Dr. Kim Leis-Keeling

Dr. Amanda Boccio

 

Serving Albany and Guilderland

2021 Western Avenue, Ste 102

Albany, NY 12203

518-869-3415

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Carpal Tunnel Syndrome VS Cervical Radiculopathy

By: Dr. Amanda Boccio

It’s just before lunchtime, and you’ve had a busy morning at the office.  Calls have been coming in non-stop, so you’ve had the phone clenched between your right ear and right shoulder as you simultaneously work at your computer.  You start to notice a faint pins and needles sensation in your right index finger, and your forearm starts to cramp and stiffen up.  You hang up the phone, shake out the hand and notice how tight your neck and shoulder feel from hunching over the keyboard.  “Thank goodness I can take a break to move and stretch out”, you think to yourself. “It’s been so crazy at work, I can’t tell if I’ve aggravated my disc bulge from two years ago, or if I’m starting to get carpal tunnel!”

Patients commonly seek advice from their health care provider when they experience numbness, tingling or pain in the hand or upper extremity.  The key to developing an effective treatment plan to address these symptoms is to find the source of the problem.The nerves that provide sensation, power muscles, and elicit pain in the upper extremity exit the spinal cord as nerve roots in the neck, or cervical spine. These nerves can be irritated in several predictable locations, especially at the wrist, as they traverse from the neck to the fingertips.  Irritation of the 7th cervical nerve root in the neck and irritation of the median nerve at the wrist can both cause symptoms into the hand.  How can we determine the difference between carpal tunnel syndrome and a cervical spine issue when symptoms seem to overlap?

Carpal Tunnel Syndrome is the compression of the median nerve at the wrist.  Symptoms include pain, numbness, tingling and weakness typically affect the palm, thumb, index, middle and part of the ring finger.  These symptoms can be caused by arthritis in the wrist, repetitive motion, or even swelling and fluid retention during pregnancy.  With a true carpal tunnel syndrome, symptoms are often aggravated by repetitive hand and wrist motion such as with typing, gripping a screwdriver, or even using equipment that vibrates- like a snow blower.  Patients will complain of numbness and tingling when they sleep, especially if they curl their wrists and hands under the pillow.  They will have the urge to “shake out” their hand upon waking in the morning.  If symptoms persist, weakness in grip strength or clumsiness with fine motor activities may result.   Carpal Tunnel Syndrome can be treated conservatively with manual therapy, modalities, forearm and wrist stretching exercises, and night splinting.

Cervical Radiculopathy is a condition where hand and arm symptoms are caused by compression or irritation of the nerve roots exiting the spine in the neck.  Symptoms include pain, changes in sensation, muscle weakness and diminished reflexes in a predictable pattern based on which nerve is affected. The cervical nerve roots can be irritated by common neck conditions including disc bulge or herniation, and arthritis.  Degenerative changes in the cervical spine that occur with aging include decreased disc height, and formation of bone spurs.  Decreased disc space combined with bony hypertrophy leads to narrowing of the spaces for the cervical nerve roots.  Mechanical impingement of these nerves can lead to symptoms into the arm and hand.  C6-C7 disc pathology, or degenerative changes in this motion segment impinge upon and irritate the C7 nerve root.  This is the most commonly affected nerve root- and it just so happens to overlap the areas of the hand and arm innervated by the median nerve.

When hand symptoms are caused by cervical radiculopathy, patients often have concurrent neck pain, stiffness and decreased range motion.  Pain, numbness and tingling in the hand are often reproduced with neck extension and rotation (like when turning your head to check your blind spot in the car) or prolonged sitting with poor posture (like the office worker described above).  Conservative management is very effective for symptoms caused by cervical radiculopathy.  Treatments include cervical traction, chiropractic adjustments, soft tissue therapy, modalities, stretches and exercises to improve posture. 

