# Inflammation & Immune Response ##### Untangling Pain ---  --- ## tl;dr - Inflammation can protect and help us heal, but an ongoing immune response can also add to pain. - Women’s immune responses and autoimmune conditions are one part of why this matters. - Hormones and the menstrual cycle may change inflammation and how pain feels at different times. - Oestrogen can have effects in both directions; I notice cyclical, fluey feelings around ovulation myself. - Stress, inflammation, and pain can feed into each other, so it helps to look at the whole pattern. > [!abstract]- Transcript > > This third area that we're going to look at is inflammation and the immune response and why as females this makes us more susceptible to pain. > > The first thing I need to point out is that women generally have a stronger immune system and immune response compared to men. Now obviously this is brilliant because it helps us fight off infections and illnesses so much more effectively than it does in men. > > The problem with this is that it can actually backfire on us too. And this can increase inflammation in our body even when it's not needed. This is the case with autoimmune conditions where the immune system mistakenly starts attacking healthy tissues causing pain and chronic inflammation. > > So having this powerhouse of immune system is brilliant until it's not. > > Inflammation is the body's natural response to injury or illness, and it is designed to protect us. And designed to heal us. So when we have an acute injury, say go over on our ankle, inflammation and pain are there to prevent us from moving so that the body can heal the area. > > And it is these inflammatory chemicals, these cytokines, these prostaglandins, that actually irritate the nerve endings. As a result, they set off the fire alarms and the body produces pain. But when it comes to chronic pain, it's because for whatever reason, the brain thinks that it needs to protect us. > > It becomes oversensitive, it becomes overactive or chronic. And when there is no injury and inflammation is being produced, that is not a good thing. > > There is a time and a place for inflammation, but sometimes the body works overtime and inflammation can become chronic. > > As we mentioned, these inflammatory chemicals can then become the driver of pain by activating the nociceptors or the fire alarms. > > Women have a really powerful immune system, which is why, just as women seem to put in 110% all the time, for everything they do, the immune system sometimes does exactly the same thing, which results in it becoming more overactive, and this can then lead to more pain. > > Now I'm going to go back to hormones again, as hormones play a role in inflammation, and as we know, inflammation as a driver of pain. > > So the things we know are that menstruation and ovulation, they are both inflammatory processes or have similar effects as inflammation. Which may be why some of us experience more pain around these times. The other things that we need to know is that progesterone suppresses the immune system response. > > And this makes perfect sense. The idea is that during the luteal phase, when our body is under the impression that we may be pregnant, it suppresses the immune response so that it doesn't attack the foreign entity during pregnancy. So the immune system down regulates, and this is controlled by progesterone. > > This may mean that if your pain is being driven by inflammation, or if it is one of the drivers, then you may find that during the luteal phase, you may experience less inflammation and less flare ups. Now, that's not the case for everyone. Remember this is a whole big jigsaw puzzle and this is just part of it. > > But it may be worth tracking your menstrual cycle to see if this is the case for you. Because it can give you an idea if inflammation is a driver in your pain. > > Now if you remember me mentioning earlier about the paradox of oestrogen when it came to pain, that it can reduce pain and it can increase it. > > Now this seems to be the case again with oestrogen and the immune system and inflammation. Oestrogen has both pro inflammatory effects. and anti inflammatory effects. So again, it can actually increase inflammation and it can decrease inflammation. But obviously this depends on so many different other factors, different conditions, different amounts. > > But tracking your menstrual cycle is well worth doing because you might find that you get flare ups when oestrogen is higher or things might be better at these points. Now for me, I tend to find that ovulation, or just before ovulation, when my oestrogen is peaking, I can actually feel a little bit fluey. Like I'm coming down with something. And I realise that this is a cyclical thing, and that this probably has more to do with my immune system. > > Oestrogen is increasing the inflammatory response for me, which again, my body thinks is doing this really great job, but it's doing too good of a job. And this is when I can get this feeling. Obviously there are things I can do. But even just knowing that this is the case, knowing that when I feel a little bit poorly around ovulation, it's not because I've done something wrong or that I'm going to be flat out or anything. > > It just means that for a couple of days when my oestrogen levels are higher, I know that my inflammatory response has increased. I know there are a few things I can do to help that, and I know what I need to do to help my body get through that time. > > So finally, just to finish off this little part, I just want to mention the cycle of inflammation and stress and pain. > > As I've already mentioned, chronic stress has been linked to increased pain, but it's also linked to increased inflammation through