What is inflammatory pain?

When we talk about "inflammatory pain," we are referring to pain associated with an inflammatory process in the tissues. But contrary to what many people think, inflammation itself does not directly cause pain—rather, it makes your nervous system more sensitive to stimuli.

Understanding this nuance is important for effectively managing this type of pain and choosing the right treatment approaches.

Inflammation: An Essential Healing Process

Why your body creates inflammation

Inflammation is your body's protective response. When you injure yourself, your immune system triggers a cascade of reactions:

• Increased blood flow to the area (resulting in redness and warmth)
• Release of chemicals that attract repair cells
• Swelling that helps immobilize the area
• Nerve sensitivity that encourages you to protect the area

These reactions are essential for healing. Without inflammation, your tissues would not be able to repair themselves effectively.

The classic signs of inflammation

The Romans had already identified the five cardinal signs of inflammation:

• Rubor (redness): due to increased blood flow
• Heat: also due to blood flow
• Tumor (swelling): caused by fluid buildup
• Pain: due to nerve sensitization
• Functio laesa (loss of function): limited movement

How does inflammation cause pain?

An awareness-raising mechanism

Here is something important to understand: inflammation does not usually directly generate nociception (pain signals). Rather, it makes your nervous system more sensitive.

The chemicals released during inflammation (prostaglandins, cytokines, etc.) act on the pain sensors in your tissues and make them more reactive. This is why:

• Light pressure that would not normally hurt becomes painful.
• Movements are more uncomfortable
• The area remains sensitive even at rest.

The pressure of the edema

The swelling associated with inflammation also creates pressure on surrounding tissues, including nerves. This mechanical pressure can itself generate pain signals.

Acute inflammation vs. chronic inflammation

Acute inflammation: Useful and temporary

After an injury, acute inflammation:

• Lasts from a few days to a few weeks
• An integral part of the healing process
• Naturally diminishes as tissues repair themselves

• Recent ankle sprain
• Whiplash following an accident
• Acute tendonitis

Chronic inflammation: When the system goes into overdrive

Sometimes, inflammation persists beyond its useful role:

• It may become "low grade" but constant.
• It continues to sensitize the nervous system
• It can contribute to chronic pain.

• Osteoarthritis (variable inflammatory component)
• Rheumatoid arthritis (autoimmune inflammation)
• Certain chronic tendinopathies
• Inflammatory bowel diseases

Inflammatory pain in common conditions

Osteoarthritis

Contrary to what was long believed, osteoarthritis is not simply mechanical wear and tear. There is often a low-grade inflammatory component that contributes to pain and disease progression.

This is why some people with lumbar osteoarthritis or cervical osteoarthritis experience periods of inflammatory flare-ups with increased pain, morning stiffness, and swelling.

Tendinopathies

Irritated tendons often exhibit an inflammatory response, especially in the early stages. The term "tendinitis" (inflammation of the tendon) is increasingly being replaced by "tendinopathy" because inflammation is not always the dominant mechanism.

Autoimmune diseases

In conditions such as rheumatoid arthritis, the body mistakenly attacks its own tissues, creating chronic inflammation. These conditions require specific medical management.

Strategies for managing inflammatory pain

In the acute phase

Protecting the injured area makes sense in the early days, but prolonged complete rest is rarely beneficial. The goal is to find the right balance between protection and movement.

Applying cold can help reduce inflammation and swelling in the first 48-72 hours. Apply for 15-20 minutes at a time, with protection between the ice and the skin.

For members, these strategies help limit bloating.

NSAIDs (ibuprofen, naproxen) may be useful in the short term, but prolonged use carries risks. Consult a professional before using them regularly.

In the medium and long term

Gradual physical activity promotes healing and helps reduce low-grade chronic inflammation. It is one of the most powerful tools you have at your disposal.

Some foods promote inflammation (refined sugars, trans fats, ultra-processed foods) while others reduce it (fatty fish, colorful vegetables, nuts, olive oil). A Mediterranean-style diet is associated with less systemic inflammation.

Excess adipose tissue produces pro-inflammatory substances. Maintaining a healthy weight reduces this low-grade inflammation.

Poor sleep quality amplifies inflammation. Prioritizing quality sleep is an often overlooked anti-inflammatory strategy.

Chronic stress keeps your body in a state of inflammation. Stress management strategies (breathing, exercise, recovery time) can help.

Physical therapy and inflammation

What physical therapy can do

Physical therapy offers several approaches for inflammatory conditions:

Determine the role of inflammation in your condition and tailor treatment accordingly.

Prescribe exercises that respect the healing phase and promote recovery without aggravating inflammation.

Certain techniques can help modulate local inflammation (manual therapy, modalities).

Helping you understand your condition and manage inflammatory flare-ups.

What you can do

• Maintain regular physical activity appropriate to your condition.
• Recognize the signs of an inflammatory flare-up (heat, redness, increased swelling).
• Adjust your activity level during flare-ups
• Apply the anti-inflammatory strategies mentioned above.

When inflammation does not explain everything

Other types of pain

It is important to recognize that not all pain is inflammatory. Neuropathic pain (related to the nerves) and nociplastic pain (related to sensitization of the nervous system) have different mechanisms and require different approaches.

Mixed pain

In reality, many conditions involve multiple mechanisms. Your back pain or neck pain may have an inflammatory component, a mechanical component, and a sensitization component—all interacting together.

This is why a comprehensive approach, which considers all these factors, is generally more effective than an approach that targets only one mechanism.

Key takeaways

• Inflammation is a healing process —it is useful in the acute phase.

• Inflammation sensitizes rather than directly causing pain —it makes your nerves more reactive.

• Chronic inflammation can contribute to persistent pain and requires a long-term approach.

• Exercise, diet, sleep, and stress management are powerful anti-inflammatory strategies.

• A comprehensive approach that considers all pain mechanisms is more effective than focusing exclusively on inflammation.

Additional resources

• Understanding chronic pain
• Acute pain vs. chronic pain
• Neuropathic pain
• Nociplastic pain
• Pain management strategies