When we describe inflammation, we use words like swelling, irritation, tenderness, redness, soreness and even in some cases, infection. While inflammation is very normal immediately following an injury, accident, surgery or other traumatic event, it should subside with time. When inflammation lingers long past the acute inflammation stage, we call it chronic inflammation.

Inflammation that persists for several weeks, months or even years and is primarily characterized by its persistence and lack of clear resolution is considered chronic inflammation. In physical therapy, we meet patients regularly who have chronic inflammation. During physical therapy we determine, when we can, the root cause of, for instance, chronic knee inflammation. When we treat the root cause(s), the inflammation and the pain typically subside and the patient returns to normal life activities.

There are times when patients describe a body that is inflamed in more than one area, leading to pain “all over.” Patients may describe multiple areas of joint or muscle inflammation. Sometimes these patients fail to get better in PT or only see marginal improvements with physical therapy interventions. In these instances, we consult with other experts like functional medicine providers, primary care doctors, specialists and nutritionists to determine underlying causes of whole body chronic inflammation. Joint pain and inflammation coupled with ongoing muscle inflammation unrelieved by physical therapy is often a sign that interventions around lifestyle are necessary.

In this week’s blog post, Northwest Functional Medicine provider, Michiko Oishi, PA-C, provides her outlook on how lifestyle affects inflammation, and gives recommendations for reducing pain and inflammation.

Lifestyle and Joint Pain

Lifestyle can have a huge effect on joint pain. How you sit and stand along with how much you sleep, what and how you eat, and how you think can have a huge impact on joint pain and inflammation.


All of our stressors (emotional, physiological and physical) pile up into our stress bucket until it eventually overflows and we get symptoms. Until our early 20s, the body is resilient and can easily deal with poor eating habits, change and lack of sleep. As we age, we lose our reserves and can get sick, become chronically inflamed and simply feel bad.


Most Americans don’t get enough rest. Constant stimulation from our various electronic devices makes it difficult for our brains to shut off and rest. Without proper rest, the body cannot heal, recover and renew. Sleep debt may lead to anxiety, increased pain levels, chronic inflammation and other diseases.


What we eat has a huge impact on inflammation in the body. You can control chronic inflammation by controlling what goes into your body.

Proteins and fats are essential for building new cells, recovering from injury, and stabilizing blood sugars. Without them the body cannot heal. Be sure to include healthy proteins and fats in your meals.

Eat colorful fruits and vegetables. These colorful foods have essential macro and micronutrients that enable the body to function well and recover from injury. Some are naturally anti-inflammatory like blueberries. A variety of fruits and vegetables ensures you are getting all the nutrients you need to treat your chronic inflammation and heal.

Avoiding sugary and starchy foods are a great way to reduce chronic inflammation. Though these foods – our comfort foods – feel good in the moment, they inflame us in the long run. Take a pass on the bread and pasta if you are trying to reduce your chronic inflammation and pain.

Avoid processed foods. (Ugh. This is all the good stuff like cookies, cakes and crackers…) While tasty, these items are full of inflammatory ingredients like sugars, preservatives and many ingredients that you simply cannot pronounce. If you crave sweets or starch, try a sweet potato or brown rice; both are nutrient dense without the bad stuff. If you don’t recognize the ingredients, don’t eat it.


Fear, catastrophizing and negative thoughts increase cortisol in the body making you irritable, more painful and even fatter. While happy, positive thoughts don’t solve joint inflammation or chronic inflammation, they do promote a better body environment for healing. Things like meditation, taking a walk, getting support from friends/family or enjoying a hobby all help promote a healthy internal environment for healing.

While most patients’ chronic inflammation resolves with the right physical therapy program, some painful problems don’t. We are learning more about lifestyle as a causal factor in chronic inflammation. As Michiko Oishi from Northwest Functional Medicine explained above, sleep, nutrition, stress, emotions and even our thoughts may affect inflammation in the body. It’s worth trying some of her suggestions to see how your lifestyle may be affecting your chronic pain.

Please contact us at 503-295-2585 or www.lifesworkpt.com today if you are suffering with chronic pain or chronic inflammation. We are here to help you succeed! If you don’t live in our area, please refer to our Find a Good PT blog for tips on getting the right PT on your team!