Tag: treatment

Arthritis is NOT Just For The Elderly: Early Signs Of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease that, according to the Arthritis Foundation, affects 1.5 million people in the US. Women are 3 times more likely to develop RA and are usually diagnosed between ages 30 and 60, while men are rarely diagnosed before the age of 45 . Unlike osteoarthritis which is caused by wear and tear on joint cartilage over time, RA is caused by an overactive immune system that triggers unnecessary inflammation responses. One effect of this is that the body attacks its own joints causing swelling, stiffness, and chronic joint pain as well as irreversible damage. This limits joint mobility and decreases the quality of life for those impacted by it, especially those diagnosed as children or young adults.

This disease cannot be cured but treatments like medicine or dietary/ lifestyle changes are most effective when diagnosis happens early. When joint damage occurs it is irreversible, meaning the only treatment option is surgery. The joints most commonly affected in the early stages of this disease are finger joints which are usually the first sign of inflammation and will be the focus of this article. The image below shows the progression of finger joint damage in a patient with RA starting with no damage (a) to severe damage (c).

As an RA patient, a typical visit to your doctor would always include a pain/inflammation assessment. With a focus is on early stages of RA, fingers and hands would be the most important areas to look at. Each joint of focus would be felt by your doctor to check for swelling and tenderness, but the most important aspect is the patient’s self-assessment of inflammation and pain. It is important for patients to accurately assess their pain and mobility in order to find a medicine or treatment that works effectively. This was the focus of a study that was conducted on 52 RA patients (33 women and 19 men) which used a variety of tests in an attempt to quantify arthritis damage and compare it to the predictions made my patients.


The first test looked at range of motion for fingers flexed (in a fist) and extended (straightened). The next test measured grip strength in different positions like using a pencil, opening a jar or turning a key by using a device that measured the force produced by the hand in each position. Stiffness was measured visually, and pain levels were also recorded, but it should be noted that pain cannot accurately be quantified because pain tolerances vary among patients. The result of this study was that the patients predictions on grip strength and stiffness best correlated to the real results and were therefore the best predictors of hand function. This means that patient reports of strength and stiffness are the most accurate and helpful to be used by doctors when choosing medications or treatment plans.


Because joint damage from RA cannot be reversed, surgery is usually the only option to repair damaged joints, and even surgery will not bring back full mobility. Because RA treatments (both medicines and surgery options) are still very new there isn’t widely available or reliable data on the impact of hand surgery. Additionally, with the increasing use of the newer class of biologic drugs there has been a noticeable decrease in damage to the synovial tissue (the specialized tissue between the bones in any given joint) and the need for hand surgery has significantly decreased because of this. Overall, a variety of surgeries are available and there is almost always a tradeoff between mobility, vanity and elimination of pain. It is up to the patient, doctor, and surgeon to decide the best treatment option.

Overall, it is important to listen to your body and look out for early signs of RA to avoid lasting joint damage. This is especially important if you have a family history of RA. Early symptoms include, redness, pain, stiffness and swelling at joints, a lack of muscle strength, decreased range of motion/mobility, and even unexplained fatigue or fever.


References and Further Reading

What Can Different Types of Facial Wrinkles Tell Us?

Few people enjoy having wrinkles. Some people spend a lot of time, money and efforts trying to reduce the wrinkles on their face, while others simply appreciate them as something naturally occurs with aging. Regardless, wrinkles are always associated with aging. However, if we look into what different types of wrinkles are and how they form, we will find that not all wrinkles are bad. Not all wrinkles are caused by aging, and not all wrinkles should be treated the same way. Here, we introduce different types of facial wrinkles categorized by plastic surgeon and their corresponding treatment.

A person smiling that shows some wrinkles on her face.
The wrinkles created by the motion of smiling are dynamic wrinkles. They will disappear once the smile stops. Credit: Masterfile.

In general, there are two main types of wrinkles, dynamic wrinkles and static wrinkles. Dynamic wrinkles are the type of wrinkles that only appear when you make expressions such as smiling, laughing, or frowning. These wrinkles disappear once your expressions stop. The facial muscles have enough elasticity to return to their original positions. These are temporary wrinkles that everyone may have, even little kids!

