While there is a tendency to consider the inflammatory response as a reaction that is harmful to the body, a more balanced view is that it is actually a protective and restorative response.
I explain to my patients that inflammation stops them from doing the very movement that causes pain or injury. The splinting or spasming they feel in adjacent muscles is a signal to STOP, the muscle are actually protecting the deeper structures ( discs, ligaments, and tendons) from further injury.
The healing process is very complex and involves more than just an inflammatory response. Tissue that has been injured must be repaired. It is well established that nutrients can be rate-limiting factors for tissue repair and wound healing. For example, vitamin C deficiencies have been directly linked to slow wound healing.
THE INFLAMMATORY RESPONSE
The classic signs of inflammation are local redness, swelling, heat, pain, and loss of function. The events of inflammation that underlie these manifestations are induced and regulated by a large number of chemical mediators, including eicosanoids, kinins, complement proteins, histamines, and monokines. Some forms of anti-inflammatory therapy involve regulating the production of some of these chemical mediators. For instance, the regulation of eicosanoids synthesis is a classic mechanism for controlling inflammation
Eicosanoids
Eicosanoids are short-live, hormone-like substances present in tissues throughout the body. They function as mediators of a variety of physiological responses such as inflammation, blood clotting, vascular dilation, and immunity. Eicosanoids can be divided into four classes:
Prostaglandins
Leukotrienes
Thromboxanes
Prostacyclins
Beyond ibuprofen. Natural ways to reduce inflammation
There are a number of herbal remedies that have been reported to help reduce inflammation when you have an injury.
The number of chemical compounds, called phytochemicals, found within the plant kingdom is truly vast and some of the phytochemicals found in certain herbs and plants are reported to demonstrate pain and inflammation-reducing properties. Like aspirin, many are presumed to work by blocking the cyclooxygenase and lipoxygenase pathways and possibly by other mechanisms as well. Bioflavonoids are a broader class of phytochemicals found largely in citrus fruits, tea, and wine. Research suggests that bioflavonoids, such as quercetin, may reduce pain and inflammation by inhibiting cyclooxygenase, lipoxygenase, and phospholipase.
Ginger and Tumeric
Ginger (Zingiber officinale) and turmeric (Curcuma longa), two very popular herbs used within the East Indian system of medicine (Ayurveda), have long been used in folk medicine for a variety of both acute and chronic inflammatory conditions such as sprains and arthritis. Numerous animal and in vitro studies have demonstrated significant anti-inflammatory and antioxidant activities for both ginger and turmeric. These studies suggest that both herbs may block cyclo-oxygenase and lipoxygenase activity, thereby inhibiting prostaglandin and leukotriene release. In addition, turmeric may inhibit the release of histamine.
The anti-inflammatory properties of curcumin, the principal compound found in turmeric, were studied in a double-blind clinical trial of 49 patients with rheumatoid arthritis.Significant improvement was seen, with relief of morning stiffness and joint swelling
Cayenne Pepper
Another compound structurally related to those found in ginger and turmeric is capsaicin, the main constituent of cayenne pepper (Capsicum annuum). Capsaicin may play a role in inhibiting prostaglandin synthesis by blocking cyclooxygenase activity. In addition, cayenne pepper has been shown to possess powerful antioxidant compounds, reduce platelet aggregation, and improve blood circulation, and thus may play a role in reducing inflammation.
Boswellia
Boswellia gum resin, derived from the Boswellia serrata tree, is a traditional Ayurvedic remedy that is used for a variety of inflammatory diseases, such as rheumatoid arthritis, osteoarthritis, and cervical spondylitis. Boswellic acids have also been shown in vitro to inhibit the complement system, a set of enzymes that work with antibodies to attack foreign cells and bacteria. Pathologically prolonged and sustained activation of the complement system is implicated in a variety of inflammatory disorders.
Boswellic acids have been shown to possess anti-inflammatory and anti-arthritic activity in a variety of animal experimental models as well as human studies. Unlike traditional NSAIDs, Boswellia extract appears to exhibit no significant side effects or toxicity.
PROTEOLYTIC ENZYMES
A great deal of the research that describes an anti-inflammatory effect of proteolytic enzymes centers around acute (e.g., sports) injuries, although post-surgery and degenerative joint conditions have been studied as well. In most cases, the patients that received the enzymes demonstrated significant reductions in pain and inflammation and faster recovery rates compared to the placebo groups (the duration of healing was reduced by half in some instances).
*The anti-inflammatory activity of proteolytic enzymes is believed to be, in part, the result of eicosanoid modulation. Animal studies suggest that oral proteases may inhibit the synthesis of pro-inflammatory prostaglandins.
Supplemental proteolytic enzymes are derived from plant and animal sources. Common proteases include bromelain from pineapple; papain and chymopapain from papaya; the fungal protease from the Aspergillus oryzae fungi; and trypsin, chymotrypsin, and pancreatin usually from porcine (pig) or bovine (cow) origins. However, porcine sources yield higher specific activity than do bovine sources.
HOMEOPATHIC REMEDIES
Homeopathic remedies for pain and inflammation have been around for over 100 years. Believed to provide an “energetic” stimulus to the natural healing qualities of the body, homeopathic remedies are reported to be highly effective and at the same time quite innocuous. Traditionally, they have been used for both acute and chronic injuries. The growing interest in alternative medicine and the numerous anecdotal reports of homeopathy’s effectiveness have led to an increase in the number of clinical trials performed. While these trials may not provide scientific explanations as to how homeopathy works, many do support their use.
INFLAMMATION INCREASES FREE RADICAL DAMAGE
A direct result of inflammation is an increase in free radical reaction with the polyunsaturated fatty acids of cell membranes leading to the eventual destruction of the cell. One single free radical can destroy an entire membrane through a self-propagating chain reaction. The body defends itself against free radical damage with an integrated antioxidant defense system that utilizes antioxidants produced naturally within the body and from antioxidants found within foods. During inflammation, the need for a variety of antioxidant nutrients may be increased.
Vitamin E, which is an important membrane antioxidant, provides chain-breaking free radical protection.
It may be especially important to include vitamin E with routine essential fatty acid supplementation since fatty acids are readily oxidized. It has been suggested that long-term fish oil supplementation, for example, may increase lipid peroxidation and compromise vitamin E status.
CONCLUSION
Basically, the idea is to shift the balance of eicosanoid synthesis toward anti-inflammatory mediators and away from pro-inflammatory mediators. Furthermore, it has been suggested that a healthful balance of omega-3 and omega-6 fatty acids leads to better overall health and may help reduce the risk of several common diseases such as hypertension, heart disease, and cancer.
For acute pain and inflammation, a more natural method for inhibiting cyclooxygenase and lipoxygenase pathways (the mechanism behind NSAIDs) is with herbal support such as ginger, turmeric, and Boswellia, and with bioflavonoids. In addition, homeopathic remedies and proteolytic enzymes are widely used as part of a comprehensive holistic approach to managing pain and inflammation.
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Thanks for watching. We’ll see you next week.
-Dr. Loretta
