Why Won’t I Heal?

To heal is the ability to make whole or healthy – the restoration of normal physical condition. Our bodies have an innate capability to fix problems that interfere with our overall health. But sometimes certain factors may slow or even halt efficient mending.

Types of Injury Healing
Superficial damage to tissues, involving only the first layers, heals through regeneration (repair, re-growth or restoration). Deeper damage or injury to other types of tissues, such as muscles, tendons and ligaments will heal through the synthesis (building) of new tissue. This restores continuity but the new tissue will be different from the original. Deeper damage requires longer healing time.

Healing Stages
Each injury goes through certain stages of inflammation and tissue healing. These stages often overlap and timeframes vary with each person.

The first stage is called the acute phase. This is the time when the injury first occurs and lasts several days, when healing is initiated. Redness and heat are present due to vascular changes. Swelling is also common in this phase. This puffiness is due to fluid leaking into the tissues from histamine, the chemical mediator of inflammation.

Pain and loss of function are also typically present. This is the body’s attempt to isolate and immobilize the area for proper healing. White blood cells then rush to the area to clean bacteria and debris.

The second stage is called the subacute phase. This can occur anywhere from two days to several weeks after injury. It is also when inflammation begins to subside. Gradual restoration of the damaged tissues begins to take place. There is a slight decrease in pain and swelling, however, pain is easily exacerbated with irritation. This stage can last several weeks.

The chronic phase is the final phase of repair. It typically overlaps with the subacute phase. It can occur two to three weeks after the injury and can continue up to two years. During this time, inflammation has resolved, yet continued loss of function is possible. Pain may occur in response to stress to the area due to the formation of scar tissue. As time progresses, scar tissue strengthens, but will only be 70 to 80 per cent as strong as the tissue it replaced.

Healing-Inhibiting Factors Beyond Our Control
1.Severity of injury. The more tissue damage sustained, the longer it will take for your body to mend.

2.Age. Healing difficulties are often seen in the very young or the aging. The very young have the ability to heal quite rapidly since their bodies are still developing. However, scar tissue, a typical result of healing, fails to grow with the child. Thus over time, these areas may become fixed. Sometimes, surgical release of these areas of increased tension may be necessary to attain full pain-free function.

As we age, the mechanisms of healing begin to slow and other changes in our bodies, such as a decreased ability of the skin to hold water and overall thinning of the skin, results in an increased risk of injury and infection.

3.Preexisting conditions. Certain medical conditions contribute to poor healing. Diabetes, for example, can cause vascular or blood vessel problems. This leads to poor transportation of blood and nutrients vital for proper, expedient healing. Chronic liver or kidney conditions or the presence of carcinomas (malignant or cancerous tumors) can also impair recovery.

4.Foreign bodies. The presence of foreign material, such as glass, wood or gravel in a wound slows healing and makes you more susceptible to infections.

5.Infection. An infection occurs when a pathogenic or disease-producing agent invades the body. An infection can cause increased inflammation. This is the body’s natural reaction to injury causing pain, heat, redness, swelling and decreased function. It can be present without infection, but its presence complicates the healing process.

6.Blood supply. Decreased blood flow due to swelling, compression of soft tissue over bone or preexisting vascular conditions interferes with healing. Inadequate blood supply slows the transportation of nutrients necessary for proper tissue recovery. It also impedes the removal of wastes such as toxins, bacteria and debris.

7.Wound separation. Open wounds with large gaps cannot effectively heal over the area. Large open areas are also more susceptible to infection. Closure of the wound with sutures can facilitate the healing process.

Healing-Inhibiting Factors Under Our Control
8.Proper care. Efficient care of the wound or injury is essential for healing. Proper emergency first aid including wound cleaning and bandaging will impede the chances of infection and re-injury.

Proper care during the mending process is also important. Follow-up with a qualified medical professional for serious wounds and injuries will decrease the risks of complications. Compliance with recommended treatment is vital for quick, efficient recuperation.

Attempting to do too much too soon will only delay healing. Walking on a badly sprained ankle just because a few days have gone by may only increase your risk for a chronic problem.

9.Nutrition. Adequate nutrition is required for proper, efficient healing. Increased protein and calorie intake is needed during tissue repair. Vitamins, such as C, A and E, promote healing and help decrease scarring, whereas minerals such as Iron and Zinc facilitate bonding of tissues, thus aiding in healing.

10.Drugs. The use of some medications will assist with the healing process, but only your healthcare practitioner can prescribe the best options. Some medications actually inhibit tissue mending. For example, steroids impede the inflammation process, a normal, necessary part of healing. Immune-suppressing drugs also interfere with tissue repair. Smoking delays the recovery process, plus it can interfere with the action of certain drugs. Pain medications can impair the sensation of pain, which can cause further re-injury.

All injuries are not the same, and healing time is as individual as each person. If you feel your injury is not healing within a reasonable time, a consult with your physician may help the problem from becoming a life-altering condition.

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