What is Anterolisthesis ?

It is another term for spondylolisthesis. It is a spine condition in which the upper vertebral body slips forward onto the vertebra below. There is a grading system used to determine the severity of the slippage. ⁽²⁾

Grading

• Grade 1 – It is a mild case wherein there is a less than 25% slippage.
• Grade 2 – The slippage is between 26% and 50%.
• Grade 3 – The slippage is between 50% and 75%.
• Grade 4 – It is a severe case of slippage (76% and above)
• Grade 5 – It is characterized by a complete fall off from the next vertebra. ^{(1, 2, and 3)}

Image 1: Images showing anterolisthesis in various grade level.
Picture Source: healthsaline.com

Image 2: A closer look at a vertebra that has slipped forward.
Photo Source: www.mdguidelines.com

Causes of Anterolisthesis

1. Aging – As the person grows old, there are geriatric changes in the body. The cartilage in between the vertebra gets weak and becomes thin. This is why geriatric patients are prone to anterolisthesis. ⁽⁴⁾
2. Genes – A defect in the growth of the spine can be associated with genetic factors. As young children grow, their spine failed to develop completely leading to anterolisthesis.
3. Trauma – back injury and trauma in general can affect the growth and alignment of the vertebra. Overworking of the body increases the possibility of having anterolisthesis. Weightlifters and bodybuilders are susceptible to anterolisthesis.
4. Tumor – A tumor in the spine causes the vertebra to move from its normal position. ⁽⁵⁾

Clinical Manifestations

• Intense pain, especially in the back area (lower back pain). The pain can be localized or widespread.
• Difficulty walking secondary to pain felt in one or both legs.
• Poor/loss of bowel and bladder control
• Limited range of motion ⁽⁵⁾
• Inflammation
• Tingling sensation
• Muscle spasms ⁽⁶⁾

Who are at risk?

Anterolisthesis is more common in male than female primarily because the former are engaged in strenuous physical activities.

The prevalence is higher in old age than the younger population. Lifestyle and occupation can also increase the possibility of anterolisthesis. Heavy lifting, jumping, hyperextension of the body, and other forms of strenuous activities can increase the possibility of anterolisthesis. (6, 7)

How to diagnose anterolisthesis?

The doctor will conduct a thorough physical examination to determine the root cause of the problem. The spine is closely examined, especially if the symptoms all lead to anterolisthesis. Additional tests should be performed to confirm the diagnosis such as x-ray, CT scan, and magnetic resonance imaging (MRI scan). (7, 8)

Treatment

The treatment for anterolisthesis depends on the grade of slippage. The first two grades are simpler to treat because they have mild symptoms. However, grade 3 to 5 are quite difficult to treat because of the severity of the condition. Most of the time, they would require aggressive treatment approach such as surgery. ^{(6, 9)}

Anterolisthesis treatment includes the following:

Rest

For mild cases of anterolisthesis, the patient is strictly put on a bed rest. Anterolisthesis exercises are performed to maintain the integrity and mobility of the spine. However, strenuous activities are highly discouraged to prevent further damage to the vertebra. ⁽²⁾

Pain Management

The patient can experience mild to severe pain. Rest and exercise are not enough to alleviate the pain. The patient should be put on pain medication such as non-steroidal anti-inflammatory drugs. For severe pain, the patient is put on steroids and opioids. ⁽¹⁾

Anterolisthesis Physical Therapy

It is important to make sure that the vertebra will regain its strength. For that to be possible, the patient is strongly encouraged to go on a physical therapy. The physical therapist knows what types of exercises work best for the patient. Physical therapy aims to improve the strength of the muscles of the back and alleviate the symptoms caused by anterolisthesis. A physical rehabilitation therapy will eventually ease the pain, decrease if not totally alleviate inflammation, promote vitality, and improve the overall well-being. ^{(3, 5)}

Surgery

If the anterolisthesis is in its severe stage, the best remedy is for the patient to undergo surgical procedure. It should be the last resort and should only be done when deemed necessary. Depending on the severity of the condition, the surgeon can opt to support the spine or adjust the vertebrae using different tools such as metal plates, rods, wires, and screws. I

t depends on the general condition of the spine and vertebra. The objective of surgical procedure is to get rid of the bone or tissues so as to release the pressure in the vertebrae, to fuse the bones in position, or both. ⁽⁶⁾

Chiropractic Treatment

Chiropractic approach is a traditional treatment method but works best for anterolisthesis. The bones of the spine are manipulated to achieve correct alignment. However, not all patients qualify for this type of treatment. Hence, a physical examination along with past medical and surgical history should be made. Who are not a good candidate for chiropractic treatment? They are the patients who have compression fractures, cancer, infection, cauda equine syndrome, and abdominal aortic aneurysm (enlargement of the aorta). ⁽¹⁰⁾

Anterolisthesis is a condition that shouldn’t be taken lightly. Anything that involves the spine can surely affect your mobility and range of motion. Problems on the spine can directly and indirect affect other parts of the body, especially the legs and arms. There are a variety of treatment approach for anterolisthesis. However, the treatment should be based on the severity of the disease and the overall condition of the patient.

