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Neck pain can be caused by many things—but is most often related to getting older. Like the rest of the body, the discs and joints in the neck (cervical spine) slowly degenerate as we age. Cervical spondylosis, commonly called arthritis of the neck, is the medical term for these age-related, wear-and-tear changes that occur over time.
Cervical spondylosis is extremely common. More than 85 percent of people over the age of 60 are affected. The condition most often causes pain and stiffness in the neck—although many people with cervical spondylosis experience no noticeable symptoms. In most cases, cervical spondylosis responds well to conservative treatment that includes medication and physical therapy.

Anatomy
Your spine is made up of 24 bones, called vertebrae, that are stacked on top of one another. These bones connect to create a canal that protects the spinal cord.
The seven small vertebrae that begin at the base of the skull and form the neck comprise the cervical spine.
Other parts of your spine include:
Spinal cord and nerves. These "electrical" cables travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord through openings in the vertebrae (foramen).
Intervertebral disks. In between your vertebrae are flexible intervertebral disks. They act as shock absorbers when you walk or run.
Intervertebral disks are flat and round and about a half-inch thick. They are made up of two components:
• Annulus fibrosus. This is the tough, flexible outer ring of the disk.
• Nucleus pulposus. This is the soft, jelly-like center of the disk.
Cause
Cervical spondylosis arises from degenerative changes that occur in the spine as we age. These changes are normal and they occur in everyone. In fact, nearly half of all people middle-aged and older have worn disks that do not cause painful symptoms.
Disk Degeneration and Bone Spurs
As the disks in the spine age, they lose height and begin to bulge. They also lose water content, begin to dry out and weaken. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.
As the facet joints experience increased pressure, they also begin to degenerate and develop arthritis, similar to what may occur in the hip or knee joint. The smooth, slippery articular cartilage that covers and protects the joints wears away.

If the cartilage wears away completely, it can result in bone rubbing on bone. To make up for the lost cartilage, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth — called bone spurs — may narrow the space for the nerves and spinal cord to pass through (stenosis).
Risk Factors
Age is the most common risk factor for cervical spondylosis. The condition is extremely common in patients who are middle-aged and older.
Other factors that may increase your risk for developing cervical spondylosis and neck pain include:
• Genetics—a family history of neck pain and spondylosis
• Smoking—clearly linked to increased neck pain
• Occupation—jobs with lots of repetitive neck motion and overhead work
• Depression or anxiety
• Previous injury or trauma to the neck
Symptoms
For most people, cervical spondylosis causes no symptoms. When symptoms do occur, they typically include pain and stiffness in the neck. This pain can range from mild to severe. It is sometimes worsened by looking up or looking down for a long time, or by activities in which the neck is held in the same position for a prolonged period of time—such as driving or reading a book. The pain usually improves with rest or lying down.
Other symptoms may include:
• Headaches
• Grinding or popping noise or sensation when you turn your neck
• In some cases, cervical spondylosis results in a narrowing of the space needed for the spinal cord or nerve roots. If this occurs, your symptoms may include numbness and weakness in the arms, hands, and fingers
• Trouble walking, loss of balance, or weakness in the hands or legs
• Muscle spasms in the neck and shoulders


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Slip disc: Rupturing of the tissue that separates the vertebral bones of the spinal column.

The center of the disc, which is called the nucleus, is soft, springy and receives the shock of standing, walking, running, etc. The outer ring of the disc, which is called the annulus (Latin for ring), provides structure and strength to the disc. The annulus consists of a complex series of interwoven layers of fibrous tissue that hold the nucleus in place.

A slipped disc is also known as a herniated disc. The term "slipped disc" comes from the action of the nuclear tissue when it is forced from the center of the disc. The nuclear tissue located in the center of the disc can be placed under so much pressure that it can cause the annulus to rupture. When a disc herniates or ruptures, it may create pressure against one or more of the spinal nerves which can cause pain, weakness or numbness in the area of the body served by those nerves. Other names for slipped (herniated) discs are prolapsed and ruptured discs.

