What to Expect at Your Consultation

What to Expect at Your Consultation

When seeking relief from your chronic back and neck pain, there are many factors to consider. Treating chronic pain requires an individualized approach to find lasting relief, and will depend on the source and location of your pain, and the severity of your symptoms. If you have been suffering from chronic back and neck pain that affects your quality of life, it’s time you schedule a consultation with our spine specialists at Spine Surgery of Idaho.

If you haven’t been to our offices before, or haven’t been in for more than three years, you are considered a new patient and must inform our staff about any changes in your name, address, telephone numbers, or insurance changes that have occurred during that time. In addition, you will need to fill out all necessary paperwork prior to coming to the office for your scheduled appointment. You will have the choice of downloading the paperwork, or the office will send it to you. Please plan to arrive 15 minutes prior to your scheduled appointment time for registration.

What to bring

There are a few important items you should bring with you to your consultation appointment, including:

  • Insurance card(s)
  • Written referral (if required by insurance), or sent by your primary care physician
  • Patient forms you may have downloaded and completed at home
  • A list of current allergies and all medications
  • Co-payment, if necessary

During your consultation

Your comfort and care are our top priorities throughout your experience, starting with your first consultation. At your first consultation we will:

  • Perform a thorough physical examination
  • Evaluate the medical history of your current spine problem
  • Review any previous treatments you’ve had in the past
  • Consider other medical conditions that may need review

After these steps have been taken, advanced diagnostic tests may be ordered to accurately assess the source of your back and neck pain and determine the right treatment plan for you. Some diagnostic tests include:

  • Magnetic Resonance Image (MRI)
  • Myelography
  • Nerve Blocks
  • Epidural Injection
  • Computerized Tomography (CT)
  • Bone Density Scan
  • Discograms
  • Vertebroplasty
  • Dynamic X-ray

Stop suffering from chronic back and neck pain. Call Spine Surgery of Idaho today at (208) 944-0056 to see how our spine specialists can help relieve your pain and get you back on track.

How Cold Weather Affects Chronic Pain

How Cold Weather Affects Chronic Pain

Sometimes, people who experience chronic joint pain can “predict” weather changes based on how their joints feel. Many people have reported that as the temperature drops, conditions like back pain, neck pain, arthritis, and fibromyalgia are exacerbated.

Chronic pain and barometric pressure

Though researchers have yet to unanimously agree that weather worsens pain, there are theories as to why this may occur. One popular theory addresses air pressure changes, which occur when the temperatures drop. Though many people say that their pain worsens with cold, rainy weather, research shows that it’s not because of the low temperatures, rain, or snow. It’s actually the barometric pressure.

What is barometric pressure?

Barometric pressure is the weight of the atmosphere that surrounds us. The tissues surrounding the joints are similar to a balloon. As barometric pressure rises, it pushes against the body and keeps the tissues from expanding.

Barometric pressure will often drop prior to when the cold weather actually hits. As the barometric pressure lowers, it significantly decreases the amount of pressure placed on the body. This causes the tissues to expand and puts extra pressure on the joints.

Ways to remedy the pain

When cold weather makes your chronic pain worse, try incorporating heat therapy into your daily routine. Heat helps to decrease stiffness and promotes healthy circulation. Try these tips:

  • Apply a hot pack, warm towel or heating pad to the painful area for 20 minutes at a time
  • Try over-the-counter heat wraps applied directly to the skin
  • Use water therapy by swimming in a heated pool or soaking in a Jacuzzi or hot bath
  • Stay active to keep the muscles warm

If you are suffering from chronic back or neck pain, call the spine specialists at Spine Surgery of Idaho today at (208) 944-0056 to schedule your next appointment.

Common Spine Injuries and How to Avoid Them

Common Spine Injuries and How to Avoid Them

Here are some spine injuries that we frequently see at Spine Surgery of Idaho:

Vertebral Compression Fractures

The bones that connect to form the spine are called vertebrae. Osteoporosis, a degenerative bone disorder that primarily affects post-menopausal women, is a leading cause of fractured vertebrae in those over the age of 45. As the condition progresses and the bones get more brittle, they become more susceptible to fracture. Often, sudden acute back pain is the first sign of a fractured vertebrae and is often followed by additional symptoms, such as:

  • Standing or walking exacerbates the pain
  • Lying on one’s back will decrease the pain
  • Stiffened spine
  • Height loss
  • Physical deformity
  • Inability to perform daily activities

Herniated Disc

The spine is made up of vertebrae that are separated by cushions called discs, which provide flexible padding between the bones and allow the spine to bend. These discs have a tough exterior and a softer core, and when some of the softer core protrudes out of the disk, it is called a herniated or ruptured disc.

