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Alpine Physical Therapy
Three Locations
In North, South, and Downtown Missoula
Missoula, MT 59804
Ph: 406-251-2323
Fax: 406-251-2999
Info@AlpinePTmissoula.com






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  • I've heard that thoracic outlet syndrome is caused by an extra cervical rib. Why won't my doctor just remove the rib?
  • What is thoracic outlet syndrome?
  • I was told I have scoliosis and snapping scapula. Are the two somehow related?
  • I am a 33-year-old hairdresser with thoracic outlet syndrome. I've tried medications and exercise, but the pain just keeps getting worse. Is there else anything I can do, short of having surgery?
  • I've had pain and tingling in my left arm for several months. I've been to several doctors, and they've run all kinds of tests. They're not sure, but they think I have thoracic outlet syndrome. Isn't there a test that can show for certain that this is my problem?
  • I have tingling and pain that shoots from my shoulder to my hand whenever I grip or lift things. My doctor thinks I have thoracic outlet syndrome. Will I need surgery, or are there other ways to treat my problem?
  • I am an avid and lifelong swimmer. Recently, I have developed thoracic outlet syndrome (TOS). I have heard that swimming is good therapy. Is swimming OK for someone with TOS?
  • My doctor told me that I've got problems with thoracic outlet syndrome because I hunch over at my work bench all day. I assemble small electronic parts. My attempts to stay upright don't last very long. Before I know it, I'm hunched over again. How can I keep from slouching at work?
  • Both my parents and one of my grandparents have osteoarthritis. My upper back is really painful. Could this be from osteoarthritis too?
  • My mother has a hump in the upper part of her back. She said her upper back hurts constantly because of it. Her mother also had the same problem. Is there any way I can avoid this, or am I genetically destined to end up with a hump like hers?
  • My know-it-all neighbor said that the large hump in the upper part of my spine is from bad posture. I had excellent posture until my seventies, and then this stooping gradually developed. Can I tell her that she's wrong? Or, heaven forbid, is she right?
  • I have a job that involves a lot of heavy lifting. How can I avoid low back pain?
  • I have a compression fracture in my spine. I've tried bed rest and pain medications. I just can't seem to shake the pain. Are there other treatments out there?
  • My doctor says my osteoporosis puts me at risk for spinal injuries. I'm 70 and not very active. What kind of problems do I need to watch out for?
  • What is a vertebral compression fracture? How is it treated?
  • I have ongoing problems with thoracic outlet syndrome (TOS). I've seen several doctors and tried physical therapy over the past six months. My X-rays are normal, and I'm an otherwise healthy 33-year-old mother of three. Is there a reliable surgery that can improve my quality of daily life?
  • I am 28 and was recently diagnosed with a thoracic compression fracture in the lower part of my mid-back. I have been wearing a back brace for six weeks and still feel pain. My doctor said surgery wouldn't help. What can I do now? Will I always be in pain?
  • My teen's wearing a brace for scoliosis. Does time spent in the brace affect how well it works?
  • My 12-year-old daughter has scoliosis with large curves in her spine. Our doctor wants her to wear a brace. Will her age affect whether bracing works?
  • My daughter has a fairly severe case of scoliosis. Her doctor wants her to wear a brace but says surgery may eventually be needed. I don't want to put my daughter through any unnecessary treatment. Is there a way to tell ahead of time whether the brace will work?
  • My mother had osteoporosis in her later years. She often complained about getting shorter. Is there a connection?
  • I have a compression fracture in my spine due to osteoporosis. The fracture has caused my spine to hunch forward, and I'm in pain all the time. I prefer not to take pain medicine because it makes me so groggy and constipated. Is there anything else I can do?
  • My 15-year-old son had surgery three months ago for scoliosis. He has finished his physical therapy program and continues to do exercises at home. When can he return to sports activities?
  • I notice at night that if I donít sleep with my right arm over a pillow, I wake up with upper back and arm pain. Do I just need a new mattress?
