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External medicine: Spine West local expansion provides nonsurgical options

Physiatrist Dr. John Tobey at Spine West new offices in Steamboat Springs talks with Ann Hogan, who underwent spine surgery in the past. Physiatry is a medical specialty in functional, external medicine.
Suzie Romig/Steamboat Pilot & Today

Even at 84 years old, Steamboat Springs resident John Rostenberg is riding his new gravel bike, alpine skiing and climbing tall ladders to fix smoke detectors.

Rostenberg credits some of his success fighting gravity to the doctors at Spine West, which is headquartered in Boulder but expanded its longtime satellite services in Steamboat Springs by opening a clinic space here on June 1.

“I’m a fan because of the results that I’ve been able to obtain through Spine West,” said Rostenberg, who was referred to Spine West following lower spine surgery and then hip pain. “I’ve been going to Spine West for about 10 years, and it really started out as focusing on pain management along with rehabilitation.”



Local physician Dr. David Niedermeier at Steamboat Medical said, “From a primary care perspective, we are definitely happy to have the Spine West physicians more available to our patients.”

Spine West’s founding physician Dr. Cliff Gronseth has been visiting Steamboat to see patients an average of once a week for some 25 years by renting exam room space in the offices of local orthopedic surgeons. Spine West most recently utilized exam room space at Steamboat Orthopaedic & Spine Institute (SOSI).



The goal at Spine West is to treat muscles, ligaments, nerves and bones in a comprehensive manner to help patients avoid surgery and manage pain, said Dr. John Tobey, during a visit in the new office on Thursday, July 7.

The four partnering doctors — Gronseth, Tobey, Michael Blei and Bradley Gale — practice the medical specialty of physiatry, which may not be widely known to the general public.

“Even my mom does not know what I do,” Tobey joked.

Dr. John Tobey stands inside the new clinic space for Spine West in Steamboat Springs. Spine West headquarters is in Boulder but has been providing satellite care inside other local medical offices since 1997.
Suzie Romig/Steamboat Pilot & Today

As opposed to the commonly recognized term internal medicine doctor, physiatrists are external medicine doctors. They specialize in neck and back pain, joint pain, shoulders, knees, elbows, pain and weakness, and numbness or tingling in feet or wrists, Gronseth noted.

“They do a great job with lots of nonsurgical musculoskeletal problems, especially back and neck issues,” Niedermeier said. “They have a lot of experience with complicated work comp cases. I’ve had lots of positive feedback from patients about the care they have received from both Dr. Tobey and Dr. Gronseth.”

According to Spine West, physiatrists focus on nonsurgical care and rehabilitation, are expert diagnosticians, look at the whole person not just one symptom or body part, and collaborate with other team providers to optimize health and function, maximize performance and prevent future injury.

“We overlap in many different specialties, so we are able to figure things out fairly well. We try to maximize people’s ability to move and function physically,” Gronseth said.

According to the Association of Academic Physiatrists, physiatry might also be called physical medicine and rehabilitation. The medical specialty emphasizes the prevention, diagnosis, treatment and rehabilitation of people disabled by disease, disorder or injury.

“It is one of the newer subspecialty areas of medicine that manages a diversity of conditions involving the nervous and musculoskeletal systems and focuses on function, independence and quality of life,” the AAP explained.

The satellite practice has developed a local patient base since 1997, and the new office will reduce drive time to Boulder for existing patients for full services. Starting in September, the Steamboat office also will offer the final service that is currently available in the main office in Boulder with special X-ray-guided spinal injections in the clinic setting, Tobey said.

Spine West also offers electromyography, EMG, which previously had been offered locally by Dr. Alexis Tracy at SOSI. Tracy left Steamboat in May for new family opportunities in Oregon. EMG testing measures electrical activity in response to a nerve’s stimulation of the muscle to help detect neuromuscular abnormalities.

The Spine West doctors also utilize real-time diagnostic musculoskeletal ultrasound, which they believe can help patients avoid the costs of an expensive MRI.

Patients such as Rostenberg are happy with Spine West’s help for him to stay active, even in his 80s.

“Following surgery, I gave pain management and rehabilitation efforts a try, and it’s worked for all this time,” Rostenberg said.

“I really want to avoid an operation if I can because its nerve-related,” Rostenberg said. “Getting shots, when combined with more of a whole-life program purposely, it’s allowed me to participate as active as I am without another operation.”

The new Spine West office at 1475 Pine Grove Road, Suite 108, in Steamboat currently is open 11 a.m.-5 p.m. on Thursdays and 8 a.m.-5 p.m. on Fridays. For more, SpineWest.com or 970-875-3021.


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