A herniated disc can cause mild to severe pain by putting pressure on the nerves as they branch out from the spinal cord. Sometimes no symptoms are present, allowing the herniated disc to go undetected. If you do experience symptoms, they’ll likely include the following:

  • Pain – Depending on where the herniated disc is located, you’ll likely feel some pain. If it’s in the upper back or neck, the pain will be present in your shoulder and can shoot into your arm. A herniated disc in the lower back tends to send pain down the buttocks, thigh and calf.
  • Numbness or tingling – Generally present in the area where the herniated disc is located, or along the course of the nerve.
  • Weakness – When a herniated disc affects your nerves, the muscles they serve can weaken, leading to stumbling or dropping objects.


When one vertebra slides forward out of place, it’s called spondylolisthesis. This condition can be caused by an accident, sports injury, birth defect or as a result of the wear and tear of aging. If you have spondylolisthesis, some symptoms you’ll typically encounter include:

  • Back or buttock pain
  • Pain shooting down the leg
  • Numbness, tingling or weakness
  • Difficulty walking
  • Pain exacerbated by twisting or bending over
  • Less commonly, loss of bladder or bowel control

However, like a herniated disc, spondylolisthesis can sometimes be present without symptoms.

Causes and Prevention

Generally speaking, most spine injuries tend to result from an impact or trauma. Some of the most common causes of spine injuries include:

  • Car crashes
  • Falls
  • Assaults
  • Sports Injuries

Take proper precautions during physical activity and (for those over 50) limit your bending, twisting and lifting Using proper form when exercising or lifting heavy objects is also necessary to preserve spine health. If you do suffer from one of these injuries, or have other pain in your back or neck, it’s important to visit a spine specialist to check the health of your neck or back.

If you want more information on common spine injuries, or would like to make an appointment, call us at (208) 944-0056.

Keep Your Posture in Check With These Helpful Tips

Keep Your Posture in Check With These Helpful Tips

Poor posture isn’t just a threat to your typical office worker. Those who lift heavy objects or drive for a living can also suffer the harmful effects of poor posture. A few common types of posture problems include:

  • Forward head posture – An issue faced by office workers everywhere, forward head posture results from bending the head forward for long periods of time. This overstresses the upper back muscles, irritates the neck joints and causes pain throughout the upper torso and neck.
  • Hunchback posture – Both working at a desk and driving a car involve sitting with your arms extended forward for long periods of time. This tightens the chest muscles and weakens the upper back muscles, causing your back to round and your shoulders to roll forward.
  • Lifting with the back – Although often repeated, it is all too easy to forget to bend down with your knees instead of leaning over with your back when lifting something. While picking up light objects with our backs often doesn’t have immediate negative consequences (although it’s definitely possible), it builds up poor lifting habits that can carry over to the next couch or table that you move.

Improving your posture
Tip #1 – If you’re unsure of what good back posture feels like, imagine there is a balloon tied to the center of your chest. Now lift the balloon toward the ceiling. This should be your neutral position to avoid developing poor posture.

Tip #2 – If you spend long periods of time sitting because you drive for a living, work at a desk, or regularly engage in other sedentary activities, taking stretch breaks is one of the best things you can do to avoid poor posture. Specifically, stretching your hip flexors, hamstrings and chest muscles will counter many of the ill effects of prolonged sitting.

Tip #3 – In order to build good lifting habits, discipline yourself to lift all objects (not just heavy ones) by bending your knees instead of your back. These habits will continue the next time you move something heavy, and you’ll be less likely to have a back injury.

If you feel your posture has caused you pain and would like more information, or if you’d like to make an appointment, call our office at (208) 944-0056.

Thank you for the kind words!

Thank you for the kind words!

