What exactly is inflammation—and why do spa therapists need to know about it?


Mention inflammation and almost everyone has a personal example to share: Swollen feet and ankles, painful joints and red, puffy skin are a few typical signs of an inflammatory condition. So it’s not surprising that your spa clients may ask for your help in relieving the discomfort. However, before you can discuss the role that spas can play in addressing inflammation, you need to understand the types and causes of this common yet potentially disabling problem.

From a holistic perspective, inflammation can be both the cause and the result of medical conditions. Wallace Nelson, naturopathic doctor and president of M’lis, points out that pre-existing inflammation may cause weakening of cells and provide a breeding ground for illness. A perfect example is gingivitis (inflammation of the gums), which has been linked to heart disease. “Some experts believe that nearly every disease happens in a state of inflammation,” Nelson says.

Understanding Flare-ups

Acute inflammation begins as a normal process in response to an internal or external event such as an injury, infection, trauma or even a bug bite. Chemical changes and pain receptors are activated, which in turn alert the surrounding tissue to become more sensitive, enabling the body to eliminate any irritants and heal the damaged cells. This process is often characterized by swelling in one particular area. Such inflammation is the healthy body’s emergency reaction to losing its state of homeostasis. Typically, once healing occurs, the inflammation subsides.

But when it doesn’t, this natural process becomes harmful, Nelson explains. “The normal process of cell regeneration stops, and the body is left waiting to battle a disease that isn’t coming,” he says. “The cells stay in overdrive, in a state of fight or flight.”

“But when it doesn’t, this natural process becomes harmful, Nelson explains. “The normal process of cell regeneration stops, and the body is left waiting to battle a disease that isn’t coming.”

Non-acute, or chronic, inflammation manifests in various ways, including ongoing swelling in the feet and ankles, sinus issues and skin problems. “The skin is a telltale,” Nelson says. “In skin, inflammation manifests as acne, eczema, psoriasis and rosacea.” Many people, including Nelson, see a dietary connection.

We know that compounds in the blood called C-reactive proteins are at high levels when inflammation is present. “Saturated fats, salt, refined sugars and high-glycemic carbohydrates like those made with white flour are foods that set off C-reactive proteins,” says Nelson. “In a condition like irritable bowel syndrome, inflammation may be the result of a low-level allergic reaction to something like wheat or dairy.”

Medical conditions such as diabetes and arthritis may cause inflammation but, properly treated, the inflammatory reaction should be temporary. Conversely, arthritis, a breakdown of cartilage, can be caused by inflammation. Chronic inflammation is commonly seen in people with autoimmune diseases such as rheumatoid arthritis and lupus, or in the presence of infection or virus.

“Inflammation may manifest in obvious ways such as swelling or fatigue, or it might present in the organ systems,” says Dr. Stratos Christianakis, rheumatologist and assistant professor at the Keck School of Medicine at the University of Southern California in Los Angeles. “It can be generated itself by the immune system. With something like diabetes, it could be neurological. There could also be a genetic predisposition to inflammation.”

Untreated chronic and systemic (as opposed to localized) inflammation can cause irreversible harm. “Patients with inflammation may be at higher risk for endorphin damage,” Christianakis says. “It can cause ulcers. In rheumatoid arthritis, the space between joints can be destroyed. It can accelerate problems like cardiovascular and lung disease.”

Quenching the Fire

Clients who come to your spa with sudden changes or redness in their skin; swelling, heat or pain in their body; or even a change in their energy level should consult with a physician about a possible inflammatory condition. A doctor may recommend testing their C-reactive protein and erythrocyte sedimentation rates, which are both markers of inflammation that can be measured and tracked. There may be an infection that requires antibiotic treatment. Inflammation-fighting medications, such as steroids or NSAIDs (non-steroidal anti-inflammatory drugs) may be prescribed, but aren’t recommended for long-term use. New prescription medications for conditions like rheumatoid arthritis are able to target cells that cause inflammation, but their risks and benefits have to be carefully weighed as they can alter the immune system.

A good starting point for treatment is diet. Healthy eating that includes lots of fruits and vegetables can help reduce inflammation.

When a medically screened client with inflammation turns to you for help, your first step is to take a health and lifestyle profile. “Factors like stress or hormone surges can throw a body into that fight-or-flight response,” Nelson says. “By the time you see visible swelling, there may already be a high level of internal inflammation.”

A good starting point for treatment is diet. Healthy eating that includes lots of fruits and vegetables can help reduce inflammation regardless of its cause. Recommend—and retail—supplements such as Omega-3 fish oils, which are a proven anti-inflammatory. Nelson also suggests flaxseed, evening primrose, bioflavonoids, zinc and vitamin C. Christianakis adds that vitamin D supplementation is beneficial as are herbal remedies of ginger and turmeric.

Quelling the pain that inflammation may bring is well within your spa’s domain. There may be swelling in the joints, around a nerve or in connective tissue as a result of increased fluid, and here’s where massage, heat treatments, hydrotherapy and acupuncture treatments can help. Whereas acute inflammation calls for rest, chronic inflammation can be greatly alleviated by an increase in exercise. Inflammatory pain tends to be worse in people with sedentary lifestyles or after periods of inactivity such as upon rising in the morning, but is relieved after periods of movement. So if your spa offers yoga classes or Pilates, or is in partnership with a local gym, you can suggest those strategies to your clients.

Inflamed skin may be your client’s main concern. There are a myriad of calming topical treatments and skincare lines dedicated to this cause. Sending clients home with a daily detoxifying regimen is also critical. “Keeping the skin very clean is important,” reminds Christianakis. “Encourage healthy skin turnover.”

Even meditation and visualization can quiet inflammation, as Nelson suggests: “Take both an internal and external approach to the problem.”


“Everything from a common cold to a sprain can result in inflammation and even a light massage may help get it out of the body,” says Barbara Savage, owner of Synergy Holistic Wellness Spa in Murfreesboro, Tennessee. Committed to helping clients relieve pain without medication, Savage offers a multitude of inflammation-reducing services.

Infrared Sauna Utilizing heaters as opposed to hot air or steam, infrared heat penetrates deeply to relieve pain and help rid the body of the toxins and metabolic waste that linger in inflamed areas. Infrared heat aids in the production of white blood cells, which reduce swelling. It also helps the body regulate cortisol levels to keep stress at bay.
Low-Level Laser Therapy Also known as cold laser, here photon energy is used to accelerate healing. The laser stimulates cellular function and immune responses for an anti-inflammatory effect. Light transmitted into the blood via laser supplies oxygen and energy to cells.
Lymphatic Drainage Massage Inflammation may result from a lack of lymphatic circulation, and massage techniques using rhythmic strokes decongest areas to help drain fluids and toxins.
Craniosacral Bodywork This soft-touch therapy releases restrictions in the membranes and cerebrospinal fluids, boosting the body’s ability to heal from inflammation’s state of “dis-ease.”
Acupuncture The ancient tradition serves two purposes: to increase the flow of energy throughout the body, and to help relieve the pain that inflammation may cause. Acupuncture can help the body return to a healthy homeostasis.
Antioxidant facials Detoxification with free radical–fighting ingredients such as vitamins A, C and E, minerals and enzymes, help pull out fluids that have built up in the skin.

Andrea Renskoff is a freelance writer based in Los Angeles.

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