What Is Slipped Disc (Herniated Disc)?
The discs are protective shock-absorbing pads between the bones of the spine (vertebrae). The discs of the spine are also referred to as intervertebral discs. Although they do not actually "slip," a disc may bulge, split, or rupture. This can cause the disc cartilage and nearby tissue to fail (herniate), allowing the inner gel portion of the disc to escape into the surrounding tissue. This protruding, jelly-like substance can place pressure on the spinal cord or on an adjacent nerve to cause symptoms of pain, numbness, or weakness either around the damaged disc or anywhere along the area supplied by that nerve.

Many people experience no symptoms from a herniated disc, and the majority of people who have herniated discs do not need surgery.

The layman's term "slipped disc" is, therefore, a misnomer and actually refers to a condition whereby portions of an abnormal, injured, or degenerated disc have protruded against adjacent nerve tissues. This condition is also known as a slipped disk, herniated disc, ruptured disc, or prolapsed disc. The most frequently affected area is in the low back, but any disc can rupture, including those in the neck.

Slipped Disc - Symptoms, Causes, and Treatment
Understanding the spine
The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue, which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.

The spine protects the spinal cord, which contains the nerves that come from the brain. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body. Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround and are attached to various parts of the spine.

What is a prolapsed disc?
When you have a prolapsed disc (commonly called a 'slipped disc'). A disc does not actually 'slip'. What happens is that part of the inner softer part of the disc (the nucleus purposes) bulges out through a weakness in the outer part of the disc. A prolapsed disc is sometimes called herniated disc. The bulging disc may press on nearby structures such as a nerve coming from the spinal cord. Some inflammation also develops around the prolapsed part of the disc.

Any disc in the spine can prolapse. However, most prolapsed discs occur in the lumbar part of the spine (lower back). The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be.

Who gets a prolapsed disc?
It is not clear why some people develop a prolapsed disc and not others, even when they do the same job or lift the same sort of objects. It seems that some people may have a weakness in the outer part of the affected disc. Various things may trigger the inner softer part of the disc to prolapse out through the weakened outer part of the disc. For example, sneezing, awkward bending, or heavy lifting in an awkward position may cause some extra pressure on the disc. In people with a weakness in a disc this may be sufficient to cause a prolapse. Factors that may increase the risk of developing a prolapsed disc include: a job involving lots of liftin, a job involving lots of sitting (especially driving), weight-bearing sports (weight lifting etc), smoking, obesity and increasing age (a disc is more likely to develop a weakness with increasing age).

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Overview
Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea.

The main types of sleep apnea are:

Obstructive sleep apnea, the more common form that occurs when throat muscles relax
Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing
Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea
If you think you might have sleep apnea, see your doctor. Treatment can ease your symptoms and might help prevent heart problems and other complications.

Symptoms
The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:

Loud snoring
Episodes in which you stop breathing during sleep — which would be reported by another person
Gasping for air during sleep
Awakening with a dry mouth
Morning headache
Difficulty staying asleep (insomnia)
Excessive daytime sleepiness (hypersomnia)
Difficulty paying attention while awake
Irritability
When to see a doctor
Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores. Talk to your doctor if you have signs or symptoms of sleep apnea. Ask your doctor about any sleep problem that leaves you fatigued, sleepy and irritable.

Causes
Obstructive sleep apnea
This occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in. You can't get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.

You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.

Central sleep apnea
This less common form of sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. This means that you make no effort to breathe for a short period. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.

Risk factors
Sleep apnea can affect anyone, even children. But certain factors increase your risk.

Obstructive sleep apnea
Factors that increase the risk of this form of sleep apnea include:

Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
Neck circumference. People with thicker necks might have narrower airways.
A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.
Being male. Men are two to three times more likely to have sleep apnea than are women. However, women increase their risk if they're overweight, and their risk also appears to rise after menopause.
Being older. Sleep apnea occurs significantly more often in older adults.
Family history. Having family members with sleep apnea might increase your risk.
Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who've never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you're more likely to develop obstructive sleep apnea.
Central sleep apnea
Risk factors for this form of sleep apnea include:

Being older. Middle-aged and older people have a higher risk of central sleep apnea.
Being male. Central sleep apnea is more common in men than it is in women.
Heart disorders. Having congestive heart failure increases the risk.
Using narcotic pain medications. Opioid medications, especially long-acting ones such as methadone, increase the risk of central sleep apnea.
Stroke. Having had a stroke increases your risk of central sleep apnea or treatment-emergent central sleep apnea.
Complications
Sleep apnea is a serious medical condition. Complications can include:

Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely.