We’d like to take a moment to express our appreciation for our patients who have given us such incredible praise. The passion for spine care demonstrated by Dr. Marano and his staff comes from a deep dedication to restoring the well-being that spine problems frequently hamper. It’s warming to hear when our goals are met!

Here are just a few of the comments we’ve received from our patients:

“Dr. Marano and James both spoke to me in a way that allowed me to understand what was going on in layman’s terms. Both were very patient with my many questions.”

“All staff members were great, professional, courteous and thoughtful during a difficult time.”

“As with my first visit 12 years ago, I’m satisfied – Dr. Marano took the time to see what and where my problems were coming from”

“I was very pleased to get an appointment the day after I called. I’m glad I met the whole team — they put me at ease with my medical issues and explained things in a context that I could easily understand”

“Everyone I worked with gave me the time that I needed to get things figured out. I felt Dr. Marano really cared about what would be best for me and he made sure that all the questions I had were answered thoroughly.”

We strive to give our patients the best spine care available, which goes far beyond simply performing a procedure correctly. That’s just the bare minimum for acceptable care. An excellent patient experience means having the right team who cares about patients as individuals and will comfortably guide them through their treatment plan. We at Spine Surgery of Idaho work tirelessly to give that experience to our patients, and we truly thank them for their appreciation.

If you’re in need of excellent spine care, make an appointment with Spine Surgery of Idaho by calling (208)-944-0056. We’ll give you a full assessment of your condition and offer you guidance through your entire experience.

Do You Need Revision Surgery?

Do You Need Revision Surgery?

You did it. You had spine surgery. And now, months or years after you were supposed to have recovered, you’re still experiencing back pain. Unfortunately, due to the complexities of spinal work, operations don’t always solve the problems they’re meant to address.

A common misconception is that your pain must be persisting because the surgeon did a subpar job. This is often not the case! While surgical errors and failures are certainly within the realm of possibility, it’s more likely your spine simply didn’t heal correctly. And even after a successful surgery, age and activity can deteriorate your spine over time. Due to these potential troublemakers, spinal revision surgery is an unfortunately common necessity.

Signs that you may need revision surgery

Here are some indicators that you should seek a revision surgery consultation:

  • Persistent pain or discomfort
  • Noticeable deformity
  • Trouble performing every day activities
  • Loss of balance

Know the facts and discuss every detail

Revision surgery is another chance at correcting your spine problems and living life without back pain. Revision surgeries are often more complex than initial surgeries because the surgical situation becomes more individualized — everyone’s surgery will progress (or regress) in different ways over time. It’s important to have an in-depth conversation with your spine surgeon so none of your questions go unanswered and, should you decide to undergo revision surgery, so she has a complete understanding of the task before her.

Making the right decision

Considering the variables involved with spinal revision surgery, only you and your doctor can make any sort of definitive call on what’s right for you. However, if you’re living a life of discomfort, putting yourself in a position to make that call is something you owe to your own well-being.

If you think you’re a candidate for revision surgery or have any other neck, spine or back questions, call us at 208-944-0056 today.

The Benefits of Physical Therapy and Massage

Back pain can impact many aspects of your life, making everyday activities difficult to manage. People experience both physical and emotional symptoms when living with back pain. Emotionally you may feel anger, depression, anxiety or a loss of desire to do things you previously enjoyed. Physically, back pain can cause you to tire easily. You may have difficulty concentrating or completing common tasks.

The caring team at Spine Surgery of Idaho understands the emotional and physical toll caused by back pain. We provide a comprehensive treatment approach  customized to your specific needs. We focus on finding noninvasive or minimally invasive solutions to relieve your pain. Physical therapy and massage are treatment options that can provide many benefits when incorporated into an overall plan of care.

Physical therapy is often prescribed when back pain makes moving difficult. The goal of physical therapy is to restore function, flexibility, strength, balance, endurance and coordination, and to decrease pain: to get you back to your normal level of activity. Physical therapy techniques may include the application of cold or heat, ultrasound, electrical stimulation, stretching and the introduction of a specialized exercise program.

