Acute or chronic? Sprain or strain? Some common terminology and jargon explained.
September 11, 2023
Do you know your ‘itis’ from your ‘osis’, acute from chronic, a fracture from a break, or the difference between a strain and a sprain?
When you come to see a therapist at BWT you are looking for answers. With clear explanations you can understand what is happening to your body and together we can achieve the best outcomes.
So here is a quick run through of common terms we use.
‘. . . . ITIS’
Anything with the suffix ‘itis ‘indicates there is inflammation or a condition involving inflammation. It comes from Latin and Greek is usually attached to a word root that signifies a part of the body that is inflamed e.g. bursitis, tendonitis and capsulitis.
Many things can cause inflammation from infection to traumatic or overuse injury and it is our job to find out what has been the causative factor, although in many cases there are multiple contributory reasons. There are tips on how to manage acute inflammation (which is needed to stimulate healing) in a later article on page ………..
Our role is to ensure that this phase of acute inflammation is controlled and that there are no ongoing irritating factors that prolong the inflammation so that it becomes established and delays or leads to problems with healing.
‘. . . . OSIS’
You may also be aware of conditions such as osteoporosis. This is perhaps the more correct suffix to use where inflammation has subsided, and there are now changes in structures that are causing symptoms. This suffix is a little more complicated as it can mean several things
1 A structure or body part that is undergoing a process or state such as osteoporosis
- A diseased condition such as tuberculosis
- Or the formation or development of something for example what happens in scar tissue where a process of fibrosis occurs.
By knowing the type of ‘osis’ you have you can manage your condition yourself often with medical intervention or monitoring.
Where BWT can help would be to help with this management or to influence the formation of unwanted scar tissue with physical treatment or even the use of ultrasound.
Sometimes an ‘osis’ can relapse and become acutely inflamed again, and in other scenarios we may even carefully foster an ‘osis’ to return to its inflammatory state, for example to promote a return to full range of movement if scar tissue has become adherent or thickened. Treatment with shockwave therapy can be useful alongside specific rehab for the structures involved.
ACUTE VS CHRONIC
Here the definitions can overlap. An acute condition can become chronic and a chronic condition can develop an acute flare! So here goes with a brief explanation.
An acute condition generally means an injury or condition that develops suddenly and lasts a short period of time. In ideal situations inflammatory chemicals and hormones in our body peak at around 3 days and subside by day 5.
When dealing with soft tissues including the skin, healing generally ‘fixes’ the injury with new scar tissue by days 10 – 14 – which is why stitches are removed at this point.
However this process is heavily influenced by many factors and different structures, such as ligaments and bones take much longer to repair and then proceed to undergo a fantastic process of remodelling, along the lines of stress put through them.
It is important to know when and how to start putting the correct stresses through injured structures as they heal. Assistance with graduated stretching and loading will ensure recovery is optimum. Often walking aids, supports or taping are used to assist with this.
Chronic conditions are those that persist for a long period of time or are recurring. With injuries this can be that the factors causing acute inflammation are not addressed, such as adaptive postures to relieve pain, poor technique in sport or work practices or adherent scar tissue restricting movement.
Some conditions are progressive and may also be termed chronic as they are long lasting.
Pain can also become chronic. This is a whole topic with so many factors involved. Put very simply the body can ‘learn’ pain pathways and even when a physical cause for the pain may not be obvious or evident, the way in which the brain reacts to many stimuli including movement, temperature or touch is felt as pain.
This does not mean that the pain is not real, or is ‘all in your head’ but just that the processing of information has become sensitised due to the longstanding nature of the pain. This then leads to sensations which would normally be differentiated as movement, temperature or touch being interpreted by the brain as pain.
BWT can help with this processing, often by stopping pain becoming a barrier to movement early on in the management of your condition. However, approaches such as acupuncture, CBT and other cognitive/ brain therapies are the most effective in addressing this if pain sensitisation has become ingrained.
FRACTURE OR BREAK?
Well this is a simple one!
A fracture is the medical term for a broken bone. So, a fracture and a break are essentially the same thing.
And finally :-
SPRAIN OR STRAIN?
SPRAINS are a stretch and/or tear of a ligament, and are classified by severity. Ligaments are like guy ropes around joints, acting as stabilisers during movement and loading. Sprains typically affect the ligaments of the ankles, knees, wrists, and thumbs.
There are 3 grades of sprain
Grade 1 mild: This involves a slight stretching and some damage to the fibres of the ligament.
Grade 2 moderate: Here there is a partial tear of the ligament with abnormal looseness (laxity) in the joint when it is moved in certain ways.
Grade 3 severe: Diagnosed as a complete tear of the ligament. This can be further complicated if the joint capsule has also been involved.
A STRAIN is a stretch or tear of muscle fibres, facia or tendon. Fascia put simply encases muscles or muscle groups and tendons attach muscles to bone. Strains are also classified by severity as grades 1-4. They typically affect the foot, hamstring, and back.
Classification is complex and can even be sub- classified with the aid of MRI scanning.
BWT has the advantage of on – site diagnostic ultrasound imaging which can not only detect grades of injury but can also provide images of inflammation for example with a bursitis or tendonitis.
So there you have it a potted run down of terminology to help with your understanding and recovery.