Static wrinkles, on the other hand, are wrinkles that form when your muscles cannot return to their original position due to gravity and loss of collagen and elastin. These wrinkles cannot disappear like the dynamic wrinkles. When the collagen fibers become thinner, the skin loses elasticity and gets more wrinkles, whose width and height grow with age. (Lemperle, 2001) Lemperle et al. from the University of California put these wrinkles into three categories.

Three hand-drawn figures that show textures of different wrinkles.
Figures that show the textural change of skin experiencing (a) superficial wrinkles, (b) mimetic wrinkles, (c) folds. Source: A Classification of Facial Wrinkles.

The first type is superficial wrinkles. These are the less severe wrinkles that only involve textural changes of the skin surface. These wrinkles lines are separate lines at first but will gradually group together. (Arumugam, 2015) Common causes are aging, excessive exposure to UV light, and gravity. Superficial wrinkles, according to Lemperle, can be reduced or removed by chemical peeling (applying chemical solution on the face to peel off the top layer and then grow it back), or laser resurfacing. (Lemperle, 2001)

A figure with 2 side-by-side photos that show the effect of laser resurfacing before and after the treatment. The wrinkles of the person's face reduces.
Before and after laser resurfacing. Credit: Tahoe Aesthetic Medicine.

The second type is mimetic wrinkles. These are more severe and visible dermal creasing. Major causes include aging and repeated dramatic facial expression. (Arumugam, 2015) Because the facial creasing is deeper, the reduction methods include more complicated procedures such as muscle resection (cut out a portion of muscle and inserted the shortened muscle at the same place), botulinum toxin (a neurotoxic protein), or skin filler injection. (Lemperle, 2001)

The picture shows a person's lower half of the face with dash line indicating where the nasolabial line is. A needle is pointing at the dash line mimicking the process of skin filler injection.
Skin filler injection to reduce the effects of nasolabial lines. Credit: Filling in Wrinkles Safely

The last type is folds, the part of the face where droopy skin overlaps. Folds and mimetic wrinkles usually occur together. To correct the overlapping skin, tightening procedures such as blepharoplasty (surgery that repairs droopy eyelids), face lift, or skin excision are needed. (Kligman, 1985)

Noticeably, researchers have discovered that wrinkles formation may be different by gender, race, etc. For example, women in general have finer and less apparent wrinkles than men because their skin is thinner and softer. (Wu, 1995) Asian skin connects more firmly to the tissues underneath because of its thicker dermis and higher collagen density. Therefore, the repetitive pulling of the skin surface affects wrinkles on Asians and Caucasians differently. (Ahn, 1999)

Wrinkles are nothing horrible. They are something that everyone has or will have in the future. There is nothing wrong with wanting to reduce the wrinkles on your face, either. Just remember that there are many types of wrinkles and each of them requires a bit of a different treatment. Spending some time finding the appropriate treatment will most likely save you more time, money, and effort in the future.

Sources:

[1] Lemperle, Gottfried, et al. “A Classification of Facial Wrinkles.” Plastic and Reconstructive Surgery, vol. 108, no. 6, 2001, pp. 1751–1752., doi:10.1097/00006534-200111000-00050.

[2] Arumugam, P, et al. “Facial Forehead Wrinkles Detection using Colour based Skin Segmentation.” Advances in Natural and Applied Sciences, Aug. 2015, pp. 71–80., doi:10.22587/anas.

[3] Kligman, A.M., et al. “The Anatomy and Pathogenesis of Wrinkles.” British Journal of Dermatology, vol. 113, no. 1, 1985, pp. 37–42., doi:10.1111/j.1365-2133.1985.tb02042.x.

[4] Wu, Yin, et al. “A Dynamic Wrinkle Model in Facial Animation and Skin Ageing.” The Journal of Visualization and Computer Animation, vol. 6, no. 4, 1995, pp. 195–205., doi:10.1002/vis.4340060403.

[5] Ahn, Ki-Young, et al. “Botulinum Toxin A for the Treatment of Facial Hyperkinetic Wrinkle Lines in Koreans.” Plastic & Reconstructive Surgery, vol. 105, no. 2, 2000, pp. 778–784., doi:10.1097/00006534-200002000-00050.

