Healthy Islands: What is the Situation with INFLAMMATION? By Christopher Mainella


Hello Denman and Hornby Community,

PhysioAlternativeChristopher Mainella here, certified and registered Physiotherapist with the BC College of Physiotherapists, I provide Physiotherapy receipts if you are claiming on your extended health benefits or MSP Premium (which covers $23/session up to 10 sessions). I am currently working on Wednesdays out of the Hornby and Denman Health Care Society building on Hornby and Fridays out of the Denman Medical Clinic. I have recently completed an advanced training in Vestibular Rehabilitation, if you have any issues with vertigo, dizziness, loss of balance please contact me.

Most of us, I am quite sure, have had some form of injury, condition or illness in which inflammation was present in our body. Symptoms may have presented themselves as; pain, an increase in fluid build up and in temperature, bruising the colors of a rainbow and/or redness locally. Then the questions we may have asked ourselves were; what is going on? what can I do? who can help me?

Inflammation is the body’s attempt at self-protection. The aim of any kind of inflammation is to remove harmful stimuli, including damaged cells, irritants, or pathogens – and begin the healing process. When something harmful affects a part of our body, there is a biological response which tries to remove it. The signs and symptoms of inflammation, specifically acute inflammation, show that the body is trying to heal itself (Parkin, 2016).

So why the need to stop it before it starts? Why are we prescribed and why do we choose to use anti-inflammatories (NSAIDs) immediately instead of allowing the body to heal itself first? What about plant medicine, diuretics, adaptogens?

Many studies are now showing that if the body is allowed to go through its natural inflammatory process, the recovery time may be about the same but most importantly the chance of re-injury decreases and there is more optimal tissue repair. Inflammation at times is our friend not our foe!

For example, anti-inflammatory modalities are commonly used for the treatment of various musculoskeletal injuries. Although inflammation was originally believed to interfere with skeletal muscle regeneration, several recent studies have highlighted the beneficial effects of inflammatory cells on muscle healing. This discrepancy is attributable to an evolving understanding of the complex inflammatory process (Duchesne, Dufresne, Dumont, 2017).

“When you don’t eat healthy, don’t get enough exercise, or have too much stress, the body responds by triggering inflammation,” says Varinthrej Pitis, MD.

There are different approaches and factors to consider between acute vs. chronic inflammation, local vs. systemic. There are always exceptions to the rule and we should make choices in those situations on a case by case basis. When we seek out help in relation to our inflammation we are often provided with quick fixes and band-aid solutions that may have long term consequences. We may need to re-learn the concept that the body often has the appropriate tools to heal itself and we need to allow it the appropriate time to do so.

Rehabilitation of soft tissue injuries can be complex. Over the years, acronyms guiding their management have evolved from ICE to RICE, then to PRICE (Protect, Rest, Ice, Compression, Elevation). Although widely known, the evidence for these treatments is limited. ICE/RICE/PRICE focus on acute management and ignore sub-acute and chronic stages of tissue healing. These two new acronyms encompass the rehabilitation continuum from immediate care (PEACE) to subsequent management (LOVE). PEACE & LOVE (see image below) underscores the importance of educating patients and addressing psychosocial factors to enhance recovery. The acronyms flag anti-inflammatories and their potentially harmful effects on optimal tissue repair. It is suggested that they not be included in the standard management of soft tissue injuries (Dubois, Esculier 2019).

What can Physiotherapists do to help: Physiotherapists generally use techniques that include heat therapy, cold therapy, therapeutic electrical stimulation, therapeutic ultrasound, traction and massage. They also can provide education on pain reduction strategies and the inflammatory phases, beneficial movement patterns, how to use assistive equipment, when and how to return to activities and how to avoid re-irritating the injury.

My contact information: Physio Alternative (,, (514) 605-9398 (Montreal based number)