What We Get Wrong About Inflammation—and How to Better Manage It

What inflammation is really telling you 🚨

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Inflammation has become a buzz word. From Instagram influencers hawking anti-inflammatory brownies to wellness gurus claiming that inflammation is the root of all disease and can be fixed with juice cleanses, it's become the boogeyman of modern health discourse.

I've had patients arrive convinced that their bodies are "on fire" after reading that their slightly elevated ESR means they need to eliminate nightshades and invest in expensive supplements to put out the flames.

But numbers on a lab report never tell the whole story. A single marker can mean everything—and nothing—at the same time.

I recently saw a patient in her early 60s for knee pain. She had called the week prior complaining of pain that worsened over the course of the day or after long periods of standing. Her voice had that familiar edge of worry, the kind that tells me this isn't just about physical discomfort. She mentioned she'd been taking her grandchildren to the park but had to sit on the bench while they played because her knee simply wouldn't cooperate. In her 30s, she had had arthroscopic knee surgery for a torn meniscus, so I suspected her pain was probably related to "wear and tear."

We'd done some investigative work before our appointment, and, sure enough, her knee X-ray showed clear signs of osteoarthritis—the telltale narrowing of joint space, those small bone spurs forming at the edges.

But my patient wasn't just worried about the mechanical issues around her knee. The pain was less concerning to her than her lab test results done the week prior. Her CRP (“C-reactive protein”) test result—a nonspecific marker of inflammation—was elevated. I could hear the fear in her voice: Should I be taking Advil to lower my CRP? What kind of foods can help reduce inflammation? Is this a sign of an autoimmune problem or some kind of cancer?

Photo by Kai Pilger on Unsplash

These are common questions I hear. The problem is that inflammation isn't a simple enemy to be vanquished. There is no single pill or prescriptive diet to combat it. It also doesn't represent any single diagnosis.

Rather, inflammation is a complex messenger, a nuanced signal from our body that demands a more sophisticated approach. So I used my usual analogy to explain an elevated inflammation marker: “It is like a smoke detector for your entire body. It doesn't tell us exactly what's smoldering—just that something somewhere might be generating smoke. And with CRP in particular, it's not typically elevated as a result of mechanical inflammation—aka “wear and tear”—like the kind that would be triggered by osteoarthritis.

Understanding Different Types of Inflammation

There's an important distinction to make between mechanical inflammation and systemic inflammation. Mechanical inflammation is localized—it's what happens when tissues are physically damaged or stressed. The swelling, warmth, and pain around a sprained ankle or an arthritic knee joint is mechanical inflammation, the body's repair crew rushing to the scene. This type of inflammation generally stays put and performs its necessary healing function.

Systemic inflammation, however, is when the inflammatory response circulates throughout your entire body. It's like the difference between a small kitchen fire and smoke filling the whole house. This is what CRP measures—not the local repair work happening at a specific joint, but a body-wide inflammatory state.

An elevated CRP can represent:

• Infection (bacterial, viral, or fungal)

• Autoimmune disorders (rheumatoid arthritis, lupus, inflammatory bowel disease)

• Malignancy (certain cancers trigger inflammatory responses)

• Metabolic dysfunction (insulin resistance, obesity, metabolic syndrome)

• Cardiovascular disease (atherosclerosis is fundamentally an inflammatory process)

• Chronic stress (yes, psychological stress can manifest as physical inflammation)

• Environmental exposures (pollutants, toxins)

• Tissue injury/trauma (severe enough to cause systemic effects)

• Chronic sleep disruption (poor sleep quality can raise inflammatory markers)

In other words, I didn't think her CRP was directly related to her knee. Was it possible? Absolutely. She certainly could have Lyme disease or osteomyelitis or an autoimmune condition such as rheumatoid arthritis as a cause for her elevated CRP.