Not Everyone Breathes While they Sleep: The Dangers of Sleep Apnea

You might think that breathing in our sleep should come naturally – if breathing and sleeping are both physiologically necessary, then we must be able to do them simultaneously right? Unfortunately, almost a quarter of middle-aged American men and nearly 10% of women suffer from sleep apnea, a chronic condition characterized by repeatedly stopping breathing while sleeping. The clinical symptoms seem rather benign – snoring, sleepiness, fatigue during the day or other issues sleeping. However, by far the most dangerous aspect of this disease is that it puts patients at increased risk of high blood pressure, stroke, coronary heart disease, as well as occupational and/or automobile accidents. Over the last several decades, a variety of therapy options have been studied to treat this condition, ranging from drugs to masks to surgery.

One of the earliest documented therapy options is using protriptyline to treat obstructive sleep apnea. Protriptyline is an anti-depressant drug that was used for its ability to clear airway obstructions during sleep; however, it did not gain significant popularity due to its adverse effects including cardiac complications and limited demographics for whom it would be an appropriate treatment.

The next treatment discussed was altering sleep positions for patients suffering from sleep apnea. A seemingly simple idea, a study determined that laying on the back significantly increased the severity of sleep apnea. Interestingly, the difference in severity between back and side sleeping positions was most noticeable in healthy, non-obese patients. The authors believe that lying on the back causes tissues of the throat to obstruct the trachea and prevent smooth airflow during breathing, as shown in the image below, which would explain why obesity can exacerbate sleep apnea.

Diagram of airflow obstruction through mouth and throat
Photo by Habib M’Henni on Wikimedia Commons.

Multiple non-invasive devices were also studied, including oral appliances, sleep posture alarms, and positive airway pressure devices. Oral appliances can either protrude the lower jaw or restrain the tongue; both aim to restructure the upper airway (mouth, trachea, etc.). Sleep posture alarms were suggested to train patients to sleep on either side, rather than on their backs. Positive airway pressure devices (Bi-PAP, CPAP) are the most commonly used treatment for sleep apnea currently; they maintain a consistent air pressure flowing into the mouth to ensure the airways do not collapse during sleep.

Man sleeping while using CPAP machine
Photo by ApneaMed

The final treatment studied was nocturnal supplemental oxygen (NSO), which involves increasing the concentration of oxygen in the air inhaled while sleeping. However, a study comparing use of a CPAP with use of NSO found that CPAP treatment was far more effective at decreasing the patients’ blood pressure and still proved effective in patients already taking blood pressure medication.

Overall, the best method for treating sleep apnea is dependent on the patient and his or her underlying conditions. Changes in sleep posture could greatly enhance the sleep quality of a moderate case of sleep apnea; CPAP would be ideal for someone who can easily tolerate the mask and does not frequently move in his or her sleep. Each of these demographics makes it difficult to define one optimal solution for treating sleep apnea, but the variety of available treatment options provides hope for those patients who suffer from this chronic illness.

Ankle Sprains: An Epidemic in the World of Athletics

Have you ever been out running on a gorgeous fall day, only to have the run cut short by a painful misstep on a tree root covered by leaves? I have, and let me tell you – it’s awful! And even if you aren’t a runner, according to the Sports Medicine Research Manual, ankle sprains are a common, if not the most common, injury for sports involving lower body movements. Now, the solution to preventing this painful and annoying injury could be as simple as avoiding tree roots and uneven ground, but the real problem behind ankle sprains deals with the anatomy of the ankle.

The ankle is made up of many ligaments, bones, and muscles. However, when sprained, it is the ligaments that are mainly affected. Connecting bone to bone, ligaments are used to support and stabilize joints to prevent overextensions and other injuries. The weaker a ligament is, the easier it is to injure. There are three main lateral (outer) ligaments supporting the ankle joint that can become problematic: the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament. According to a study from Physiopedia, these lateral ligaments are weaker than those on the interior (medial) of the ankle, with the anterior talofibular ligament being the weakest.

