Understanding Inflammation
Inflammation is your body’s natural response to injury or threat. It’s what helps you heal after a cut or fight off infection. While acute inflammation is short-term and protective, chronic inflammation can persist and contribute to health issues, particularly in rheumatic conditions. Chronic inflammation can affect your joints, muscles, and overall well-being, making its management a key focus in conditions like rheumatoid arthritis (RA), lupus, psoriatic arthritis, gout and others.
How do we define chronic inflammation?
When asking this question, it’s important to first ask, what area of the body are we talking about? Common signs of chronic inflammation in the joints include persistent joint pain or swelling, fatigue, prolonged joint stiffness—especially in the morning—and occasional low-grade fevers. Recognizing these patterns early is important, and tracking your symptoms can make a big difference in managing your health effectively. In rheumatology, inflammation can also affect other organ systems (lungs, blood vessels - AKA vasculitis, nervous system, skin, and many more) and so signs of inflammation can vary depending on the organ system involved.
What are signs of inflammation in the laboratory testing?
Elevations in the sedimentation rate (ESR), c-reactive protein (CRP), and platelet count (thrombocytosis) are sometimes elevated in the setting of inflammation (both acute and chronic), and can help in assessing disease. Keep in mind that these lab tests are not perfect! Furthermore, labs in rheumatology are important tools, but by far the most important part of my assessment is talking to YOU and getting a detailed story, coupled with a detailed physical exam. The ESR and CRP can be elevated in the setting of chronic inflammation, such as when RA disease activity is high. However, these labs can also be abnormal if you have a common cold or any other infection. Additionally, there are instances where patients have inflammation, but the ESR and CRP is normal. Each person’s case is truly individual. Let’s not forget, ESR and CRP can also be elevated in cancer.
There are several ways to address inflammation, and it depends on the type/severity of inflammation. The medications we use in rheumatology often need to target different parts of the immune system in order to treat chronic inflammation. Medical approaches, including lab monitoring and personalized treatment plans, are also important. Lifestyle strategies such as eating a balanced diet, staying active with gentle movement, getting adequate sleep, and managing stress all help too. Remember, each person’s experience is unique, so strategies are most effective when tailored to you.
What can you do to be your best advocate
if you think you have symptoms of inflammation?
Know your body well. Get checked out early. Accurately share your symptoms and story with your rheumatologist. It’s my job to be your cooperative partner and do the assessment part, but I rely on your story and details of your symptoms. Getting diagnosed and treated early can make a big difference, so don’t hesitate to reach out.
If you’re experiencing persistent joint pain, fatigue, or other signs of inflammation, I’d be happy to partner with you in finding answers and creating a plan that helps you feel your best.