– 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.



(1) Trauma

– 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 .

– Electrical

– Chemicals like acids, bases and metals .

(2) Infections

– Viruses

– Fungi

– Bacteria

– Protozoa.


(3) Infarction


– Obstruction of blood flow results in ischemic and necrosis.

(4) Degenerative conditions

– Osteoarthritis


(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 .


(5) Supporation


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 :

√ Rest

√ Ice massage

√ Compression

√ Elevation.


(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



√ Ultrasound.





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