Important: please read the medical dislaimer before continuing

The body's primary response to injury or infection is called inflammation.  The purpose of inflammation is to provide an environment around the injured or infected region that maximises repair and anti infection processes.  It does this by flooding the area with the materials and enzymes neefed so that repair work can be done most effectively and infection fought.  There are some side effects with this, though, such as stiffness, and pain due to compression of nerves.  For more information on inflammation see 1

In general inflammation is a good thing.  For every occurrence, in the absence of research suggesting otherwise, the inflammation should not be suppressed.  The important ethical point here is that the baseline position should be to allow the inflammation to continue unhindered unless primary research clearly advocates an alternative course of action.

Possible reasons to want to suppress an inflammation response:

• The inflammation is in a part of the body where the swelling could be dangerous.  For example, inflammation of any region of the brain is dangerous because the skull restricts the volume so pressure builds up.
• The region of damage is so extensive that the inflammation draws away too much fluid.  This is a problem with burns of a large skin area.  The inflammation response can actually kill because of its fluid requirement.
• Research has demonstrated a better outcome.  Possible example is multiple cuts (such as from broken glass) where a reduction in inflammation can speed up healing time.
• Cause is chronic and incurable.  The inflammation is therefore pointless and the associated pain and stiffness is not offset by benefits.  For example, auto immune diseases such as rheumatoid arthritis - see 2
• The inflammation is an inappropriate reaction such as with asthma.
• Where research has demonstrated the effectiveness of reducing or truncating the inflammation.  This may be because the inflammation is overstimulated and persists too long.  Also if research shows a technique that can replace the inflammation process to produce the desirable recovery without the side effects.

For sporting injuries, interfering with the inflammation process is justified if it does not worsen outcome, and either quickens repair time or improves the quality of repair, or both.

At this stage we have not been able to identify research supporting interference in general (see 3 for an example of lack of support).  A generalised procedure called ICE, and anti-inflammatory drugs, are often used to interfere with inflammation.  ICE is the application of ice, compression and elevation to reduce swelling.

We currently recommend against using the ICE procedure or any anti inflammatory drugs for sports injuries.  This is because the risk/benefit profile is unknown.  If this advice changes, it will probably be selective - depending on the type of injury.

There is a common class of pain killers which are non steroidal anti inflammatory drugs (NSAIDs) including aspirin and ibuprofen.  As these will adversely affect the inflammation we recommend not using them.  Instead you should use paracetamol and/or codeine.  Make sure you follow the directions on the packet as these can become unsafe if the dose is too high (especially paracetamol).  In some countries (UK for example) codeine is either prescription or available in small doses combined with another drug such as paracetamol.

References

1) http://medweb.bham.ac.uk/http/mod/3/1/a/acute.html - overview of inflammation
2) BMJ Clinical Evidence Concise, Rheumatoid arthritis section
3) BMJ Clinical Evidence Concise, Ankle sprain section

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