– Inflammation is defined as the normal physiological response of the living tissues to an injury or external stimuli to wash out the irritants and prevent the spread of infection.
– Physical trauma like wounds , bruises, surgical incisions , crush injuries , and fracture.
– Thermal trauma like heat , wax, chills and burns .
– Radiations like sun burns , UVR, nuclear explosions .
– Chemicals like acids, bases and metals .
– Obstruction of blood flow results in ischemic and necrosis.
(4) Degenerative conditions
(5) Regenerative conditions
– Malignant neoplasms
(6) Allergic response.
• Acute inflammation
– Usually within one week
– Cardinal signs
√ Calor ( heat )
√ Rubor ( redness )
√ Dolor ( pain )
√ Tumor ( Swelling )
• Components or stages of Acute inflammation
(1) Changes in blood flow
– Initially vasoconstriction of blood vessels producing pallor.
– It is then followed by vasodilatation causing increased blood flow producing redness and heat.
(2) Exudation of protein rich fluid
– The blood vessel walls becomes more permeable resulting in escape of protein rich fluid into the surrounding tissues .
– This results in swelling and compression of nerves caused pain.
(3) Leukocyte immigration
– Initially there is rapid blood flow for an hour followed by gradual slowing of blood flow .
– Slowing of blood flow results due to ,
√ cellular concentration or hemoconcentration .
√ loss of water and small molecules rapidly than large molecule .
√ Increased viscosity of tissue fluid.
– Initially leukocytes are present in centre of blood stream (axial flow )
– Later, leukocytes flow towards the margin of vessels ( margination )
– Leukocytes then gets attached to the endothelial cells of the vessel wall.
– They are covered by gelatinous layer
– The Leukocytes produces pseudopodia into the cell gaps and are then driven chemically to the injury site.
(4) Lymphatic drainage
– Lymphatics are thin vessel walls which assists in drainage of tissue fluids
– During resting stage these lymphatics are inactive and closed and collapsed .
– During inflammation these lymphatic vessels transports the waste products from injury sites to the excretory gland .
– If there is an extensive tissue destruction then a hole or cavity is produced called as an abscess
– The cavity is filled with dead polymorphic cells called pus cells .
– It may also contain bacteria due to pyogenic infection
– This process of pus formation is called as supparation.
• Principles of physiotherapy management
– Circulation and tissue fluid interchange must be increased.
– Fascilitates normal respiration
– Removal of secretions
– Maintain joint mobility
– Maintain or improve muscle power
– General health advise
– Prevent further deterioration of symptoms.
– Ergonomic aides
• Means of treatment
(1) RICE :
√ Ice massage
(2) Passive and active ROM exercise to proximal and distal joints .
(3) Ankle foot exercise and elevation to improve circulation and venous return.
(4) If pain subsides isometrics to the affected joints .
(5) Proper support and positioning of the affected limb to prevent deformity or contractures .
(6) For pain relief,
√ Hot packs
√ Wax bath
√ Pulsed ultrasound
(7) Wound healing
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