You might have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. People with sleep apnea have an increased risk of motor vehicle and workplace accidents.

You might also feel quick-tempered, moody or depressed. Children and adolescents with sleep apnea might perform poorly in school or have behavior problems.

High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. Having obstructive sleep apnea increases your risk of high blood pressure (hypertension).

Obstructive sleep apnea might also increase your risk of recurrent heart attack, stroke and abnormal heartbeats, such as atrial fibrillation. If you have heart disease, multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat.

Type 2 diabetes. Having sleep apnea increases your risk of developing insulin resistance and type 2 diabetes.
Metabolic syndrome. This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar, and increased waist circumference, is linked to a higher risk of heart disease.
Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea might be more likely to have complications after major surgery because they're prone to breathing problems, especially when sedated and lying on their backs.

Before you have surgery, tell your doctor about your sleep apnea and how it's being treated.

Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring (nonalcoholic fatty liver disease).
Sleep-deprived partners. Loud snoring can keep anyone who sleeps near you from getting good rest. It's not uncommon for a partner to have to go to another room, or even to another floor of the house, to be able to sleep.

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Contact dermatitis is inflammation of the skin (rash) that may result when the skin is touched by irritants or substances that cause an allergic reaction. Contact dermatitis can occur from exposure to many different compounds found both in the home and at work. There are two types of contact dermatitis:

Allergic contact dermatitis occurs when skin, which has become sensitized to a certain substance (allergen), comes in contact with that substance again
Irritant contact dermatitis occurs when the skin is exposed to a mild irritant (such as detergent or solvents) repeatedly over a long period of time or a strong irritant (such as acid, alkali, solvent, strong soap or detergent), which can cause immediate skin damage
Common sources of allergic contact dermatitis
Not everyone reacts to allergens. However, some people will react to an allergen which they had previously tolerated for many years. Skin can become allergic to a substance after many exposures or after just one exposure. Most people will have an allergic reaction to poison ivy after one exposure, for instance. This is a delayed skin reaction that typically develops 12 to 72 hours after exposure.

Common sources of allergic contact dermatitis include:
Nickel (a common metal used in jewelry) and other metals. Nickel has been reported to cause contact dermatitis in up to 10 percent of women. Gold is also becoming a widespread allergen. This type of allergic contact dermatitis can begin with intermittent rashes under earrings or other jewelry.
Fragrances – for example, those found in perfumes, soaps, lotions, and shampoos
Cosmetics
Topical medications such as antibiotics or anti-itch preparations – these cause worsening of the problem and are often misinterpreted as infection
Preservatives, which keep topical products from spoiling
Sunscreens – commonly cause a hive-like rash that can appear hours or days after sun exposure
Rubber ingredients – a common source of work-related allergy. Rubber can cause immediate allergic reactions, such as itching, burning, or welts. Some people experience itching and tearing eyes or even shortness of breath.
Common sources of irritant contact dermatitis
Detergents, soaps, cleaners, waxes, and chemicals are substances that can irritate the skin. They can wear down the oily, protective layer on the skin's surface and lead to irritant contact dermatitis. Irritant contact dermatitis is most common among people who regularly work with strong chemicals, such as restaurant, maintenance, and chemical workers.

Symptoms of Allergic contact Dermatitis and Irritant contact Dermatitis:

Allergic contact dermatitis

Reddening of skin (either in patches or all over the body)
Intermittent dry, scaly patches of skin
Blisters that ooze
Burning or itching that is usually intense without visible skin sores (lesions)
Swelling in the eyes, face, and genital areas (severe cases)
Hives
Sun sensitivity
Darkened, "leathery" and cracked skin
Allergic contact dermatitis can be very difficult to distinguish from other rashes.

