5 Cardinal Signs of Inflammation

Cardinal signs are special to people who follow astrology. It's much the same way with physicians, who rely on cardinal signs to help them make a diagnosis, such as for inflammation.

Inflammation is how your body responds to infection. Five cardinal signs characterize this response: pain, heat, redness, swelling, and loss of function.

Not all five cardinal signs are present in every case of inflammation. And when the condition is truly sneaky, it can be silent and spawn no symptoms at all.

This article describes the two types of inflammation—acute and chronic—and details the five cardinal signs. It also discusses additional signs and complications of the condition as well as treatment options.

What Is Inflammation?  

Inflammation is a complex process involving a variety of cell and signaling proteins that protect the body from infection and foreign substances, such as bacteria and viruses. Inflammation helps the body by producing white blood cells, which your body needs to fight infection.

Sometimes, the immune system triggers an inflammatory response inappropriately. This is the case with autoimmune diseases. The body compensates by attacking its own healthy tissues, acting as if they are infected or abnormal.    

When the inflammation process starts, chemicals in white blood cells are released into the blood and the affected tissues to protect the body. The chemicals increase blood flow to the infected or injured body areas, causing redness and warmth. 

These chemicals may also cause leaking of fluids into tissues, resulting in swelling. This protective process can also stimulate nerves and tissues, causing pain. 

3 Basic Causes

The causes of inflammation are extensive but can be broadly classified as:

• Biological, such as infections, diseases, and abnormal immune responses (including autoimmune diseases, atopy, allergy, and drug hypersensitivity)
• Chemical, including poisons, toxins, and alcohol
• Physical, such as injuries, burns, frostbite, or radiation exposure
  

Inflammation of any type can be acute or chronic.

Acute Inflammation

Acute inflammation may include heat (sometimes from fever) or warmth in the affected area. 

Acute inflammation is a healthy and necessary function that helps the body attack bacteria and other foreign substances in the body. Once the body has healed, inflammation subsides. 

Examples of conditions that cause acute inflammation include:

• Acute bronchitis, which causes inflammation of the airways that carry air to the lungs
• An infected ingrown toenail
• A sore throat related to the flu
• Dermatitis, which describes multiple skin conditions, including eczema, which causes red, itchy inflamed rashes in areas where the skin flexes (such as inside the elbows and behind the knees)
• Physical trauma
• Sinusitis, which can cause short-term inflammation in the membranes of the nose and surrounding sinuses (usually the result of a viral infection)
• Skin cuts and scratches
  

Chronic Inflammation

Chronic inflammation, on the other hand, may continue to attack healthy areas if it doesn't "turn off." It may not be as visible as acute inflammation because it includes:

• Inflammatory arthritis, which covers a group of conditions distinguished by inflammation of joints and tissues (including rheumatoid arthritis, lupus, and psoriatic arthritis)
• Asthma, which causes inflammation of the air passages that carry oxygen to the lungs. Inflammation causes these airways to become narrow and breathing to become difficult. 
• Periodontitis, which causes inflammation of gums and other supporting teeth structures. It is caused by bacteria triggered by local inflammation.
• Inflammatory bowel disease (IBD), which, like Crohn’s disease and ulcerative colitis, results in chronic inflammation in the gastrointestinal (GI) tract  

Cardinal Signs 

The five cardinal signs of inflammation are common enough that you should be able to spot them immediately:

Pain

With both acute and chronic inflammation, pain is the result of inflammatory chemicals that stimulate nerve endings, causing the affected areas to feel more sensitive.

Inflammation can cause pain in joints and muscles. When inflammation is chronic, a person will experience high levels of pain sensitivity and stiffness. The inflamed areas may be sensitive to touch. 

Heat

When inflamed areas of the body feel warm, it is because there is more blood flow in those areas.

People with arthritic conditions may have inflamed joints that feel warm to the touch. The skin around those joints, however, may not have the same warmth. Whole-body inflammation may cause fevers as a result of the inflammatory response when someone has an illness or infection.  

Redness 

Inflamed areas of the body may appear red because the blood vessels of inflamed areas are filled with more blood than usual.

Swelling 

Swelling is common when a part of the body is inflamed. It results from fluid accumulating in tissues either throughout the body or in the affected area.

Swelling can occur without inflammation, especially with injuries. 

Loss of Function         

Inflammation may cause loss of function related to both injury and illness. For example, an inflamed joint may not move properly or a respiratory infection may make it difficult to breathe. 

The reason for all these symptoms is the same: Cytokines released into the bloodstream lead to increased vascular permeability, or the ability of molecules to pass through blood vessels and reach tissue. Cytokines are molecules that encourage your cells to communicate with each other. A healthy immune system depends on them.

Additional Signs and Complications

When inflammation is severe, it may cause additional signs and symptoms, including:

• Exhaustion
• Fever
• General feeling of sickness 

Inflammation due to illness may have dangerous complications, including a condition called sepsis. This occurs when the body's immune system overwhelmingly responds to a serious infection, which leads to generalized, life-threatening tissue damage.

Treatment 

it's vital to identify and treat the underlying cause of inflammation, be it infection or another issue.

In many cases, treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

NSAIDs

NSAIDs can alleviate pain associated with inflammation. They also counteract enzymes that contribute to inflammation in order to reduce these processes. Examples of NSAIDs are ibuprofen and naproxen, which are available without a prescription. 

Sometimes, healthcare providers will prescribe stronger NSAIDs for people who have chronic inflammation. These include Mobic (meloxicam) and Celebrex (celecoxib).

Long-term use of NSAIDs has been associated with stomach ulcers and GI bleeding. So it's important to talk to your healthcare provider before using NSAIDs for longer than 10 days. 

NSAIDs may intensify some conditions, including asthma and kidney problems. They can also increase the risk for strokes and heart attacks.

Corticosteroids

Corticosteroids are known for preventing inflammation. There are two different types of corticosteroids—glucocorticoids and mineralocorticoids:

• Glucocorticoids are prescribed for inflammation-producing conditions such as inflammatory arthritis, IBD, asthma, and allergic reactions. They are available in pill form and as injections and inhalers. Creams and ointments can be prescribed to manage inflammation of the skin, eyes, and nose.
• Mineralocorticoids are often prescribed to people with adrenal insufficiency, which happens when the adrenal glands fail to produce enough hormones.

Corticosteroid side effects are more common when taken by mouth. Inhalers and injections may reduce side effects. Inhaled medication can cause oral thrush (fungal infection) in the mouth, so rinsing with water after use is important.  

Additional side effects may include:

• Acne
• Blurred vision
• Easy bruising
• Face swelling
• Higher blood pressure
• Increased appetite and weight gain
• Mood swings
• Nervousness or restlessness
• Stomach irritation
• Water retention and swelling
  

Long-term use of corticosteroids has been associated with:

• Cushing syndrome, a condition that results from exposure to corticosteroids. Symptoms include a fatty hump between the shoulders, purplish stretch marks, and a swelled face.
• Heart disease
• Osteoporosis, a bone-weakening condition
• Ulcers and stomach bleeding
  

Summary

Inflammation occurs as your body fights infection. And as it wages the fight, you may experience pain, heat, redness, swelling, and loss of function. The symptoms are common enough, but it's still smart to learn the differences between acute and chronic inflammation. It probably will make a difference in how your particular case of inflammation is treated.

A Word From Verywell

Inflammation is a necessary part of the healing process and usually nothing to worry about. But when inflammation is chronic, it can be a serious health problem. See your healthcare provider to identify the source of the inflammation. It's the first step toward proper treatment.