CHS Inflam Swelling

Inflammation and management of swelling
What is inflammation?
Inflammation is an immune response to injury or infection, causing pain,
redness, heat and swelling. It is a sequence of complex chemical reactions
that work to defend the body. This brings plasma proteins and phagocytes
(white blood cells that engulf and consume foreign material and debris) to the
injured area for the purpose of tissue repair.
Although complex in nature it can be summarised in 7 steps:

Tissue injury

Increased blood flow

Increase in blood uptake of proteins

Movement of fluid into the tissue leading to swelling

Exit of white blood cells from the blood into the tissue

Clearance of damaged cells

Tissue repair

Management of swelling
RICE is recommended during the first 24 to 48 hours post injury to minimise
swelling. It stands for:

Rest
Rest your injured limb in the first 24 hours as much as possible. Avoid regular
exercise and reduce daily physical activity. Using crutches or a walking stick
may help if you are unable to put weight on your ankle or knee.

Ice
Ice is excellent at reducing the inflammatory response and the pain from the
heat generated. It is recommended that ice be used for approximately 15-20
minutes and placed within a wet towel to prevent frost bite or ischemia (poor
blood flow to the tissues) to the skin.

Compression
The use of a support bandage is often helpful in reducing swelling and pain.
Use a compression bandage when you are active and remove at rest.

Elevation
Keep the injured leg, knee, arm, elbow or wrist raised above the level of the
heart as this may also help reduce swelling.

After 48 hours of RICE compression should be stopped and you should try to
move the area. If after this time your symptoms get worse you should seek
further advice from a health professional.

PRICE
You may also see PRICE mentioned in the management of injuries. In this the
P stands for protection. It involves protecting the injured area from further
injury, by using a support, for example, or in the case of an ankle injury,
wearing shoes such as lace ups that enclose and support your feet.

Contrast bathing
Contrast bathing (or hot/cold immersion therapy) is a form of treatment where
a limb or part of the body is immersed in ice water followed by the immediate
immersion in warm water. Use two bowls of water for an ankle or hand injury.
The warm water should be bath temperature and the cold water should have
some ice floating on the surface. Dip for 30 seconds and always start and end
with the warm water. Ten dips should be enough to have a positive effect on
the swelling.

The theory behind this technique is that the warm water causes blood vessels
to open increasing the blood flow followed by the cold water which causes
blood vessels to close. The overall effect is to pump out the swelling.

When to use heat
Heat treatments should be used for conditions that are longer term. It will help
to relax and loosen tissues and to stimulate blood flow to the area. Use heat
treatments for longer term conditions, such as overuse injuries, before
participating in activities.

Heating tissues can be accomplished using a heating pad, or even a hot, wet
towel. When using heat treatments, be very careful to use a moderate heat
for a limited time to avoid burns. Never leave heating pads or towels on for
extended periods of time, or while sleeping.

Do not use heat treatments after activity. Do not use heat immediately after
injury or if the tissues are infected, red or warm to the touch. See the table
below for a guide.

Pain relief
Simple pain killers or anti-inflammatory medication will help to relieve the pain
caused by swelling. Speak to your GP or pharmacist for advice on which
tablets are best for you.

Ice Heat
When? After an acute
injury (e.g. ankle
sprain)
On chronic
conditions or
injuries
How? Ice pack or bag
of frozen peas in
a damp towel
Heat pad, wheat
bag or hot wet
towel
How long? No more than 20
minutes
No more than 20
minutes and never
while sleeping

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