Mild cases are easier to treat. Hence, it is a must to diagnose the condition at an early stage. If you notice any pain and discomfort in the spine, you need to consult your health care provider right away. This is to detect the underlying condition the soonest time possible.

Advanced stage of anterolisthesis requires not just medical but also surgical intervention. The success of the procedure varies depending on the general condition of the patient. This is why it is of utmost importance to detect the disease at an early stage. ^{(7, 8)}

References:

1. www.cedars-sinai.edu
2. www.spine-health.com
3. www.doctorshealthpress.com
4. healthfixit.com
5. www.hxbenefit.com
6. byebyedoctor.com
7. www.medicinenet.com
8. healthsaline.com
9. https://en.wikipedia.org
10. Handbook of Clinical Chiropractic Care By Lawrence H. Wyatt

Swimming is a great form of exercise, especially for people with lung problems. However, swimming in a pool can sometimes cause allergy, especially if you have a sensitivity to chlorine.

Chlorine is a skin irritant. Can chlorine make your skin itch? Yes, especially if you have a sensitive skin. It causes drying of the skin, which makes it prone to irritation. It can also indirectly contribute to respiratory problems by irritating the respiratory tract. Prolonged exposure to swimming pools with high chlorine content puts you at risk for asthma and other respiratory illnesses. ^{(2, 4, 6)}

Swimming pools contain chlorine but usually in small amount. However, some swimming pools have high level of chlorine. The purpose of chlorine in the swimming pool is to disinfect it so that bacteria and other pathogens will be killed.

Some people don’t have any problems being exposed to pools with chlorine. However, some people develop chlorine allergy. They complain of chlorine rash and discomfort. A chlorine rash is also known as swimming pool rash because the rash appears after patients have been to a swimming pool. ^{(1, 3, 4)}

Chlorine Rash Pictures

Photo 1: A typical clinical manifestation of a chlorine rash.
Picture Source: doctordecides.com

Image 2: A severe form of chlorine rash wherein there is an obvious inflammation and reddish discoloration of the skin.
Photo Source: medmum.com

Photo 3: A severe form of chlorine rash affecting the abdomen and the upper torso.
Picture Source: medicalbite.com

Rash from chlorine : Symptoms

• Severe itching
• Noticeable small bumps all over the skin which could turn into patches after a few hours or days
• The patches turn red and the affected body parts swell
• A noticeable pain in the affected body parts
• The patient complains of watery, swollen, painful, and itchy eyes
• There is a scaling or crusting of the skin
• Difficulty/labored breathing and a feeling of chest tightness
• Coughing, especially at night time
• Sneezing and runny nose
• An abnormal sound during breathing (wheezing/whistling sound) ^{(1, 5, 7)}

What causes a chlorine rash?

As the name implies, chlorine is the primary causative factor for chlorine rash. What is a chlorine? It is a yellow-green dense gas used to kill bacteria. It is added in the swimming pool and public pools to get rid of bacteria and other pathogens.

However, too high chlorine level can cause skin irritation and other health problems. Those with chlorine intolerance are susceptible to rashes and respiratory-related problems. ^{(8, 9)}

Chlorine Rash Treatment

How to treat a chlorine rash? What you can do to get rid of rashes? How long does chlorine rash last? If you notice a rash after being exposed to chlorine, you should immediately wash the affected area with clean water. Chlorine rash remedies are vast. The treatment of choice depends on the factors that cause the rash. On a medical standpoint, the usual treatment modalities include the following:

• Cream/ointment – A prescription cream can help improve the condition of the rash, alleviates pain and inflammation, and relieves itching. However, for the cream to be effective it should be used as prescribed by the doctor. Strictly follow the usage instruction for you to get the best result. ⁽¹⁰⁾
• Antibacterial soap – Keep the affected area of the skin clean by washing it with antibacterial soap. This is to prevent secondary infection, which could worsen the overall condition of the skin. It is important to keep the affected area of the skin clean and dry at all times. ⁽²⁾

Home Remedies for Chlorine Rash

1. Warm and cold compress – Chlorine rashes are itchy and at the same time painful. To alleviate the pain and relieves itching, a warm and cold compress should be done on the affected parts of the body.
2. Starch bath – Trying to scratch the itch can increase the possibility of infection. To somehow lessen the itchy feeling, the patient should have a starch bath. Basically, it is a water with a corn starch mixture.
3. Aloe Vera – The extracts of fresh Aloe Vera soothe itchiness. Apply the extracts directly on the affected part of the body several times a day. ^{(1, 4, 5)}

Prevention

Just because you are sensitive to chlorine does not necessarily mean that you can no longer swim in the swimming pool. You just need to find out how you can prevent chlorine rash. The following tips can help prevent the possibility of having a chlorine rash.

