What are the Stages of Inflammation?


Inflammation is a result of damage to body tissues and can be caused by a number of factors including trauma, repetitive use and those conditions affected by age such as Osteoarthritis.

The are three main stages of inflammation which can each vary in intensity and duration:

  1. Acute -swelling stage
  2. Sub-acute – regenerative stage
  3. Chronic – scar tissue maturation and remodelling stage

During the acute inflammatory stage, there is evident redness (erythema) and swelling due to vascular changes.  Exudation of cells and chemicals cause swelling and pain.  A haematoma may form if there is bleeding within the tissues.  Secondarily, chemical irritants are neutralized and the area is sealed off from surrounding tissues and circulation is impaired.  There is early fibroblastic cell activity. Pain is normally present at rest over a diffuse area and can be aggravated by activity. Secondary muscle spasm and guarding normally restrict passive movement.  During range of movement testing, pain is felt before the tissue resistance is reached.  Injuries to deep structures or poorly vascularised areas can lead to surface swelling and oedema but may not be noticeable.

The sub-acute stage is the commencement of healing and repair.  Noxious chemicals are further neutralized and new capillary beds growing into the damaged areas are supported by connective tissue growth (collagen fibres) and together form granulation buds.  Visible signs of inflammation start to subside and range of movement increases with pain felt at the point of tissue resistance.

The chronic inflammatory stage is the period when tissue remodelling takes place.  Signs of inflammation are absent and scar tissue is maturing. Pain is felt further into the range of movement after the tissue resistance has been reached.  Maturation refers to the growth of the fibroblasts to fibrocytes and remodelling refers to the organization of and shrinking of collagen fibres along the lines of stress.

The skill of the physiotherapist is to identify the exact stage of the inflammation and then intervene to enhance the healing process with the most appropriate form of treatment.

If you have an injury which requires attention, please feel free to contact the G4 clinic to discuss with a physiotherapist in Didsbury, Manchester.

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