Irritant contact dermatitis

Mild swelling of the skin
Stiff, tight feeling skin
Dry, cracking skin
Blisters
Painful ulcers on the skin

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What is a skin infection?
Your skin is the largest organ of your body. Its function is to protect your body from infection. Sometimes the skin itself becomes infected. Skin infections are caused by a wide variety of germs, and symptoms can vary from mild to serious. Mild infections may be treatable with over-the-counter medications and home remedies, whereas other infections may require medical attention. Read on to learn more about skin infections and what to do if you have one.

What are the types of skin infections?
The following are four different types of skin infections:

1. Bacterial skin infections
Bacterial skin infections often begin as small, red bumps that slowly increase in size. Some bacterial infections are mild and easily treated with topical antibiotics, but other infections require an oral antibiotic. Different types of bacterial skin infections include:

cellulitis
impetigo
boils
leprosy
2. Viral skin infections
Viral skin infections are caused by a virus. These infections range from mild to severe. Different types of viral infections include:

shingles (herpes zoster)
chickenpox
Molluscum contagiosum
warts
measles
hand, foot, and mouth disease
3. Fungal skin infections
These types of skin infections are caused by a fungus and are most likely to develop in damp areas of the body, such as the feet or armpit. Some fungal infections aren’t contagious, and these infections are typically non-life-threatening.

Different types of fungal infections:

athlete’s foot
yeast infection
ringworm
nail fungus
oral thrush
diaper rash
4. Parasitic skin infection
These types of skin infections are caused by a parasite. These infections can spread beyond the skin to the bloodstream and organs. A parasitic infection isn’t life-threatening but can be uncomfortable.

Different types of parasitic skin infections include:

lice
bedbugs
scabies
cutaneous larva migrans
Pictures of types of skin infections

What are the symptoms of skin infection?
The symptoms of a skin infection also vary depending on the type. Common symptoms include redness of the skin and a rash. You may also experience other symptoms, such as itching, pain, and tenderness.

See a doctor if you have pus-filled blisters or a skin infection that doesn’t improve or gets progressively worse. Skin infections can spread beyond the skin and into the bloodstream. When this happens it can become life-threatening.

Signs of a severe infection include:

pus
blisters
skin sloughing, breakdown
dark, necrotic-appearing skin, or skin that becomes discolored and painful
What are causes and risk factors for a skin infection?
The cause of a skin infection depends on the type of infection.

Bacterial skin infection: This occurs when bacteria enter the body through a break in the skin, such as a cut or a scratch. Getting a cut or scratch doesn’t necessarily mean you’ll develop a skin infection, but it does increase your risk if you have a weakened immune system.

A decreased immune system can be the result of an illness or the side effect of medication.

Viral skin infection: The most common viruses come from one of three groups of viruses: poxvirus, human papillomavirus, and herpes virus.

Fungal infection: Body chemistry and lifestyle can increase the risk of a fungal infection. For example, you may experience multiple bouts of athlete’s foot if you’re a runner or if you sweat a lot. Fungi often grow in warm, moist environments. Wearing sweaty or wet clothes is a risk factor for skin infections. A break or cut in the skin may allow bacteria to get into the deeper layers of the skin.

Parasitic skin infection: Tiny insects or organisms burrowing underneath your skin and laying eggs can cause a parasitic skin infection.

Dr. Yatin Bhole
Dr. Yatin Bhole
DNB, Pediatrician, 9 yrs, Pune
Dr. Ashok Lathi
Dr. Ashok Lathi
MS - Allopathy, General Surgeon, 37 yrs, Pune
Dr. Vinod Shingade
Dr. Vinod Shingade
BHMS, General Physician Homeopath, 10 yrs, Pune
Dr. Virag  Kulkarni
Dr. Virag Kulkarni
BAMS, Ayurveda Panchakarma, 14 yrs, Pune
Dr. Jyoti Shinde
Dr. Jyoti Shinde
BHMS, Diabetologist Homeopath, 9 yrs, Pune
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