An image depicting the various ligaments of the ankle, both lateral and medial.
Anatomy of the ankle, highlighting the lateral and medial ligaments

The next question that has to be asked is why are these ligaments so much weaker than other ones? The answer to this question is based on their physical make up. Ligaments are made of soft tissue that has various collagen fibers running parallel to each other throughout it. The more fibers there are, the more structure and rigidity there is. Think of the fibers as a rope: The rope can stretch to a certain point, but once it hits that point it will snap and break. But if you have a thicker rope (such as the medial ligaments), it becomes much harder to break.

The ligaments on the outer part of the ankle have fewer collagen fibers than those on the inside of the ankle. Thus, when the ankle is moved in an awkward position, it is more likely that the lateral ligaments will break.

Once you sprain your ankle, the focus turns to treatment. Treatment will differ slightly for every individual depending on the severity of the ankle sprain. The simplest way to treat a sprained ankle is to follow the RICE (Rest, Ice, Compression, Elevation) method. Other forms of treatment include taping the ankle or using a brace to restrict movement and to add support and extra stability. Wearing proper footwear is another way that one can prevent and help treat a sprained ankle, as certain shoes are specifically designed to help avoid such injuries. To prevent future ankle sprains, exercises are recommended to help strengthen and stabilize the joint and surrounding ligaments and muscles.

For more information on ankle anatomy and sprains, check out these articles on BOFAS and SPORTS-Health.

Hell for your Heels: Plantar Fasciitis and Heel Spurs

Heel and foot pain are somewhat universal issues, impacting people of all different sizes and activity levels. This type of pain can be seen in obese people, who have increased strain on their feet and heels. This pain can limit their mobility, and even discourage healthy amounts of exercise.  It is also common to extremely active people, such as runners or sports players. This type of pain can prevent a person from participating in the athletics that they work so hard to compete in. I experienced a great deal of heel pain during high school, which made it difficult for me to play sports such as soccer, basketball, and track and field. This was an issue I had to deal with throughout high school, however I never understood what caused this pain that kept me on the sidelines at times.

Image showing the plantar fascia ligament and where inflammation is common
Image from Energize Health

By far the most common cause of heel pain is damage to the plantar fascia. The plantar fascia is a ligament connecting the ball of the foot to the heel bone, critical for stability and power in human locomotion. Damage to this ligament is caused by 2 main factors: weight and use. Increased weight, especially over a short period of time, significantly increases the load experienced by the plantar fascia. This increased load pushes the ligament past its yield load and causes tears in the ligament, weakening its mechanical abilities and causing pain. Another important contributor to this ligament’s damage is its workload. Active athletes and runners push this ligament to its limit by regularly undergoing periods of high-intensity loading, causing fatigue failure. In my case, a combination of these two factors caused damage to my plantar fascia: a large growth spurt combined with regular athletics overloaded this ligament, causing damage.

Artist's rendition of the medical conditions plantar fasciitis, where the ligament is damaged and swollen, and heel spurs, where abnormal bone growth is seen to to ligament damage.
Image from 2019 Harvard Health Publishing

This damage to the plantar fascia relates to two resulting conditions: plantar fasciitis and heel spurs. Plantar fasciitis is the swelling of the plantar fascia ligament. This inflammation is caused by the tears and damage as previously discussed, causing sharp pains to the bottom of the foot and heel. Tears in the ligament typically occur at the connection of the bone and ligament. Certain factors can make a person more susceptible to this condition, such as having flat feet or wearing footwear with poor support. In both cases, the plantar fascia is loaded poorly, causing the painful inflammation. There are conflicting studies as to how this condition relates to heel spurs and heel pain.

Heel spurs are calcium deposits located around the connection of the plantar fascia to the heel bone, which cause abnormal bone growth in the area. Heel spurs are caused by prolonged loading and damage to the foot muscle and plantar ligament. Heel spurs are often seen as a result of plantar fasciitis, however the two aren’t mutually exclusive. Heel spurs are found in patients without any evidence of heel pain, raising doubts about how they are directly related. Some studies argue that the heel spurs themselves cause pain, while others contest that they develop in response to plantar fasciitis, the true source of the pain.