Massage therapy is also used to manage back pain that is limiting your ability to perform daily activities. Massage is a treatment done with the hands or a vibrating instrument to help relax muscles, relieve pain and increase flexibility and movement. Massage involves the rubbing, pressing and general manipulation of the muscle or soft tissue. There are many different types of massage (Swedish, deep tissue, sports) and the correct massage for you will depend on your specific back care needs.

Physical therapy and massage are noninvasive techniques that can provide excellent results with minimal downtime. Benefits may include:

  • Relaxation
  • Stress and anxiety reduction
  • Increased flexibility and function
  • Symptom relief
  • Cost-effective treatment option
  • May eliminate the need for prescription medications or surgery
  • Provides the patient the chance to participate in their treatment

If you or a family member is experiencing back pain, Dr. Stephen Marano and the team at Spine Surgery of Idaho can help. We have extensive experience diagnosing and treating back- and spine-related problems. Call (208) 522-6930 to schedule a personalized consult.

What is Lumbar Spinal Stenosis?

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis is defined as the narrowing of the spinal canal in the lower back. This narrowing occurs when the growth of bone and/or tissue reduces the size of the channels or openings where the nerves are. This progressive narrowing can squeeze or irritate the nerves that branch out of the spinal cord. This often leads to back pain, and/or numbness, weakness or tingling in the legs, feet or buttocks. If severe, it may lead to bowel or bladder dysfunction.

Symptoms of lumbar spinal stenosis

Lumbar spinal stenosis may or may not produce symptoms, depending on how severe the stenosis is. The more the spinal canal narrows, the more likely it is to result in nerve compression. Increased pressure or inflammation of the nerves results in painful, sometimes even unbearable, symptoms. Symptoms can include:

  • Numbness, weakness, cramping, tingling or pain in the legs, feet, or buttocks
  • Stiffness in the legs and thighs
  • Low back pain
  • In severe cases, inability to control bladder or bowels
  • Leg pain with walking

Causes of lumbar spinal stenosis

The most common cause of lumbar spinal stenosis is age-related changes of the spine, often referred to as degenerative arthritis. These changes include; thickening of the soft tissues, a gradual deterioration of the spinal discs and joints, loss of cartilage between the bones of the joints, formation of bony spurs, and loss of the height of the discs between the vertebrae (degenerative disc disease). Any of these processes can narrow the normal space available for the nerves and directly press on the nerve tissue to cause lumbar spinal stenosis.

Other conditions that may cause lumbar spinal stenosis include:

  • An abnormally narrow spinal canal (which can be an inherited condition)
  • Spinal fractures
  • Tumor
  • Infection
  • When the vertebrae slides forwards and backwards over the bone below, resulting in squeezing of the spinal cord or nerve roots.

How is lumbar spinal stenosis diagnosed?

Spinal stenosis can usually be diagnosed based on:

  • History of symptoms
  • Physical examination
  • Imaging studies

Diagnostic studies include:

  • CT Scan of the spine
  • MRI of the spine
  • X-rays
  • Myelogram
  • Electromyelogram (EMG)
  • Nerve conduction tests

Treatment options available

Initial treatment:

  • Education about your condition and how to relieve symptoms
  • Medications to relieve pain and inflammation such as Tylenol or anti-inflammatory drugs
  • Exercise (especially riding a stationary bicycle)
  • Weight loss
  • Physical therapy

Treatment if the condition gets worse:

  • Medications specifically directed at nerve pain
  • Cortisone injections
  • Narcotic medications for pain
  • Surgery
  • X stop spinal decompression device
  • Decompressive laminectomy with or without spinal fusion

What can be done to control the severity of the lumbar spinal stenosis?

Unfortunately, the degenerative changes responsible for lumbar spinal stenosis can occur as part of the normal aging process. It may be impossible to ultimately prevent lumbar spinal stenosis, but you may be able to control the severity of the symptoms or delay surgical intervention by observing the following:

  • Regular exercise and flexibility stretches
  • Maintaining a healthy body weight
  • Maintenance of good posture
  • Stop smoking
  • Risk reduction for falls
  • Taking medications only as directed by your physician

If you have further questions regarding lumbar spinal stenosis or would like to have your particular situation evaluated, please call our office at (208)522-6930.