various mechanisms. So we've got this cycle going on. We've got chronic stress, which leads to inflammation, inflammation that leads to pain and pain causes more stress. > > So everything is connected and it's even more connected as I'm going to show you a little bit later on. Next lesson → [[Untangling Pain – Module 3 Lesson 07 – Emotional & Psychological Factors - Starting With Trauma|Emotional & Psychological Factors - Starting With Trauma]] %% ## Extra ## Version 1: Full Inflammation and the Immune Response in Women This third area that we’re going to look at is inflammation and the immune response and why as females this makes us more susceptible to pain Women generally have a stronger immune system and immune response compared to men This is brilliant because it helps us fight off infections and illnesses more effectively than it does in men The problem is that it can backfire on us too This can increase inflammation in our body even when it’s not needed This is the case with autoimmune conditions where the immune system mistakenly starts attacking healthy tissues causing pain and chronic inflammation So having this powerhouse of immune system is brilliant until it’s not The Role of Inflammation Inflammation is the body’s natural response to injury or illness, and it is designed to protect us And designed to heal us When we have an acute injury, say go over on our ankle, inflammation and pain are there to prevent us from moving so that the body can heal the area These inflammatory chemicals, these cytokines, these prostaglandins, actually irritate the nerve endings As a result, they set off the fire alarms and the body produces pain Chronic pain happens when, for whatever reason, the brain thinks that it needs to protect us It becomes oversensitive, it becomes overactive or chronic When there is no injury and inflammation is being produced, that is not a good thing There is a time and a place for inflammation, but sometimes the body works overtime and inflammation can become chronic These inflammatory chemicals can then become the driver of pain by activating the nociceptors or the fire alarms Women’s Immune System and Pain Women have a really powerful immune system Just as women seem to put in 110% all the time, for everything they do, the immune system sometimes does exactly the same thing This results in it becoming more overactive, and this can then lead to more pain Hormones and Inflammation Hormones play a role in inflammation, and as we know, inflammation is a driver of pain Menstruation and ovulation are both inflammatory processes or have similar effects as inflammation This may be why some of us experience more pain around these times Progesterone suppresses the immune system response During the luteal phase, when our body is under the impression that we may be pregnant, it suppresses the immune response so that it doesn’t attack the foreign entity during pregnancy The immune system downregulates, and this is controlled by progesterone If your pain is being driven by inflammation, or if it is one of the drivers, then you may find that during the luteal phase, you may experience less inflammation and less flare ups That’s not the case for everyone This is a whole big jigsaw puzzle and this is just part of it It may be worth tracking your menstrual cycle to see if this is the case for you It can give you an idea if inflammation is a driver in your pain Oestrogen and Inflammation The paradox of oestrogen when it comes to pain is that it can reduce pain and it can increase it This seems to be the case again with oestrogen and the immune system and inflammation Oestrogen has both pro-inflammatory effects and anti-inflammatory effects It can increase inflammation and it can decrease inflammation This depends on many different other factors, different conditions, different amounts Tracking your menstrual cycle is well worth doing You might find that you get flare ups when oestrogen is higher or things might be better at these points For me, I tend to find that ovulation, or just before ovulation, when my oestrogen is peaking, I can actually feel a little bit fluey Like I’m coming down with something I realise that this is a cyclical thing, and that this probably has more to do with my immune system Oestrogen is increasing the inflammatory response for me My body thinks it’s doing this really great job, but it’s doing too good of a job This is when I can get this feeling There are things I can do Even just knowing that this is the case, knowing that when I feel a little bit poorly around ovulation, it’s not because I’ve done something wrong or that I’m going to be flat out or anything It just means that for a couple of days when my oestrogen levels are higher, I know that my inflammatory response has increased I know there are a few things I can do to help that I know what I need to do to help my body get through that time The Inflammation-Stress-Pain Cycle Chronic stress has been linked to increased pain It’s also linked to increased inflammation through various mechanisms We’ve got this cycle going on Chronic stress leads to inflammation Inflammation leads to pain Pain causes more stress Everything is connected and it’s even more connected as I’m going to show you a little bit later on Resources or Mentioned Cytokines Prostaglandins Nociceptors Menstrual cycle tracking ⸻ ## ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-32.jpeg|slide-32.jpeg]] ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-33.jpeg|slide-33.jpeg]] ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-34.jpeg|slide-34.jpeg]] ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-35.jpeg|slide-35.jpeg]] ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-36.jpeg|slide-36.jpeg]] --- ## Watch the lesson %%