Differentiating between carpal tunnel syndrome and cervical radiculopathy can be challenging.  At the Sports & Spinal Wellness Center, we are more than happy to work with you to determine the root cause of your symptoms and formulate a treatment plan to get you back to feeling well.  As always, if you have questions about the article, please feel free to contact me at 518-869-3415.  Follow us on Facebook or visit our website at www.sportsandspinalwellness.com.

March 04, 2019
Category: Uncategorized
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PROBIOTIC BREAKDOWN

BY: Dr. Kim Leis-Keeling

 

 

What do you know about probiotics…other than they are in your yogurt? Maybe you have seen Jamie Lee Curtis on the commercials promoting Activia yogurt for intestinal regularity. Here is the scoop: probiotics are microorganisms that live in our gut (small and large intestine) and other areas of our bodies. These little guys are a major component of your immune system. Science has referred to our guts as a “second brain” because these organisms send signals to our brains to let it know what is going on below. This system is called the Brain-Gut-Microbiome Axis. Scientists are discovering more specifications as to their effects on the human body. Recent research suggests that by having a strong intestinal immune system it has a synergistic effect on the integrity of the brain. This communication through the endocrine system (hormones) and the immune system can result in reduced stress, anxiety, depression and appetite control to name a few benefits.  In years to come, you will start to see more information relating specific bacteria (or lack of it in our gut-biome) and causing illness in our bodies. Here is a list of some of the most common probiotic microorganisms that you may see on supplement labels:

Lactobacillus acidophilus: One of the main probiotics found in mouth, intestines and vagina.It aids in digestion and also treats diarrhea, Candida, irritable bowel syndrome (IBS), UTI’s, leaky gut syndrome, reduces lactose intolerance, increases our absorption of calcium, B vitamins and can even improve appetite control. Helps balance pH of the upper intestinal track which may help with heartburn. It also facilitates the digestion of lactose.

Bifidobacterium lactis: Main probiotic to break down body waste & aid in the absorption of various vitamins & minerals. Decreases lactose intolerance, IBS, constipation and diarrhea. It decreases cavity causing bacteria in the mouth, fights cancer tumors, reduces colds, flu and strengthens the immune system.

Lactobacillus plantarum: This probiotic produces antibiotics and lysine, an essential amino acid. It can help fight topical burn infections while accelerating burn healing. Fights fungal infection and postoperative infections. It decreases frequency of colds, flu and strengthens your immune system specifically in nasal and sinus passages.

Lactobacillus casei: Good for digestion, allergies, immune system. Helps to maintain remission of diverticular disease, resists ulcers by inhibiting H. pylori. It prevents colorectal tumor growth and inhibits tumor growth of carcinomatous peritonitis/stomach cancer.

Lactobacillus rhamnosus:   Helps maintain a healthy vaginal microbiota by increasing beneficial bacteria making this a great treatment for chronic vaginosis. Supports urogenital health. Boosts immune system to reduce colds and flu, respiratory infections and ear infections.

Bifodobacterium bifidum:  This probiotic directly competes with Candida & yeast overgrowth, fights E. coli infections, decreases allergies, reduces ulcers and inflammation.

Lactobacillus salivarius: Fast growing hardy probiotic that crowds out bad bacteria quickly. It produces antibiotics that target invading pathogenic bacteria such as E. coli, Salmonella. It aids in protein digestion, reduces cavities, gingivitis and strep throat. It can also reduces mastitis, ulcerative colitis and IBS. Supports intestinal epithelial tight junctions to reduce leaky gut or intestinal permeability.

Streptococcus thermophiles: Produces antibiotics that prevent infections like pneumonia, C. difficile and ulcers caused by H. pylori. Decreases ulcerative colitis, IBS, and acute diarrhea. Reduces symptomatic dermatitis, chance of kidney stones and has anti-tumor activity. Improves immunity.