Advanced Diagnostics

Advanced Diagnostics

At Spine Surgery of Idaho, we offer the most advanced diagnostics available to evaluate your symptoms and examine your pain to find the best treatment option available for you. To determine the root cause of your back or neck problem, one or more of the following test and tools may be used:

Magnetic Resonance Image (MRI) – A noninvasive test that uses a powerful magnetic field and radio frequency pulses to create detailed pictures of internal spinal structures to examine the discs, spinal cord, ligaments, joints and openings between the vertebrae.

Myelography – An imaging exam that involves the injection of a contrast dye into the spine in order to view the spinal cord and nerve roots more clearly through a real-time X-ray and computed tomography (CT).

Nerve blocks and epidural injections – An anti-inflammatory medication accompanied by a numbing agent is injected into the spine towards the area of pain. If the pain is relieved, this will help to identify the problem’s location.

Computerized Tomography (CT) – A diagnostic test that combines several X-ray images to create cross-section views and three-dimensional images of targeted areas of the spine.

Bone Density Scan – An enhanced X-ray that measures bone loss, most often in the lower spine and hips, typically used to diagnose osteoporosis.

Discograms – A dye injected into the center of the injured discs to produce a visible image on an X-ray screen.

Dynamic X-ray – A diagnostic test that uses X-ray techniques to obtain measurements of your spinal alignment to assess joint weakness or incomplete bone formation.

Certain conditions or issues that can be diagnosed using these methods include:

  • Degenerative disc disease
  • Spinal stenosis
  • Work-related spinal injuries
  • Revision surgeries
  • Tough cases
  • Second opinions
  • Spinal trauma
  • Athletic spine injuries

For more information on the advanced diagnostics at Spine Surgery of Idaho, call (208) 944-0056 to schedule an appointment.

Injections for Pain

Injections for Pain

Injections for pain are used to temporarily relieve pain and discomfort caused by a number of pain conditions. Injections are often implemented before exploring other, more aggressive treatments. (In fact, they serve a diagnostic function, providing valuable information about the pain generator by whether or not they provide relief.) Injections have shown to help to reduce back pain and inflammation and usually consist of a steroid and a numbing medicine. Epidural injections are one of the most common methods used today.

What do epidural injections treat?

Epidural injections treat a variety of pain conditions that affect the back and spine. These include:

  • Spinal stenosis – Spinal stenosis occurs when areas within the spine become narrowed, placing pressure on the spinal cord and nerves. Pain typically is felt in the lower back and neck area and can increase with movement.
  • Herniated discs – Usually the result of gradual wear and tear, a herniated disc occurs when the discs (often in the lower back) in the spine have bulged or become damaged.
  • Degenerative disc disease – Degenerative disc disease occurs when the discs in the spine begin to break down from wear and tear as they age.
  • Failed back surgery syndrome – This occurs when a back surgery does not have the outcome intended, because of nerve damage and/or incomplete healing of the nerve with continued pain.
  • Sciatica – Sciatica occurs when there is pressure or damage done to the sciatic nerve.
  • Vertebral fractures – Often the result of a traumatic injury or osteoporosis, small breaks can occur in any of the vertebrae, causing pain.

How do epidural injections work?

During your treatment, you will be instructed to lie face down on the exam table. The next steps include:

  • Cleaning the skin and injecting an anesthetic for numbing purposes
  • Inserting a needle through the skin toward the spine
  • Injecting a contrast dye to help confirm if the needle is positioned in the epidural space (space between the spine and the spinal cord)
  • Maneuvering the needle between the bones of the spine using real-time X-ray, called fluoroscopy
  • Once the needle is positioned, injecting an anesthetic and steroid-medicated solution (corticosteroid)

The injection is normally not painful due to the numbing medicine used. Temporary, mild tenderness can sometimes occur afterward. The relief from epidural injections will vary from person to person.

Benefits of pain injections

  • Injections are a common method for providing pain relief and are generally safe
  • Injections can help to flush out pain-inducing inflammatory proteins
  • Injections can help you safely return to enjoying your normal activities without the dependency of pain medication
  • Pain relief can significantly improve your quality of life

Take back the life you enjoyed before the pain began. For more information, call the spine specialists at Spine Surgery of Idaho today at (208) 944-0056 to schedule your next appointment.