Inflammation is defined as a localized protective response elicited by injury or destruction of tissues which serves to destroy, dilute or wall off the injurious agent and the injured tissues. The inflammatory response can be provoked by physical, chemical and biological agents including mechanical trauma as well as psychological trauma.
It is important to understand that inflammation is the root of the problem when we have low back pain. No matter what the type is, all types of low back pain have an inflammatory component because inflammation is the first phase of the healing process. Inflammation happens first. The body’s immune system recognizes damaged cells and the inflammatory response is there to block off the damage and reabsorb all of the dead cells so that the body can move on and lay down new tissue, new cells and ultimately heal the injured area.
So all low back pain has a component of physical stress where friction and motion that is improper is creating damage to the tissues whether it is bones, muscles, ligaments or tendons. We are getting physical trauma that is damaging the tissues and the body responds by getting inflamed. Inflammation is ultimately then creating fluid pressure around nerves and creating pain signals to the brain. We know that inflammation is normal but we often times, many, many times see patients that are in chronic inflammatory state where the inflammation is not going away. The reason it is not going away is because the root of the problem is not being addressed. So in this chapter we are here to talk about the 4 main causes of inflammation in the body.
The number 1 important one is what physical therapy is designed to reduce which is the physical stress on the part of the body which is causing damage and then ultimately inflammation.
That is very, very important to do. We are going to talk about, in the next chapter, ways to do that and what are the areas of the body that are contributing or that aren’t to contributing to cause the lower back to ultimately have too much physical stress. But for this chapter, identifying that physical stress is the most important thing to reduce to get the inflammation to go down. Think about it like the inflammation needs to end. It needs to go through its normal process and then the phases of healing continue. Physical stress.
The second one is emotional stress.
We know that a hormonal response happens when we have psychological stress. That hormonal response releases a chemical called cortisol which is a stress hormone. Cortisol ultimately increases the inflammation in the body so that we have more of it. Our body is more heightened. We are more sensitive to damage. The body will get inflamed more aggressively. We know that the emotional state of the individual has huge effects on inflammation of the body. We also know that lack of sleep has a very large effect on the cortisol levels.
So therefore sleep patterns affect how the body responds to damage and ultimately how much inflammation that there is.
We also know that nutrition is a very important aspect of what is happening.
This is probably the newest topic that is out there. We know that foods that we eat can either decrease the inflammation in our body or increase the inflammation. Foods that increase the inflammation are flours and sugars. So simple carbohydrates, they break down to sugar right in your mouth with the help of digestive enzymes and ultimately these simple sugars, simple carbohydrates are a going to feed the inflammation response in the body. As the body tries to break down the agents, the immune cells secrete inflammatory messengers called cytokines. Depending on where the inflammation occurs and your genetic predisposition, this could evidentially result in arthritis, cataracts, heart disease, poor memory, wrinkled skin and ultimately just increased inflammation in the body. So we want to avoid the simple carbohydrates. We also want to avoid any foods that we have sensitivities to or are allergic to. That is also going to create this stress response and the hormones for cortisol to increase inflammation. We know that eating a very colorful diet, reds, oranges, purples, dark greens. These have antioxidants which dampen the inflammatory effect. They help our body build cells. We also know that eating lean protein is very effective in reducing inflammation. And the opposite would be true. Consuming lots of red meat with lots of fat is going to increase our level of inflammation in the body. Also beyond the concern of sodium of nitrates, red meat contains high amounts or arachidonic acids that can promote inflammation. Other food sources to consider include eggs and dairy products as well. Finally, for nutrition, looking at the type of oil that you are using when you are cooking. We know that we want to avoid refined trans fat, Omega 6 oil in cooking oil and use more olive oil. Omega 6 oils would include soy, corn and cottonseed oil. Olive oil is a great source of oleic acid making it a powerful anti-inflammatory. Spanish researchers reported in the Journal of American College of Nutrition that people who consume more oleic acid have better insulin function and lower blood sugar. We also know that pasture-fed livestock, flax, chia and hemp seeds, wild salmon (not farmed) or smaller cold water fish such as herring, sardines and mackerels are your best choices of high powered anti-inflammatory foods. So diet has a huge effect.
So review here: we know that physical stress, emotional stress, lack of sleep and poor nutrition are going to affect the inflammatory response. It is important to identify that because the normal treatments that are out there right now are basically altering the inflammatory response by things such as cortisone injections, oral steroids, anti-inflammatory medications such as ibuprofen or any NSAIDs. These are things that alter the body’s inflammation response but ultimately do not get to the root of the problem. They do not fix the inflammation response because inflammation is a normal phase of healing so our body is still getting damaged. We are just hiding it. We are masking the problem. That is really where getting to these 4 main factors: physical stress, emotional stress, lack of sleep and poor nutrition are going to be ways that people can find permanent solutions to their back pain. Regardless of the type of back pain, it is important to understand that inflammation is the source of what you are feeling. So whether it is SI joint pain, disc herniation or stenosis, all of those have inflammation around the nerve root that is coming out of the spine. So if we want to not alter the problem, if we want to find a permanent solution, if we want to fix the problem, we need to address the 4 main factors that cause inflammation in the body. If we can address that, the body will stop being damaged. The inflammation will stop happening and we will feel better and will have pain free motion.
In the future chapters we are going to be talking about ways that we can reduce the physical stress. What are the common parts of the body that are contributing to the physical stress?
If you would like more information on this topic we are hosting a lower back pain and sciatica workshop to address inflammation as it relates specifically to the low back. Click Here for more Info.