If you would like to learn more about how probiotics can improve your health, we are here to answer your questions and help you boost your immune system. If you want to do your own research, GO TO GOOGLE SCHOLAR, not regular Google! This will give you research articles about whatever health topic you wish to learn about. As always, feel free to contact me at the Sports & Spinal Wellness Center at 518-869-3415 or visit our website www.sportsandspinalwellness.com, follow us on Facebook at www.facebook.com/sportsandspinalwellness.

 

 

 

 

March 04, 2019
Category: Uncategorized
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JUST START MOVING!

By: Dr. Kim Leis-Keeling

Here we are again. A new year…a fresh start. Do you feel obligated to have a revolutionary resolution? I really get annoyed with New Year’s Resolutions articles and media discussions about it. But here I am writing about it. We all have the same goal – to be healthier. So let’s stop thinking about the perfect plan, the perfect goal and just start moving! By the time we ponder what our goals should be and spend 5-10 hours researching how to exercise and what program we need, downloading and figuring out fitness apps and how many macros we need (new fancy way to say we are counting calories), we could have lost 5 pounds. Let’s just start moving!

How many of you have said this to yourself? “I need to get in shape to go back to the gym.” I know I have. How crazy is that? Let’s just start moving! We are never going to be back in our twenty-something bodies. But we can improve our health at any age. How did exercise become so complicated? It seems that there is so much information out there that it feels overwhelming and confusing knowing where to start. Keep is simple – start by walking and moving your body more through the day. Let’s pay some homage and reminisce about the great fitness enthusiast that got us all moving and grovin’ back in the day – Jane Fonda, Richard Simmons and Arnold Schwartzenager.  Exercise used to be fun and not a burdensome chore. How many of you fitness junkies have tried these trends over the years? I have done most of these just to try something new. 

Jazzercise, Aerobics, Step Aerobics, Bodybuilding, P90X, Insanity, Billy Blank’s Tae Bo,

Tabata, Cross training, Spinning, Pilates, Yoga, Zumba, Crossfit, Orange Theory

Let’s start a new trend called…. PDYPAM, (pronounced: piddy-pam) Put Down Your Phone And Move! Occasionally The Husband will ask me to exercise with him. This drives me nuts. We have a treadmill and a cycling bike in our basement. My fitness prep includes one thing – get on the treadmill and start running. I’ll run in my bedroom slippers just to get moving …and to be funny.  The Husband’s fitness prep takes 30 minutes! He has to put on his special cycling cloths, make sure all the parts of the bike are synced to a computer, training program uploaded with a new route, heart rate monitor synced to his fancy Fitbit, a show ready on Netflix, the fan turned on and angled just right, 3 water bottles filled with water or Gatorade. Good grief! I have my workout done before he even gets on the bike. Stop monkeying around and start riding already.

Whatever you love to do, just start doing it. Let’s all just start moving! We don’t need to be fit to exercise. We don’t need a new outfit to look good at the gym. We don’t need a fancy watch to monitor our every move – while awake and asleep. Let’s just start moving!  If you don’t know where to start or are not sure if a certain program is right for you. We can help! We are more than happy to sit down with you and talk about your fitness goals, discuss your physical limitations and perform a movement assessment to help get going in the right direction. Simply call the office and ask us for a FREE 30 MINUTE FUNCTIONAL MOVEMENT ASSESSMENT. We would love to be a part of your healthcare team! For more information, contact me at The Sports & Spinal Wellness Center at 518-869-3415 or visit our website at www.sportsandspinalwellness.com or on Facebook at www.facebook.com/sportsandspinalwellness/

 

 

 

           

 

 

 

December 26, 2018
Category: Uncategorized
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THE JOY OF PARENTING

BY: Dr. Kim Leis-Keeling

Last December I wrote an article titled The Art of Finding Joy. It seemed to resonate with many of you and in the spirit of the season, I’d like to share one of my greatest joys – The Joy of Parenting. For me, this is the greatest gift I have been given in my life. I know it has not all been easy, actually it is has been the complete opposite. But I have loved every second of being a mom and right now, I am living in the “sweet spot” of parenting. I’ll explain.

