Issue link: https://www.massageandbodyworkdigital.com/i/1037165
100 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 8 themselves have strong anti-infl ammatory capacities) and other cells begin new tissue formation. Local warmth and redness diminish, as does pain—though pressure or stretch can still provoke protective tenderness as the new tissues form. Adaptation In the days, weeks, or months that follow, the proinfl ammatory process gradually matures and diminishes as the fi rst- responder cells themselves become the target of degradation and cleanup via phagocytic, lymphatic, and other resolution mechanisms. Tissue strengthening continues, as fi broblasts cross-link collagen structures. Sensation normalizes and tenderness diminishes as the adapting brain gradually reevaluates and relinquishes the need for protective guarding. CHRONIC INFLAMMATION Problems arise when any of these stages fails to resolve, and the infl ammation becomes ongoing or chronic. This can happen when the immune system is overwhelmed by pathogens or damage, or when its resilience is taxed by stress, inactivity, diet, lack of sleep, etc. Factors such as adverse childhood experiences 4 or genetics can also predispose us to chronic infl ammation. But the causes of many chronic infl ammatory conditions are not fully understood. These include autoimmune disorders, such as rheumatoid arthritis; fi bromyalgia; and "infl amm-aging," the low- grade infl ammation-like changes that accompany aging. In prolonged infl ammation: • Fibroblasts, which usually have strong anti-infl ammatory effects, can instead play an infl ammatory role. Together with myofi broblasts, their unregulated activity over time can cause tissue fi brosis, stiffening, and pathologic scarring. • Treatment-resistant depression is more common, supporting the idea that some depression has infl ammatory causes. 5 • Pain can be persistent and diffi cult to treat. A recent study found that pain sufferers who didn't respond to other forms of therapy had higher levels of chronic infl ammation, suggesting (though not confi rming) that infl ammation can directly trigger persistent pain responses. 6 I'll talk more about the link between pain and infl ammation in the next issue. NEXT There is a lot more to know about infl ammation, of course. Later, I'll be writing about: • Local and systemic infl ammation • Pain, infl ammation, and the neuroimmune system • Ways to use what we know about infl ammation in our hands-on work. Special thanks to Robert Schleip and Ruth Werner for their ideas and input. Notes 1. E. Bullmore, The Infl amed Mind: A Radical New Approach to Depression (Australia: Simon & Schuster, 2018); F. R. Balkwill and A. Mantovani, "Cancer-Related Infl ammation: Common Themes and Therapeutic Opportunities," Seminars in Cancer Biology 22, no. 1 (February 2012): 33–40, https://doi.org/10.1016/j.semcancer.2011.12.005; B. Kennedy et al., "Geroscience: Linking Aging to Chronic Disease," Cell 159, no. 4 (November, 2014): 709–13, https://doi.org/10.1016/j.cell.2014.10.039. 2. I. R. Klein-Wieringa et al., "Infl ammatory Cells in Patients with Endstage Knee Osteoarthritis: A Comparison Between the Synovium and the Infrapatellar Fat Pad," Journal of Rheumatology 43 (2016): 771–8. 3. C. N. Serhan and J. Savill, "Resolution of Infl ammation: The Beginning Programs the End," Nature Immunology 6 (2005): 1191–7, https://doi.org/10.1038/ni1276. 4. N. N. Burke et al., "Psychological Stress in Early Life as a Predisposing Factor for the Development of Chronic Pain: Clinical and Preclinical Evidence and Neurobiological Mechanisms," Journal of Neuroscience Research 95, no. 6 (July, 2016): 1257–70, https://doi.org/10.1002/jnr.23802. 5. E. Bullmore, The Infl amed Mind. 6. J. Lasselin et al., "Low-Grade Infl ammation May Moderate the Effect of Behavioral Treatment for Chronic Pain in Adults," Journal of Behavioral Medicine 39, no. 5 (October 2016): 916–24, quoted in P. Ingraham, "Chronic, Subtle, Systemic Infl ammation: A Possible Insidious Cause of Mysterious Chronic Pain," last updated February 19, 2018, accessed September 2018, www.painscience.com/articles/ infl ammation-chronic-subtle-systemic.php. Til Luchau is the author of Advanced Myofascial Techniques (Handspring Publishing, 2016), a Certifi ed Advanced Rolfer, a practice coach, and a member of the Advanced-Trainings.com faculty, which offers online learning and in-person seminars throughout the United States and abroad. He invites questions or comments via info@advanced- trainings.com and Advanced-Trainings.com's Facebook page. THE SOMATIC EDGE 3 Swelling, warmth, redness, and pain of acute infl ammation. Though uncomfortable, these are signs of the healing processes at work. Watch Til Luchau's technique videos and read his past articles in Massage & Bodywork's digital edition, available at www.massageandbodyworkdigital.com, www.abmp.com, and on Advanced-Trainings.com's YouTube channel. Watch Til's ABMP video playlist where all his videos have been compiled. "Infl ammation"