammation?
Symptoms of inflammation include:

• Redness
• A swollen joint that may be warm to the touch
• Joint pain
• Joint stiffness
• A joint that doesn’t work as well as it should

Often, you’ll have only a few of these symptoms.

Inflammation may also cause flu-like symptoms including:

• Fever
• Chills
• Fatigue/loss of energy
• Headaches
• Loss of appetite
• Muscle stiffness

What causes inflammation, and what are its effects?
When you have inflammation, substances from your white blood cells enter your blood or tissues to defend you against invaders. This increases blood flow to the site of damage or infection. It can produce flush and warmth. Some of the chemicals cause fluid leakage into your tissues, which causes swelling. This protective process may produce nerve stimulation and pain.

Higher numbers of white blood cells and the things they make inside your joints cause irritation, swelling of the joint lining, and loss of cartilage (cushions at the end of bones) over time.

How are inflammatory diseases diagnosed?
Your doctor will ask about your medical history and do a physical exam, focusing on:

• The pattern of painful joints and whether there are signs of inflammation
• Whether your joints are stiff in the morning
• Any other symptoms
• They’ll also look at the results of X-rays and blood tests for biomarkers such as:
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)

Can inflammation affect internal organs?
Inflammation can affect your organs as part of an autoimmune disorder. The symptoms depend on which organs are affected. For example:

• Inflammation of your heart (myocarditis) may cause shortness of breath or fluid build-up.
• Inflammation of the small tubes that take air to your lungs may cause shortness of breath.
• Inflammation of your kidneys (nephritis) may cause high blood pressure or kidney failure.

You might not have pain with an inflammatory disease, because many organs don’t have many pain-sensitive nerves.

Inflammation treatment:
Inflammatory diseases may be treated with drugs, rest, exercise, and surgery to correct joint damage. Your treatment plan will be determined by a number of factors, including the type of disease, your age, the medications you're taking, your overall health, and the severity of your symptoms.

The goals of treatment are to:

• Correct, control, or slow down the disease process
• Avoid or change activities that aggravate pain
• Ease pain through pain medications and anti-inflammatory drugs
• Keep joint movement and muscle strength through physical therapy
• Lower stress on joints by using braces, splints, or canes as needed

Medications:

Many drugs can ease pain, swelling and inflammation. They may also prevent or slow inflammatory disease. Doctors often prescribe more than one. The medications include:

•  Nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin, ibuprofen, or naproxen)
• Corticosteroids (such as prednisone)
• Antimalarial medications (such as hydroxychloroquine)
• Other medicines known as disease-modifying antirheumatic drugs (DMARDs), including azathioprine, cyclophosphamide, leflunomide, methotrexate, and sulfasalazine
• Biologic drugs such as abatacept, adalimumab, certolizumab, etanercept, infliximab, golimumab, rituximab, and tocilizumab