All baseball players know about the “sweet spot” of their favorite bat. Without getting too much into the physics of a bat, if you make contact between the ball and the bat at this exact spot, the chances of hitting a homerun are the greatest. This is where I am right now. Trying to hit a “mom” homerun. Can you see me running around the house with my arms up in the air and my kids cheering “YOU’RE THE GREATEST MOM EVER!” The “sweet spot” of parenting starts when your kids reach about age 7… when they look cute with missing teeth. Long gone are the days of diapers, random crying, temper tantrums, car seats and bedtime struggles. No more daily morning fights “Get your shoes on before you miss the bus!”   Life starts to get a little easier and you get a glimpse of parent freedom. Kids are more independent but yet they still want snuggle while watching a movie and will still hold your hand in public.

The “sweet spot” ends around age 11-12 when it is not “cool” to hold hands with their mom anymore. The kids have a stronger sense of their identity and fashion becomes important.  Snuggles become less frequent but you can leave your children home alone. They now start to come to tuck you into bed because you can’t stay awake past 10 P.M. (Guilty!) But this is where the worries transition into the heavy stuff filled with teenage drama. I’m not ready for that…I want to stay in the sweet spot longer.  I’m heading to the end of it with my children…so I’m trying to cherish every second I can.

In early November, I experienced a parenting homerun. It was a Thursday night and we were all home by 4:00. I was actually making a real dinner, not leftovers, not pizza or tacos, but a real meal on a weeknight. My son came home from school and started to play Christmas music. He was raving about how excited he was for the holidays this year. I asked why and he said that he is looking forward to all the traditions that we do throughout the season – not just Christmas morning.  Yes! I have succeeded…he gets it…there is more to Christmas than the presents. He grabbed me from the kitchen and we started dancing to the music. Later, the kids were studying their French together and quizzing each other. It was the perfect evening but felt surreal- like I was watching my life on an old fashion movie reel and I was Carol Brady.

Do you ever wonder if your kids think you are a good parent?  I’ll never forget this time when my son was 4 years old. He was playing at a friend’s house and when he came he home he said “Ben has the best mom ever…she buys him fruit snacks!” Confession: This was during my “only organic” days of being a new mom - no way was I buying that junk for my kids. I’ve caved since then. And thank goodness Santa brings them one box of Fruit Loops every year for Christmas. Nonetheless, this is an ongoing joke between us. Do I rank higher than Ben’s mom yet on the “Best Mom Ever” scale?

I pray that I am a good mom and that I am making an impact on my children which will lead them to make good life choices. My parenting style is based on a strong moral compass, leading by example and having conversations versus barking orders. “Listen children, we are having a snowstorm today. This is going to suck but I need your help shoveling and plowing the driveway. I don’t want to do it either but can you help me so we can come back in and make some hot cocoa?” versus “GET OFF YOUR PHONE AND SHOVEL THE DRIVEWAY!” No one likes to be screamed at and no one wins in a fight. Both sides end up feeling angry. Life always presents hiccups along the way but it can made easier knowing how to react to situations.

I absolutely love being a mom. I know the phases of parenting are forever changing. This has just been my favorite so far…my “sweet spot.” This holiday season, continue to search for the things in your life that bring you joy and fulfill your soul. If you are struggling with your children and parenting here is a good book that may help you navigate the tough spots. It is called Raising Resilient Children by Robert Brooks and Sam Goldstein. This has become my reference manual for how to parent the tough stuff. I highly suggest reading Chapter 4 – I’ll give you the cliffhanger last paragraph: “A difficult lesson for many of us is that we have control over only one person: ourselves. We should not attempt to control our children, but through our courage to change our words and actions we can guide and teach them. In doing so, we serve as models of resilience and hope.”