These conditions are typically first treated through non-invasive methods. These strategies include specific stretches, targeted exercising, a reduction in workload, and weight loss (if safe). These treatment methods help to improve the mechanical properties of the ligament, making it stronger, less stiff, and less fatigued. Dr. Jarocki from Michigan Medicine gives a thorough and concise summary of the causes of heel pain, as well as some exercises that can help to alleviate this pain.

If these fail, invasive surgery can be required. Surgery can be used to repair the ligament itself or to remove the heel spur. The controversy over the relationship between heel spurs and pain has important implications for the effectiveness of this type of surgery.

Sources and Additional Information:

https://www.health.harvard.edu/a_to_z/heel-pain-a-to-z

https://www.sciencedirect.com/science/article/pii/S1067251601800715

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309235/

https://www.sciencedirect.com/science/article/pii/S1067251609800653

Patellar Tendinitis: The Kryptonite of Jumping Athletes

Volleyball is a sport of quick movements. For hitters, one of the most common movements in the game is the jump, whether that be to block or to hit. Although a higher vertical leads to improvement in game performance, it can increase the risk of developing a serious injury that affects many volleyball players: patellar tendinitis. This condition is associated with pain and tenderness directly below the knee cap that is especially apparent during explosive, jumping movements. But what exactly causes this condition? And what can be done to remedy it?

A schematic of the knee and patellar tendon.
Image from Wikipedia “Patellar Tendinitis”

Since volleyball is such a quick game, muscle memory is required to react to different situations that can occur. The main way to build muscle memory is repetition. Therefore, young volleyball players are encouraged to play the sport as much as possible. For many athletes, this means playing for their school during that season and then playing for an independent club for the rest of the year. Although this increases the athlete’s skill level, it also increases the chance of patellar tendinitis, according to a study.

Besides overuse, lack of ankle mobility can also lead to a higher risk of the condition. A study found that players that couldn’t flex their ankle upward past 45 degrees could have 2 times the risk of patellar tendinitis as players with a higher ankle mobility. This is most likely due to the ankle and calf’s role in absorbing impact upon landing. Less absorption by the ankle causes more force to be put on the patellar tendon. This is bad news for volleyball players who often have poor ankle mobility due to a past injury.

There are a few ways to treat patellar tendinitis. For an orthotic approach, players use straps or tape around their patellar tendon. Some think this is simply due to the fact that the strap or tape makes the athlete feel more stable, which allows them to load the tendon more properly. However, a study done in 2011 analyzed the strain in the patellar tendon using a computational model. The researchers found that the patellar tendon strap increased the angle between the tendon and the kneecap, which caused the strain to decrease. Decreased strain means that the tendon stretches less, which would decrease the incidence of patellar tendinitis. Another way to treat the condition is surgically. One of the more simple surgeries is a removal of the dead or torn tissue of the patellar tendon. This allows new, healthy tissue to form.

A strap being put around the patellar tendon that can ease pain.
Image from Sports Injury Clinic “Patella Tendon Taping”

Patellar tendinitis is a serious condition affecting many high-level athletes. Although there isn’t a simple cure, researchers have brought to light different causes and treatments of the condition. These can be used to help athletes remedy the pain they are experiencing and perform at their best.

Sources:

Study on How Vertical Affects Patellar Tendinitis

Study on How Training Volume Affects Patellar Tendinitis

Ankle Flexion Study

Patellar Tendon Strap Proprioception Study

Patellar Tendon Strain After Applying a Strap

Additional Reading:

Clinical Trial on Patellar Tendon Strap

Ways to Prevent and Treat a Common Annoyance: Headaches

Headaches can range from a mild annoyance to a debilitating condition that results in the inability to complete simple daily tasks. Odds are you have experienced a headache since about 50% of the population has suffered some type of headache. While there are many different variables that may have triggered it (injury, stress, chemical imbalances, etc.), the resulting symptoms are always negative. Scientists have been investigating what causes different types of headaches in hopes that they can help people prevent their occurrence and mitigate their symptoms.

One of the most common types of headaches is a cervicogenic headache – a secondary headache caused by referred pain from the neck to the head and facial regions. The high prevalence of cervicogenic headaches – 70% of people who suffer from headaches – prompted one study using a MyotonPRO device to measure and compare the tone, stiffness, and elasticity of the suboccipital and upper trapezius neck muscles in people who have and have not suffered from cervicogenic headaches.