• When swimming in a public swimming pool, do not hesitate to ask the manager about the level of chemicals in the waters.
• After swimming, you should immediately remove your swimsuit so as to limit the skin contact with chlorine.
• Take a shower before and after swimming.
• If you have a private pool, you need to make sure you are going to put the right amount of chlorine in the water. It is important to keep the level of bacteria low but it is also important to take care of your skin. Too much chlorine in the water can cause skin irritation. The ideal chlorine level is between 1.0 – 3.0 ppm. ^{(4, 6)}
• When swimming in a public pool, you should first test the pH level of the water. You can try submerging a part of your feet and wait for a few minutes. If rashes didn’t appear, then it is an indicator that the water has a safe chlorine level.
• There are skin care products designed to prevent the development of chlorine rash. It is usually in the form of lotion. Apply the lotion before swimming. There are different brands to choose from and the prices vary depending on the brand.
• After swimming, you should apply vitamin C spray. This is to prevent skin irritation which can be caused by high level of chlorine in the water. ⁽⁸⁾
• Make it a habit to rinse after swimming. Use antibacterial soap and clean your skin properly. It would also help if you are going to hit the sauna after swimming. This is to bring out the chlorine smell through sweating. ⁽⁹⁾

Many people can stand a high level of chlorine in the water. However, if you have a sensitive skin you are most likely susceptible to chlorine rash and other forms of skin rashes. The skin is the first line of defense and so it is important to keep it clean and intact. Avoid rashes brought by high level of chlorine by following the above-mentioned recommendations.

References:

1. http://acaai.org
2. http://mddk.com
3. http://doctordecides.com
4. www.fastmed.com
5. www.treatnheal.com
6. http://health-benefits-of.net
7. www.swimspray.com
8. http://medicaltreasure.com
9. www.livestrong.com
10. www.healthy-skincare.com

Why is my belly button itchy?

The area around the umbilicus might itch because of yeast disease, contact dermatitis (cleansers, creams or piercings), dermatitis, hives, and stretch skin during pregnancy. Bacterial infection is another conceivable reason.^(4,12)

Itchy Belly Button

Risk factors

• Poor skin hygiene
• Skin disorders
• Infections

Causes of Itchy belly button

• Irritation of the umbilicus (belly button) can come from rashes of the skin around it, or from a contamination within it. A wide range of rashes can develop near the umbilicus.⁽¹⁰⁾
• If there should be an occurrence of bacterial disease, the belly button and the surrounding zones might develop a red rash and itching. The condition might be accompanied with a foul scent and discharge.⁽⁹⁾
• It can also be caused by a bad response to an external substance on the skin such as cream or clothing cleansers.
• In any case, many other skin rashes can affect this region, and if you have seen any skin changes (redness, flakiness, swelling), you should make an arrangement to see a doctor.
• Another probability is contamination of the belly button tract. Sometimes foreign bodies build-up from clothes or body hair can enter the belly button channel and cause an incendiary response.⁽⁵⁾
• Skin conditions like dermatitis and psoriasis might bring about a red rash and tingling.
• Contact dermatitis is another condition that might influence the stomach catch locale, and cause side effects like rash and tingling. This is for the most part created by cleansers, creams, penetrating, and so forth. A few individuals might build up this condition because of contact with the belt clasp or the metal snaps of pants.^(3,6)
• Pregnancy is another condition that might bring about an itchy belly button. Typically, such tingling is because of the stretching skin.

Conditions associated with itchy belly button

• A skin rash near the umbilicus or a disease within the belly button might bring about irritation. Rashes around tummy might arise because of numerous things, especially contact dermatitis. This is a sort of hypersensitivity response to substances detected to be foreign by the body, for example, cream, garments, clothing cleansers, and detergents.⁽⁸⁾
• The navel tract can have an infection. Foreign substances, for example, build up that confined from garments and body hair could enter the umbilicus along these lines bringing about irritation or swelling. A disease might therefore occur, chiefly accompanied by a foul smell, tingling, and discharge from the umbilicus.⁽⁷⁾

Symptoms of Itchy belly button

• Redness
• Soreness
• Tingling
• Pain.
• Once in a while draining might occur or some release of a whitish watery substance from the navel.
• The zone around the belly button might experience burning, inflammation, and moistness because of contamination.
• Itchy navel might also bring about fever, which is a non-particular side effect.^(3,5,6,8)

