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Why Reduce Swelling?

October 19th, 2014
health, medicine  [html]
Recently I jammed my fingers, and aside from resting them the standard healing advice is to reduce the swelling with ice, compression, elevation, and ibuprofen (advil/motrin). This is surprising, especially the medication. Why would we evolve swelling, a response to a common injury, if it's harmful? I could believe that in some cases you could have excessive swelling and it would be good to reduce that, but in the typical case you would expect swelling to be useful.

A similar argument applies to fevers: the body raised its temperature, so why does it make sense to come in with acetaminophen (tylenol) and bring it back down? Again, if a fever gets high enough we do need to control it, but we should expect letting the fever run its course to be the healthiest option in most cases.

What is it that these systemic medications do that our bodies weren't able to evolve on their own? Or is the modern environment different enough from the one in which we evolved that a response like fever or swelling once was useful but no longer is? Or maybe it's not useful after all; has anyone done an RCT looking at the impact of swelling reduction actions or medication on healing? Can I get some volunteers willing to self-administer hammer blows? [1]

(This is basically an algernon argument, a use of the evolutionary optimality challenge.)


[1] People would first need to administer the hammer, then check to see which treatment to apply. The trauma must be applied blind.

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