But in my patient’s case, the elevation in CRP was more likely tied to her metabolic health. Her recent blood work revealed broader metabolic issues, including pre-diabetes and very high cholesterol levels, conditions characterized by systemic inflammation that travels beyond the knee joint. I noticed her blood pressure was slightly elevated, another piece in this metabolic puzzle. When I asked about her sleep, she admitted to frequent disruptions—another contributor to systemic inflammation.

As I explained all of this to my patient, her eyes widened. She'd been looking for a simple solution. Instead, I was offering something more nuanced—a conversation about her body's intricate signals.

The Hidden Language of Inflammation

Inflammation is one of our body's most sophisticated communication system. It's not a malfunction to be silenced, but a complex dialogue between our cells, our lifestyle, and our overall health.

Think of inflammation like an internal messaging network. When something's off—whether it's metabolic dysfunction, chronic stress, poor nutrition, or underlying health conditions—your body doesn't send a polite email. It sends an urgent, full-body alert. 🚨

In metabolic conditions like pre-diabetes:

• Insulin resistance becomes a disruptive force

• Fat cells transform from passive storage to active inflammatory agents

• Blood sugar dysregulation triggers widespread cellular stress

• Chronic, low-grade inflammation becomes the background noise of your internal ecosystem

My patient's elevated CRP wasn't just a number—it was a complex signal of metabolic distress. Her body wasn't failing her; it was communicating critical information about her overall health.

Our medical system loves treating symptoms, improving numbers, and prescribing medications. The wellness industry can be equally prescriptive, favoring symptom management through diets and supplements.

But while anti-inflammatory medicines like Advil might ease her knee pain for a few hours, they weren't going to address her metabolic health. While blueberries and oatmeal are healthy and good, they wouldn't be sufficient to address her pre-diabetes.

A Roadmap to Managing Inflammation

Instead, we developed a strategy that went beyond a prescription:

• Nutrition became our first focus. We prioritized whole and anti-inflammatory foods like fatty fish and leafy greens while reducing refined sugars and other processed foods wherever possible. Importantly, I stressed that nutrition was critical but that alone it would not solve her metabolic problems, despite what the internet might tell her. It was only a piece of a larger puzzle.

• Movement shifted from high-intensity workouts to gentle, consistent activity that helped build strength in her leg muscles to support her joint health. The goal was finding exercise that her body needed without additional stress and mechanical wear and tear on her knees. We settled on swimming and recumbent biking three times weekly, with a plan to pursue physical therapy if that wasn’t enough.

• We also focused on stress management, incorporating mindfulness techniques and prioritizing quality sleep to help her body reset its inflammatory response. I suggested a simple pre-bed routine: no screens for an hour before sleep and keeping her bedroom cool and dark.

• Finally, we came up with a metabolic health plan, working to improve her insulin sensitivity and considering potential treatments, including limiting alcohol and considering pharmaceutical options such as the GLP-1 medications. I explained that addressing her metabolic health might have the "side effect" of improving her CRP, but more importantly, it would reduce her risk for diabetes and cardiovascular disease.

We decided to recheck her CRP in three months, not because the number itself was the goal, but because it would give us one data point among many to gauge our progress. "The number matters less than how you feel," I reminded her. "Your body will tell us if we're on the right track."

Agency is the Birthplace of Health

A month later, my patient returned to my office with a different energy about her. The tension that had lined her face was softer, and she moved with more ease.

"My knee still hurts sometimes," she admitted, "but I'm having more good days than bad." Instead of fixating on her CRP number, she'd been paying attention to how foods affected how she felt. She'd noticed patterns—sugar crashes that amplified her pain, better mornings that came after restful sleep. She shared that she'd joined a water aerobics class twice weekly and reconnected with friends there, adding another layer to her healing: social connection.

This wasn't about perfection or a medical cure. She had begun to understand that inflammation isn't just a problem to solve, but a relationship to manage. Her body wasn't the enemy—it was a complex system sending signals she was finally learning to interpret.

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So, tell me: How do you approach inflammation in your own body? Is yours mechanical (i.e., “wear and tear”) or related something else? What signals has your body been sending you lately?

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Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.