Human suboccipital muscles located underneath the back edge of the skull.
Modified from BodyParts3D, Copyrightc 2008 Life Sciences Integrated Database Center licensed by CC Display-Inheritance 2.1 Japan.

Human trapezius muscle shown spanning the upper back through the neck.
Modified from BodyParts3D, Copyrightc 2008 Life Sciences Integrated Database Center licensed by CC Display-Inheritance 2.1 Japan.

The results showed that the tone – the degree of tension in a relaxed muscle – and stiffness – movement ability of the muscle – values were significantly higher in people who have suffered from cervicogenic headaches in the past. This can likely be attributed to overuse or high levels of past activity of these muscles. This can cause inflammation or other physiological changes that aggravate the nerve fibers in the neck resulting in a cervicogenic headache. The tone and stiffness data can be used to help educate patients on the importance of properly stretching their neck muscles before and after physical activity in order to keep them from tightening and shortening due to overuse. Muscle relaxing medications could also be used as a type of treatment when someone is suffering from a headache.

Tone and stiffness data for people with and without cervicogenic headaches.
Modified from Park, et al., The Journal of Physical Therapy Science 2017.

Another common type of headache is a migraine – a primary headache that has occurred multiple times throughout someone’s life. While a migraine can also have many different triggers, one study investigated the impact of a chemical imbalance of dopamine. This study found patients who suffer from migraines experience a decrease in dopamine levels before they feel the symptoms. There are a couple theories as to why decreased dopamine levels result in migraine symptoms: 1) decreased dopamine increases sensory sensitivity which may result in normally painless signals becoming painful, 2) decreased dopamine impacts motivation and reward/aversion to a point where patients withdraw and seclude themselves. In general, these findings can be useful for the advancement of dopamine regulating drugs in order to combat migraines. Further reading on different chemical causes of headaches in mice can be found here.

Figure showing dopamine levels decreasing during the onset of a migraine.
Modified from DaSilva, et al., Neurology 2017.

Overall, there are many different headache triggers and a lot more research needs to be done before science fully understands how they work. However, there are some things people can do now in an effort to lessen the probability they will suffer from headaches. Additionally, there are  medications and other techniques that work through different paths to mitigate the symptoms of a headache.

Cause and Management of Stretch Marks

Stretch marks. How are they caused? Can they even be treated?

Stretch marks can happen to anyone, of any age, so these questions are important to many. In short, our skin is made up of both collagen and elastin, two elements that support and shape our skin through their natural elasticity. This elasticity, however, does have its limits. And when that breaking point is reached, the collagen and elastin rupture, leaving behind scars many know well – a stretch mark.

Difference between normal skin tissue and stretch mark tissue
From Ud-Din, McGeorge, and Bayat, Journal of the European Academy of Dermatology and Venereology 2015

Stretch marks are caused when skin expands or shrinks at a more rapid pace than the collagen and elastin can accommodate, resulting typically in raised scars that can appear rather inflamed at first. Over time, however, these stretch marks may fade, nearly matching one’s natural skin tone, and usually fall below the surface of the skin. This results in the feeling of a slight indentation when touching older stretch marks.

Like all scars, stretch marks are permanent. But this does not mean that they cannot be treated. There are many treatments available to diminish the visual effect of a stretch mark; not all of them are effective, and some seem not to work at all.

Collagen’s elasticity is controlled by the body’s  cortisone levels, which are commonly associated with episodes of high stress. Basically, heightened cortisone production may decrease the skin elasticity, suggesting that reducing one’s stress may be the most cost-effective and cheap treatment for stretch marks.

Researchers S. Ud-Din, D. McGeorge, and A. Bayat put these post-stretch mark treatments to the test in their paper, focusing on three topical treatment categories – marketed skin creams and oils, over-the-counter home remedies, and prescription medicines and dermatologist procedures.

