The secret symptoms you need to know to beat inflammation

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Worried about inflammation? Find out more about it, plus the recipes you should be trying to help minimise its effects.

Inflammation is fast becoming the word on everyone’s lips. Doctors are discussing it with patients who are arriving in clinic already convinced they have it. Most of us have heard of inflamed joints, livers and guts, but what about blood vessels, hearts or the brain? That feels harder to grasp.

Any tissue or organ of the body can become inflamed. Long term – or chronic – inflammation is a feature of many medical conditions, including asthma, arthritis and vasculitis. It can also trigger a wide variety of symptoms – some more obvious, some easily missed.

For these reasons, it’s important that we know how to identify inflammation, despite it being tricky to spot.

Redness, swelling, heat and pain are the cardinal features of inflammation, which were first recognised by Ancient Greeks and Roman physicians. Impaired function was later added to the list, but we still typically define inflammation by what it looks like from the outside, even though we need to know the inside story, too.

For instance, an injured knee will typically be a red, warm, swollen joint that’s painful at rest or tender to touch. Loss of function is exhibited as stiffness, immobility or inability to bear weight. Inflammation is the body’s reaction to trauma, when white blood cells rush to the affected area to help repair the injury. This increases blood flow and generates energy (causing redness and heat), irritates local nerves (causing pain) and makes the tissue puffy with fluid.

These are the foundations of inflammation that underpin many other inflammatory signals, which can vary substantially between individuals. But, there are some other common symptoms worth paying attention to.

What to watch out for

Rashes: the skin is a prime place to note inflammatory changes – not just redness (or erythema), which is a key symptom of many chronic inflammatory skin conditions, including eczema, psoriasis and rosacea – but also lumps and bumps, as seen in conditions like acne and hidradenitis suppurativa, when hair follicles and sweat glands become blocked, swollen and sore. Diseases affecting internal organs may also cause skin redness, itchiness or pain – Crohn’s disease, coeliac disease and rheumatoid arthritis can all cause distinctive rashes that are often harder to recognise and diagnose.
Abdominal symptoms: these frequently occur when digestive organs (including the stomach, bowel, liver, gallbladder and pancreas) become inflamed and irritated. Inflammatory bowel disease can result in frequent diarrhoea, sometimes containing blood and mucus. Other digestive symptoms include bloating, indigestion, nausea, constipation and abdominal pain.
Joint and muscle pain or stiffness: inflammatory-type arthritis (such as rheumatoid) particularly affects the smaller joints in the hands and fingers, causing pain, redness and swelling. Over time, if left untreated, these can erode the tissues, causing visible deformity. Another telltale sign is aching and stiffness, which is usually worse in the morning and improves during the day when you get up and about.

Other symptoms to be aware of:

Tiredness all the time: inflammation triggers a series of chemical signals when active, which tell you to conserve energy and prioritise the healing process, so you respond naturally by slowing down. Over longer periods, this can disrupt the quality and timing of sleep, impact hormonal function, affect absorption of energy-boosting vitamins from the gut and even cause anaemia – a lack of red blood cells in circulation. In doing so, this once-protective measure becomes detrimental, causing ongoing, worsening exhaustion that's difficult to escape from. This symptom is very non-specific, though – practically every medical condition in the encyclopaedia can cause tiredness in some shape or form.
Brain fog: the chemical signals released during inflammation can affect the brain and mind as well as the body – sometimes with widespread and debilitating effects. "Brain fog" is the broad term covering a variety of symptoms that patients may experience and describe in different ways, including poor concentration, forgetfulness, difficulty in finding words and mental fatigue. This often overlaps with depression and can be a feature of many other conditions, including an underactive thyroid, iron deficiency and post-viral illness.
Weight loss: inflammation can alter your metabolism as the body mobilises energy to heal, and therefore impact weight. Both fat and muscle can be broken down in chronic inflammatory states, and an inflamed gut may be less effective at absorbing important building-block nutrients such as proteins. Aside from inflammation, unintentional weight loss can be a sign of serious illness such as cancer or diabetes, so be very wary of weight loss occurring without any changes in diet or exercise, and see a GP.

What should you do about it?

For any symptom, three key questions can help identify whether chronic inflammation may be the underlying cause:

Onset: when did it start, and was there a clear trigger (such as an infection, injury, stressor or contact with someone else unwell)? No clear precipitant for new symptoms can be more suspicious.
Progression: how long has it been present – days, weeks or months? Symptoms lasting more than three or four weeks are more likely to stem from chronic inflammatory patterns – sometimes they come in waves, stay the same or become more severe with time.
Severity: what’s happening to the symptoms – are they getting better or worse?

Seeing a GP is important if the symptoms are persistent, progressive or severe, as they can help with determining a likely cause. Inflammatory illness can be identified through further investigation such as blood tests, while other physical and mental conditions masquerading as inflammation can also be considered and ruled out. Getting the right diagnosis is the first step towards treating the problem successfully, which may include medication and important lifestyle changes like diet and exercise.

The signs of inflammation can be both striking and secretive, and in our pressured modern lives, the subtler ones are increasingly easy to miss. The overlap between inflammatory and non-inflammatory illness also makes symptoms difficult to interpret. Remember: if a symptom is lingering, worsens or simply makes you feel uneasy, don’t hesitate to seek medical advice. Inflammation is common, but it need not inflame your fears.