  • I am a nurse in a large surgical unit. I injured the middle of my back lifting a heavy patient. There's a large herniated disc at T9-10. If I don't have surgery to repair this, will it heal on its own?
  • My mother just came back from the doctor's office. She says she has a "giant" herniated disc in the middle of her back. Is she exaggerating or is this a real medical term?
  • I'm 74-years old and in good general health. I recently suffered a vertebral compression fracture. Why did this happen when I'm in such good shape otherwise?
  • My aging father got up out of his chair one morning and two of his vertebrae fractured. The doctor is suggesting a treatment called vertebroplasty. Is it really worth it to have this operation just for the pain relief when the spine will eventually get better by itself?
  • My father just came back from the doctor's. They say he has a vertebral compression fracture. The treatment is either kyphoplasty or vertebroplasty. What's the difference between these two operations?
  • My 78-year old uncle lives with us. He had a vertebroplasty for a spine fracture two weeks ago. At first he felt much better but now he's starting to complain of pain again. Was the surgery a failure?
  • My 80-year old mother has two vertebral compression fractures. She refuses to have a vertebroplasty to repair the problem despite the pain. The doctor has warned her this decision could lead to worse problems. What else could happen?
  • My father had an artificial disc put in his spine in January. We just found out there is a fracture in the vertebral bone above the implant. What happens now?
  • What is a clefted vertebral fracture? My mother's hospital bill just came to us with this as the diagnosis. I know she had a vertebroplasty for her spine. Is that how they treat whatever this problem is?
  • What's the difference between vertebroplasty and kyphoplasty for spine fractures?
  • My 83-year old father is going to have a vertebroplasty for two fractured vertebrae. The doctor has warned us there's a risk of re-fracture. Is that from the procedure or just because he's already frail?
  • Our 17-year old son has been wearing a brace for three years for Scheuermann's disease. It doesn't seem to be helping. How do we know when it's time for surgery?
  • My 13-year old daughter has just been diagnosed with Scheuermann's disease. She's going to have to wear a brace. What can we expect for results with this treatment?
  • My father fell and broke his back. The doctor called it a "minor compression fracture." We notice when he is lying down in bed, he looks straight. When he sits or stands, he's slumped forward. Should he be wearing a brace?
  • I had a bad bike accident while out riding with my little granddaughter. I broke my wrist and one vertebra (T12). It's been three months and my wrist has healed nicely, but my spine shows increased deformity on X-ray. What is causing this?
  • My mother fell and broke two bones in her spine between T11 and L2. The doctor told us this is the most common place for these kinds of compression fractures. Why is this?
  • Every now and then I have a bout of back pain. It comes on suddenly, lasts a week or two, and then goes away. I don't really want to take drugs, but I need some kind of pain relief. What do you suggest?
  • I saw a newspaper article about a new way to repair broken bones in the spine. The doctors use cement squirted into the main part of the bone. They used two different words to name the operation: vertebroplasty and kyphoplasty. What's the difference?
  • I had a lumbar laminectomy for back and leg pain. A week after the operation my symptoms were much worse with the added problem of bladder problems. After more testing, it looks like the problem is really higher up in the thoracic spine. I've been told the first operation was necessary to show the problem more clearly. Is this just some specialist covering for a mistake?
  • What's a "meningioma?" My daughter was diagnosed with this and is going to have an operation to remove it.
  • My mother-in-law is having her second back operation in two months. The first took pressure off her lumbar spine. The second is to remove a tumor in her upper back, which was really causing the problems. Right now she is paralyzed from the waist down. Will she recover from this?
  • Whenever I wear a backpack (even a light one) the area just above my collarbone hurts and my right hand goes numb. What could be causing this?
  • Whoa! I never thought I'd have to write in for help like this but I need it. I was told I have thoracic outlet syndrome and that's what was causing my neck and arm pain. I had surgery to set the nerves free. I'm not any better. Now the surgeon wants to take a chunk of my rib out. How is that going to help?
  • My sister says she's got a problem called Thoracic Outlet Syndrome with neck and arm pain. Sometimes there's numbness and tingling in her hand. I suspect she is in an abusive relationship with her boyfriend. Can this syndrome be caused by physical abuse?