These topical treatment methods are mainly marketed at increasing collagen production with both hydrating and anti-inflammatory traits. Ultimately, testing yielded mixed results about the efficacy of these treatments. Since participants both massaged their scars and used a topical treatment, the observed improvements to stretch mark appearance could be tied to either of these. Ultimately, however, the researchers did conclude that the age of the scar plays a role in treatment effectiveness, as younger, newer scars were more responsive to treatments.

Beyond these topical treatment methods tested, there are many other dermatological procedures designed to reduce the appearance of stretch marks, including chemical peels, laser therapy, and microdermabrasion. Chemical peels and microdermabrasion focus on removing layers of skin to expose new, non-scarred tissue underneath the stretch mark. And laser therapies are divided into two categories: those that stimulate collagen production and those that promote melanin production (so that the scar tissue matches the natural skin). While these dermatologist procedures can be more effective than the topically applied treatments, they are often expensive and are not guaranteed to be effective. Additionally, dermatologists often combine several procedures, eliminating this treatment for those with cost constraints.

All in all, there are no sure-fire ways to prevent stretch marks, but certain practices do demonstrate that one can prevent stretch marks or at least lessen their appearance fairly cheaply and effectively without any of the products and procedures detailed above. By maintaining a healthy weight, one may avoid the rapid weight loss or gain commonly associated with stretch marks.

For more information, check out these articles on Healthline and AAD.

The Study of Snoring is Anything but Boring

Here we take a deeper look about that noise that plagues some of our family members, our roommates…or even ourselves!

Elderly man sitting in the sun, asleep with head back and mouth open.
Photo by Stephen Oliver on Unsplash

What Causes You to Snore in the First Place?

The human upper airway contains anatomical parts that are membranous, meaning they lack support from cartilage. Some parts include the tongue, the soft palate, and the tonsillar pillars. A lack of cartilaginous support enables these parts of the airway to be susceptible to vibrations.

Anatomical diagram of the human upper airway.
Modified from Huang, Quinn, Ellis, and Williams, “Biomechanics of Snoring,” from Endeavor, 1995.

During sleep the upper airway muscles relax and cause the size of the airway space to decrease, resulting in airflow limitation and turbulence.

Whenever we inhale, the turbulent flow through the relaxed airway causes those membranous structures to vibrate and produce a sound most commonly known as snoring.

A Brief Mechanical Explanation of Snoring

Examining snoring in the view of mechanical systems, respiratory noise is created by the oscillation of the upper airway with the air passing through it. This oscillation is indicative of an issue with flow instability (turbulent flow) over a flexible structure (the relaxed airway).

An experiment was created to model the movement of the soft palate during snoring, where a piece of wood was used to simulate the hard palate and a piece of leather simulated the soft palate. The leather and wood were attached to each other inside of a rigid tube that was connected to a pump (meant to model the lung inspiration).

During inspiration, the leather flap oscillated until it reached its full amplitude. Upon reaching the maximum amplitude, the leather flap hit the wall of the tube and created a noise known as palatal “flutter”. This palatal flutter is the most common method of noise production in humans: snoring.

Is Snoring Something to Be Concerned About?

Young woman waking up in the morning, appearing tired.
Photo by Kinga Cichewicz on Unsplash

Approximately 44% of men and 28% of women are habitual snorers.

Snoring can be a symptom of obstructive sleep apnea, a condition distinguished by snoring and breathing that is labored by repetitive and obstructive gasps.

The fragmented sleep resulting from sleep apnea can lead to decreased energy and poor attention and concentration. Sleep apnea can also be related to vascular issues like hypertension and its prevalence appears to increase in people over 65 years of age.

What Are Some Remedies to Snoring?

Remedies for snoring range from noninvasive devices to invasive surgical procedures.

The surgical option to remedy snoring involves removing a portion of the vibratory tissue from the back of the upper airway. For those people wanting to avoid surgery, non-invasive solutions include the use of nasal strips to lift and open the nasal passages; experimenting with sleep positions other than sleeping on the back; or using oral appliances and nasal continuous positive airway pressure (nCPAP) to prevent the tongue and soft palate from collapsing into the upper airway. Losing weight, avoiding smoking and alcohol can also help to reduce snoring.

There are also resources for snoring in kids, as well as additional home remedies and surgical information regarding snoring.

Below is a great animated video which gives an introductory explanation to snoring.