Redness of the area around the belly button

Itchy belly button during Pregnancy

At the point when skin stretches it turns out to be having less moisture and dry skin tends to feel bothersome and uncomfortable. The navel might also have a similar experience if it is extending close to the midsection. The navel may then develop itchiness.^{(1, 7, 11)}

Prevention of itchy belly button

• Diseases in umbilicus can be averted by ensuring that the region around is kept clean. It ought to be washed properly and completely.
• The body hair around navel should be trimmed to create an environment that is less susceptible to growth of organisms. Trimming the hair around also guarantees that it doesn’t tumble off and enter the umbilicus trench.⁽²⁾
• Itching of belly button can be avoided by strengthening the body’s immune system and living a generally healthy lifestyle.⁽⁶⁾

What to do when you have itchy belly button

• Try not to scratch – Enticing as it might be, scratching ceaselessly at your skin worsens the condition.
• Moisturize – A light, delicate, scent free cream can help control the itching. Apply it frequently and generously.⁽²⁾
• Apply pink calamine lotion – This works well especially, in extreme cases.
• Apply Vitamin E oil –  This is extremely recuperating. It is great for sensitive areolas after pregnancy, as well.
• Douse it up – A delicate cereal shower with warm water can work better for dry skin — just ensure the water’s not very hot (it can dry out your skin considerably more).
• Utilize a humidifier in your room – It might keep your skin from drying out. However, proceed with caution, as it can also spread germs and trigger hypersensitivities if utilized indiscriminately. ⁽¹⁾

Treatment

Sometimes, home remedies are sufficient to cure itchy belly button. If the condition persists or increases in severity, you should consider more therapeutic methods or consult a doctor. This is very important because severe itching can be a sign of another hidden condition. Along these lines, the condition must be diagnosed and treated properly.⁽²⁾

• Use of warm salty water – Infections on the belly button can be treated with warm salty water. The warmth of the warm water will increase blood flow to the affected site while the salt will absorb the dampness within the belly button to help to recuperate. Additionally, it will work as a disinfectant.⁽⁶⁾
• Keep the affected area clean – To advance healing and avoid further development of microbes in the area affected, it is essential to keep the affected zone spotless and dry.⁽⁹⁾
• Antibacterial cleansers – To clean the belly, you can utilize an antibacterial cleanser while washing up. After your shower, dry the affected area thoroughly and apply some water-based antibacterial cream or moisturizer twice or thrice daily until the contamination clears up.⁽⁹⁾
• Use of antibiotic agents and antifungal medication – Antibiotic agents and antifungal medications might be utilized to treat microbes, contagious and yeast diseases. Daily washing will keep the area clean and free from germs.
• Seek medical advice – Talk to a doctor if you notice that that the irritation does not resolve and is bringing on different side effects like pain or indications of an infection such as swelling.
• Belly button infections might be treated through the utilization of hydrogen peroxide to maintain body hygiene.⁽⁸⁾

References

1. Daya T, McKaigney C. A “ticklish” belly button…. CJEM. 2015;:1-3.
2. Red itchy belly button during pregnancy [Internet]. 2014 [cited 14 January 2016]. Available from: http://www.top10homeremedies.com/how-to/treat-belly-button-infection.html
3. Kumari K. Itchy Belly Button [Internet]. Buzzle. 2016 [cited 14 January 2016]. Available from: http://www.buzzle.com/articles/itchy-belly-button.html
4. Itchy rash because of belly button piercing [cited 14 January 2016]. Available from: https://www.healthtap.com/user_questions/972083
5. Myhealthyfeeling.com. Itchy Smelly belly button ring [Internet]. 2016 [cited 14 January 2016]. Available from: http://www.myhealthyfeeling.com/itchy-belly-button-and-causes/
6. Is Itchy belly button a sign of pregnancy? | ZocDoc Answers [Internet]. 2016 [cited 14 January 2016]. Available from: https://www.zocdoc.com/answers/2760/what-causes-belly-buttons-to-itch
7. Will I. Skin changes during pregnancy.
8. The Doctors. Yeast infection and belly button [Internet]. 2016 [cited 14 January 2016]. Available from: http://www.thedoctorstv.com/videos/causes-of-belly-button-itching
9. http://symptomstreatment.org/itchy-belly-button/
10. Rusher K, Sanchez S. Navel Piercing Pain – http://www.beautyclue.com/navel-piercing/navel-piercing-pain-healing-itchy-and-navel-piercing-keloid/
11. http://www.womentribe.com/hair-beauty/belly-button-infections.html
12. http://seeyadoctor.com/itchy-belly-button/