As always, if you have questions or comments about this article, please feel free to contact me at the Sports & Spinal Wellness Center at 518-869-3415. HAVE A BLESSED HOLIDAY!

 

 

 

 

 

 

 

 

 

DOES PAIN EQUATE TO TISSUE DAMAGE?

Part 2: Pain Explained

By: Dr. Kim Leis-Keeling

Thank you all for reaching out to see if I am still alive after reading my last article.  I know you have been eagerly anticipating part 2 of the story to find out how I faired with my disc herniation. Despite all that drama, by the next day I actually felt much better. I ended up taking a few days off of work to rest and patch myself back together – life doesn’t stop right? I pulled out all the tricks to get back on my feet. After all, I couldn’t have my husband drag me around like a life sized Raggedy Ann doll forever.  My treatment consisted of lumbar decompression, cold laser, ice, acupuncture, massage therapy, taping, McKenzie exercises, core strength exercises and herbs. By the end of the week, I was pain free, but not completely healed. Healing takes time.

So let’s get back to the question of “Does pain equate to tissue damage?” The best explanation of pain that I have read is from a book entitled Explain Pain by Dr. Lorimer Moseley and David Butler. They are neuroscientists from Australia who explain it very well. I’ll share a few points from their book.

Let’s start with acute pain. When we have a new injury, there is a process that happens in the body. It starts with inflammation which triggers a cascade of events. Our nerves carry information from the injury through the spinal cord to the brain. The brain interprets this information and makes decisions about how to respond. Often this triggers our “danger alarm system.” There is a chemical exchange that happens between the neurons (nerve cells) which then sort the information, similar to a post office. If the brain feels the danger is critical, it produces pain. The brain tries to get you out of pain (danger) by limiting movement (or in my case, my entire post office shut down and I passed out).

The inflammation process is the normal way the body begins healing. Most tissues (bone, muscles, skin, etc.) heal within 6-8 weeks. Now, if you break a bone, you may not be in pain the entire 6-8 weeks, but you still have to wear a cast to allow time for the bone to mend. (And just because your acute back pain went away, does not mean that it has healed and you should go spread mulch – note to self). Tendons, ligament and spinal discs are not very vascular so these can take longer to heal. Have you ever heard someone say that it is better to break an ankle then to sprain it?

What happens with chronic pain? When pain becomes ongoing the nervous system becomes more sensitive. The danger messenger neurons and the brain become more excitable and contribute to the problem. The threshold of pain becomes so sensitive that small triggers can cause intense pain. Thoughts and belief all become a part of the contributing triggers and the brain starts to attach a “neurotag” to the thought. Here is what I mean by all that. We have all watched America’s Funniest Home Videos where someone gets hit in the groin with a ball or flying object. The men watching will all moan & groan and bend over in pain. They may actually feel physical pain. But nothing happened to them…how can they experience pain? There is no tissue damage. This is called a “neurotag.” Your brain remembers this injury very clearly and just the thought of a reoccurring injury can recreate pain in your body. This same thing can happen when you have re-injured the same body part over and over again.

So what do you do about this? One of the quotes I tell patients is: “Don’t let your diagnosis define YOU!” Just because you are diagnosed with a disc bulge or herniation doesn’t mean that you have to sit in a rocking chair for the rest of your life. It is estimated that 80% of the adult population have tissue injury to at least one disc. But are they all walking around in pain? Some people don’t ever have pain. You just have to understand the extent of your tissue damage and how to treat or manage it. More importantly understand why you have pain.

As always, if you have questions about this article please feel free to contact me at the Sports & Spinal Wellness Center at 518-869-3415. Follow us on Facebook or visit our website at www.sportsandspinalwellness.com.

 



Chiropractor - Albany and Guilderland, Sports & Spinal Wellness Center (Spinal Wellness Center), 2021 Western Ave, Albany NY, 12203 518-869-3415