How to control swelling

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It’s common for an area to become swollen after a soft tissue injury or arthritic flare up. In most cases, swelling (or oedema as it is sometimes called) is the first stage of the healing process and is an entirely normal response. It is caused by an increased movement of fluid and white blood cells to the area and the release of certain chemicals and stretching of the soft tissues and nerves can cause pain. Although unpleasant, pain in the early stages of injury tends to have a positive effect in that it encourages us to mediate and change our activity, protecting it from further trauma. Having said that, swelling (and the pain which often accompanies it) can sometimes be excessive and in some cases, lasts longer than necessary.

In the early (acute) phase of injury or a flare up, using the PRICE acronym can be very helpful:

P = Protection
Protecting the affected area by temporarily immobilising it with a support, sling or even just reducing the weight/pressure through the area may help

R = Relative Rest
Regular pain-free movement is important so please do not rest altogether. However, maintaining the same level of activity or ‘pushing through the pain’ tends to delay or worsen expected recovery rates

I = Ice Therapy
Using ice packs, certainly for the first few days after an injury/flare up, can be extremely helpful at minimising or reducing swelling. It is important you use ice packs safely. First of all, you need to make sure you do not have any reduction in temperature sensation (feeling) around the affected area. Next, rub some oil over the area you are going to treat (any type is fine) and then wrap a damp towel around your ice pack (or bag of frozen peas!). Finally, place your ice pack on the affected part for a maximum of 20 minutes at a time. Using an ice pack for longer than 20 minutes can actually reverse the effect so set a timer or alarm if required. You can repeat your ice therapy every waking hour if you find it beneficial. Coupling ice therapy with elevation (see below) can be a great combination too.

C = Compression of the affected area
Sometimes using a tubigrip or neoprene support/wrap can be helpful. It’s important that you select an elasticated bandage or support which fits you properly. Compressive supports should not feel too restrictive.

E = Elevate the affected area
Positioning the affected area above heart level encourages the swelling to return towards the lymph nodes in the body rather than ‘hanging around’ your arms or legs. It then gets gobbled up and eventually excreted from our system.
For instance, when elevating the leg for a swollen ankle, the foot ought to be higher than the hip and heart. To achieve this, you may need to lie on your back with the leg supported by several cushions or pillows. Coupling this with ice therapy and intermittent pain-free range of movement exercises can have a significant improvement on swollen areas.

It is also important to mention that, after the first couple of days of injury, swelling has an inhibitory effect on the healing process. In some cases, it may be that you are advised to take anti-inflammatory medication to help reduce swelling more quickly. If this is suggested to you, make sure you seek individual guidance from your GP or pharmacist. Sometimes anti-inflammatory medication is contra-indicated for certain health complaints.
If pain becomes your most limiting factor in making a speedy recovery, it may be helpful to take some analgesics. It is essential that you feel able to gradually increase your movement and function in the affected area. If you are limited by pain, you will not be inclined to move the area. As a consequence, joints get stiffer and muscles get weaker. Ultimately, this delays your recovery further and may lead to longer-lasting problems or secondary issues.
Finally, effleurage massage can assist swelling reduction. This treatment method can be delivered by your Physiotherapy Plus team. Get in touch if you think you’d benefit from our help.

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