  • My father-in-law has a compression fracture in his spine. He's asked me to research his treatment options. I've found out the latest is a minor surgery called vertebroplasty. What can you tell me about it?
  • My mother fell and fractured her spine in six places. She has such fragile bones they can't do a fusion or put a rod in her spine to hold it in place. The doctors talked about doing a vertebroplasty. They think it should be staged in two or three operations. Why can't they just do it all at one time?
  • My mother fell and fractured her spine about two months ago. Despite drugs for pain and physical therapy exercises (which she doesn't do), she hasn't gotten any better. In fact, she's slowly losing her ability to get up and down off the toilet. What can we do?
  • My father had some superglue injected into his spine. Itís supposed to help stiffen it up while he was healing from a vertebral compression fracture. He was no sooner home when he got a new fracture two bones below. How often does this happen? Can't they use this superglue before the bones break?
  • My father just had a vertebroplasty for a vertebral fracture. Because he's so osteoporotic, much of the glue leaked out of the bone. Will this cause even more problems for him?
  • My mother fell and hurt her back six months ago. She's tried everything to ease the pain. Last week she had an MRI that showed a vertebral compression fracture. Is it too late for her to have the new cement treatment to glue it back together?
  • Our 17-year-old son has a condition called Scheuermann's disease. The doctor has advised surgery to fuse his upper back. How much correction will he get?
  • I'm going to have surgery to remove part of the big ligament along the back of my spine. The section from T6 to T8 has turned to bone. The surgeon has warned me that paralysis is a possibility with this operation. Can I do anything ahead of time to prevent this from happening?
  • Our 45-year old son had decompressive surgery on his spine for a condition called OPLL. Right after the operation his legs were numb. He's back in surgery now. Can this kind of paralysis be reversed?
  • I'm 25-years old and I've had Scheuermann's disease for the last 10 years. It looks like it has stopped getting worse. The doctor is advising me to have surgery to fuse the spine. What would happen if I don't do this?
  • My elderly mother-in-law is Asian and just diagnosed with OLF. The doctor tells me this is fairly common among older adults from Japan or East Asia. What can you tell me about it?
  • My husband is of Japanese origin but has lived in the United States his whole life. He was recently diagnosed with a condition called ossification of the ligamentum flavum or OLF. The doctor says this is more common among Asian people, including the Japanese. He has three levels that are involved. Can we assume that the more areas affected, the worse his symptoms will become?
  • My father is going to have a vertebroplasty for a compression fracture in his spine. We've been told the main complication is leakage of the cement. What kind of problems does cement leakage cause?
  • My 82-year old grandmother has osteoporosis in all her bones. Her spine is especially prone to fracture. She's in so much pain, all she wants to do is lie down and not move. Will rest help?
  • My mother fell this week and started having severe back pain about three days later. X-rays showed two rib fractures and a vertebral compression fracture. She can hardly get out of bed because of the pain. She's 86-years old. Can anything be done to help her?
  • My father has a compression fracture in the middle of his back. His doctor has suggested doing a kyphoplasty but Dad is putting it off. If he waits too long, will it be too late?
  • I'm having some very pinpoint pain in the middle of my back. Two of the bumps you can feel in the middle of the spine hurt. There's also a spot off to the side between those two bumps that hurts when I press on it. What are those bumps and why do they hurt?
  • My surgeon told me one drawback to the cement they injected into my spine is leakage. Fortunately that didn't happen to me. How do they know how much to put in?
  • My dear uncle had a farming accident several years ago and broke his back. It happened during the harvest. He didn't take any time off and just kept right on working. I notice his upper back is starting to curve forward badly. Is it too late to do something to help him?
  • I have a job that requires a lot of overhead lifting. The items aren't that heavy but after about 3 minutes or so, I notice my arms feel very tired. Sometimes my hands go to sleep. It takes a few minutes to shake them back awake. Are there some strengthening exercises I can do to make this problem go away?
