Often when an athlete is injured, they experience swelling to the injured body part. Can you comment on how this swelling occurs?
Yes. When an injury occurs to an extremity, tiny blood vessels called capillaries are often injured. This produces leakage of fluid from the bloodstream, giving rise to swelling. Pain produced from the injury causes the heart to beat faster, which results in more blood pumped to the injured area. In addition, an inflammatory response is made by the body.
What is inflammation?
Inflammation is a chemical response that the body produces in response to an injury. This chemical reaction causes swelling and pain. The entire process is called an inflammatory reaction, and lasts about 2-3 days. Because of the swelling involved, range of motion in a muscle or joint is limited. Therefore, swelling is one of the worst enemies of the athlete. Anything that helps to diminish the inflammatory response, and the associated swelling that goes along with it, will help get the athlete back to activity faster.
How do physicians treat the inflammatory response after an injury? Is it better to use heat or cold to prevent swelling?
There are many ways to diminish the affects of the inflammatory response. The initial stages consist of RICE therapy. Physicians generally do not advise the use of heat during the initial 48 hours after an injury. Heat causes the body to produce more swelling because of the increase in blood flow to the injured body part. Conversely, when ice is applied to an injury, it decreases blood flow thereby diminishing swelling. Compression and elevation also aid in diminishing blood flow the injured area.
What types of medications are helpful in reducing the inflammatory response?
Two types of medications are typically used to control swelling and inflammation. They are steroids and non-steroidal anti-inflammatory drugs (NSAIDs).
What exactly are steroids?
Steroids are naturally occurring hormones that the body produces to combat stress. Some steroids build up tissue (anabolic), and other steroids break down tissue (catabolic). Physicians use catabolic steroids, like prednisone, to fight the effects of inflammation. The medicine may be in the form of an injection or an oral pill.
Are there any side effects?
Yes, but they are relatively rare. Sometimes the injectable form of a steroid may cause a small area of the skin to shrink or die (necrosis). Rarely, oral steroids can cause damage to the hip bone (avascular necrosis), if taken for a long period of time. Moderate weight gain can occur because steroids cause water retention. If a steroid is injected into a tendon, it may weaken the tendon and cause rupture. These side effects are all very rare, however.
What are NSAIDs?
NSAIDs stands for non-steroidal anti-inflammatory drugs, and are a class of drugs which act to diminish inflammation. They do not act as hormones like steroids do. Instead NSAIDs block inflammatory chemical pathways in the body. Ibuprofen is a common anti-inflammatory drug that is currently offered over-the-counter.
Are there any side effects to NSAIDs?
Yes. There is a small chance (1-2%) of stomach ulcer when taking an NSAID. This risk of ulcer is decreased if the medication is taken with food. NSAIDs may also cause shortness of breath in people with a history of asthma. Therefore, it is best if these medications are taken under the supervision of a physician.
Are NSAIDs painkillers?
No. A common misconception that patients tend to have is that if the NSAID does not take away their pain, they will stop taking it. It must be emphasized that while anti-inflammatory medications can decrease some of the effects of pain, their main role is to decrease inflammation and swelling. By decreasing the swelling, much of the pain of most injuries will markedly subside.
- Jason M. Tarno, D.O., is Board Certified and Fellowship trained in Sports Medicine. Dr. Tarno is an associate of Crovetti Orthopaedics and Sports Medicine.For further information call: 990-2290.
Or visit us at: www.CrovettiOrtho.com
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