  • What is a cervical rib? Our pediatrician says this may be what's causing my son's neck and arm pain. How can a rib cause arm pain?
  • After a long series of tests and doctor visits, they've finally figured out what's causing numbness and tingling in my legs. And I walk funny now, too. It's called thoracic myelopathy. I've been told I should have surgery to correct this right away. Can I just wait and see if I'll get better?
  • My wife is going to have a vertebroplasty for a vertebral compression fracture. The surgical nurse and the surgeon both went over the possible problems that can develop after such a procedure. I forgot to ask how soon after the operation would we expect to see a problem develop? Is it right away? Months later?
  • My father had a kyphoplasty yesterday for back pain caused by a vertebral compression fracture. This morning he's complaining of worse pain and leg weakness. He can hardly stand up. We're waiting for the doctor to check him out. Is this a common problem after the surgery?
  • We just came from the orthopedic surgeon's office where my husband was told he has a vertebral compression fracture. He's going to have a vertebroplasty. The nurse reviewed all of the possible complications. It seemed like she talked the most about cement leakage. How often does this happen, and why is it such a problem?
  • I just found out my father is in the hospital with three vertebral compression fractures. The doctors are discussing whether or not to operate. Dad is very resistant to the idea. What would happen if he didn't have the surgery?
  • Our son has been treated with serial casting and now a body brace for Scheuermann's deformity. The curve continues to get worse. We've been told that surgery is the next step. How do we know when the best time is for surgery? Is it possible to wait too long? Operate too soon?
  • Our 16-year-old son is going to have spinal surgery for Scheuermann's disease. I know there are complications possible with any operation. What can happen after this one? My family thinks I worry too much. But I prefer to know what to expect and prepare for the worst.
  • We are just a little disappointed in the results of surgery our son had for Scheuermann's disease. At the time of the fusion, he was 16. Now at age 22, he has developed another curve above the fusion. What causes this to happen? Does it happen often?
  • I read that some people with thoracic insufficiency syndrome were able to live with less breathing capacity than others. How is that possible?
  • How can doctors calculate if you are getting enough oxygen, other than the obvious of you being sick or dying?
  • My mother's doctor wants to inject her back with medication with an epidural injection to help relieve her back pain. I'm really worried about the potential problems. What can go wrong?
  • I was in a car accident and fractured my thoracic spine in two places. I've been trying to get by without surgery, but I notice the pain is getting worse and so is my posture. Should I wait and see if this is going to get better? Or should I go for the surgery originally recommended by the doctor on call at the hospital where I went at the time of the accident?
  • Our nephew was in a terrible motorcyle and broke the middle of his spine in half. He had a six-hour surgery to put screws in place to hold the spine upright while it heals. He's up walking already and not even using a brace. We're more than a little concerned about this. Shouldn't he have some kind of external support?
  • Is it OK to have a significant kyphosis where my spine was fractured two years ago?
  • While percutaneous vertebroplasty is shown to be an effective, minimially invasive treatment for compression fractures, often subsequent fracture can be a problem. What is the likelihood of subsequent fracture?
  • My mother's doctor wants to inject cement into her back to help her with her pain. He says that my mother has fractured discs and that the cement will help keep them stable. Will this hurt and how is it done?
  • My aging aunt lives with us. At 92, she's still pretty spry. But last week, she couldn't get out of bed because of back pain. The doctor says she has a compression fracture of the spine. They said this can happen just turning over in bed. But Aunt Millie is really very strong. Is it possible she did something to cause this? Maybe a fall that she doesn't want us to know about?
  • My elderly parents live 1,000 miles away from us. Mom called and said that Dad has a compression fracture at L3. The doctor is advising a wait-and-see approach. We've done some Internet research and think that Dad should have a vertebroplasty. Why hasn't this already been suggested to my parents? When I asked them, they had never heard of it before.
  • I'm seeing a physical therapist for neck pain that just started about two weeks ago. She's been doing some heat and electrical stimulation. But now she wants to add a manipulation procedure to the middle of my back. She says it works well and there's evidence in recent studies to support her experience. Does this sound like a good idea? I don't really want my back popped.
  • My husband is starting to get hunched forward. His shoulders are rounded forward and he can't lie on the floor without a big pillow to support his head. I keep telling him to stand up straight but he doesn't do it. Is there a brace or some other kind of shoulder harness that could help keep this from getting worse?
  • Mother has had a Dowager's hump since she was 50 years old. Now at 75, she is starting to have tiny fracture lines develop in her spine. Are the two problems connected? Why are these fractures just developing now?
  • My wife is off work with a burst fracture of the spine. She only works part-time, so she doesn't have any sick leave. I lost my job six weeks ago, so this really puts us in a financial bind. How long does an injury like this take to heal?
  • I'm using my laptop to read up on a procedure called vertebroplasty. My wife is having one as I wait in the hospital. I've found that it's not a surgery everyone can have. She's having it because of a spine fracture at two levels from cancer (multiple myeloma). I'm seeing mostly people with osteoporosis have this operation but I'm not finding much about cancer patients. What can you tell me?
  • Mother is going to have a vertebroplasty this week. Her regular surgeon isn't available, so they are recommending the radiologist do the procedure. I'm not really sure how to ask this question but are they qualified to do surgery?
  • I'm just doing a little checking for myself about treatments for vertebral compression fractures. Even though I'm active and not a little old lady, I'm 82 and I've had two of these fractures. The first one I let go and didn't have treated. I regretted that. The second one they did a kyphoplasty but there were complications. If I get another one, what's a better way to go -- or is there one?
  • I have two lumber vertebrae that were fractured and treated with kyphoplasty. I was warned about the possibility of cement oozing out and causing complications. Fortunately, this did not happen. But if it had, what would it have felt like?
  • Mom is in a lot of pain right now from a vertebral compression fracture in the middle of her back. We've been told she could have a fairly simple surgery called vertebroplasty that would put some cement in there and help with the pain. But it's expensive and the results won't be any different than if she wears a brace and waits six weeks. Is it right to let her suffer when something could be done?
  • My granddaughter is typing this for me. I am in the hospital with a compression fracture at T7-8. While I'm waiting for the doctor to come in and talk with me I'm trying to find out how long it takes to heal up from something like this. It's pretty painful.
  • Mom fell today and had an X-ray that showed what looks like an old compression fracture of the spine next to a new one. Since she recovered from the last one without knowing she had one, should we just manage this new one the same way?
  • Last month, I had a procedure called kyphoplasty. It was for a compression fracture at T10. Tomorrow I go back to the surgeon for a follow-up appointment. How will I know if the operation worked?
  • If I'm taking a bisphosphonate medication, am I protected from having a spinal fracture? I see so many of my lady friends (we are all in our 80s) having these terrible compression fractures -- one right after another. They are not taking Boniva like I am. After my first fracture, I started taking this drug and I've had no more problems. So I'm hoping it's the medicine that's helping me.
  • Is it true that once I've had a kyphoplasty procedure for vertebral compression fracture, I'm likely to have another fracture needing another kyphoplasty? What's the point of having the procedure if it's just going to create more problems down the road?
  • I am going to have surgery to remove a nasty tumor that's wrapped around the spinal cord at the T11-12 level. I've been told repeatedly by everyone who preps me for surgery that serious complications (even permanent paralysis) can occur. Is it possible I can stay awake during the operation and let them know if I'm losing sensation in my legs without feeling the surgery? I know that sounds far fetched but these days it seems like anything should be possible with all our technology.
  • I had a vertebroplasty procedure done about two years ago for a spinal fracture from osteoporosis. Now I'm hearing they aren't recommending this anymore. It worked for me -- is this rumor really true?
  • The orthopedic surgeon and hospitalist taking care of Mother (she's 83-years-old) aren't seeing eye-to-eye on how she should be treated. She has a compression fracture of the spine from osteoporosis. All the discussions have been very cordial but it looks like it might be up to us as the family to cast the deciding vote. What can you tell us about this problem?
  • I had a vertebroplasty procedure done about two years ago for a spinal fracture from osteoporosis. Now I'm hearing they aren't recommending this anymore. It worked for me -- is this rumor really true?
  • My partner is in the hospital with a bad disc pressing on his spinal cord. He may be in danger of leg paralysis. He's even been warned that he might lose his ability to have an erection. He's asked me to research this for him and find out just what are the chances that this might happen to him.
  • Our 14-year-old son was in a terrible bike accident last night. They have him in ICU and are trying to stabilize him in order to do surgery. There's a bone fracture in the lower thoracic spine that is pressing on his spinal cord. They say he could be paralyzed but they won't know for awhile. How long does it take to know for sure about things like this?
  • I had a vertebroplasty at T12-L1 for a compression fracture (probably from osteoporosis). Now three months later, I have another one right next to it. Am I just going to keep fracturing one after another of these bones? Is there any way to stop this from happening?
  • I am looking into having a vertebroplasty for a fractured spinal bone. Although I'm only 66-years-young, I do have significant osteoporosis. I don't want to end up a stooped over old lady and I've been told this little procedure helps plump up the bone again. Is there any reason NOT to have this done?
  • I'm 25-years-old and feeling old. Turning a quarter-of-a-century has really caught my attention. One thing that keeps coming to mind is the fact that I had Scheuermann's kyphosis as a teenager. I've avoided wearing a bathing suit every since. Now and then my back hurts and feels "twingy." Is this from the kyphosis? What can I expect over the next 25 years? Am I going to get worse?
  • I had a back problem as a kid they called Scheuermann's disease. Is that disease still around or have they cured it like polio? I never hear anything about it.
  • We are trying to help Mom guide Dad to a decision about surgery for his spine. As it has been told to us, he has a burst fracture of the T9 vertebral bone. With metal rods the surgeon can hold it in place until it heals. Dad is afraid the rods will slip or break. Does this ever really happen? Is there some way to reassure him that all will be well?
  • Is it possible to have a burst fracture of the spine and NOT have surgery? I find this hard to understand for someone like my mother who is in quite a bit of pain from this type of problem.
  • Tell me about balloon kyphoplasty to treat a spinal compression fracture. I read about this on-line but it sounds too good to be true. What's the downside?
  • My father had a kyphoplasty done for a fractured spine and ended up with a second fracture in the next spinal level. We took him to a second surgeon for an opinion about what caused the two fractures. She told us the first fracture was because of brittle bones. The second fracture was likely caused by too much cement oozing out of the kyphoplasty. Wouldn't extra cement make it stronger, not weaker?
  • We are back at the orthopedic surgeon's office with my 83-year-old mother. That sounds old as I type it, but she is really very active and still very sharp. Two years ago, she had a balloon kyphoplasty surgery for a spine fracture at T10. The same thing has happened again only in a different spot in her spine. We are wondering if there have been any newer or improved treatment ideas developed since that time that we should ask the surgeon about.
  • Our Dad is in the hospital with two nasty vertebral compression fractures. He has very brittle bones from osteoporosis. They are trying to decide whether or not to do a balloon kyphoplasty. We are wondering if it makes any sense to do this when all the other bones are weak, too. Treating one level won't stop the problem from occurring in the other bones, will it?
  • Is it normal to still have pain greater than one month after a motor vehicle collision?
  • Can I have a thoracic disc herniation and not know it?
  • Is it normal to still have pain greater than one month after a motor vehicle collision?
  • Can I have a thoracic disc herniation and not know it?
  • My doctor informed me my recent x-rays demonstrated DISH, what is DISH?
  • Does the presence of DISH mean that my existing kyphosis will worsen over time?
  • My mother suffers from severe osteoporosis and she was just diagnosed with a compression fracture at T12. Will she need to wear a brace?
  • I was diagnosed with a burst fracture at T11, is this common?
  • What is a burst fracture and why does it occur?
  • How long will I have to wear a brace following a burst fracture of my T12 vertebra?
  • Does recovery following a thoracolumbar burst fracture include a brace and/or a long period of bed rest?



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