PT vs Injection for pinched nerve (bulging disc) C6

Hi All.

I am hoping you can help me or give me some insight into what treatment would make more sense for me. Began having tingling and numbness in my thumb in the end of March, this year. Few months later, went to primary doc, who suggested it was a pinched nerve near my wrist, by the thumb side. Suggested splint and rest. Well, tingling and numbness spread and now goes from thumb up to neck and causes some pain (not severe)

I have a current pain doc who has been treating my back for a while, just did RFA bilaterally, lumbar area, few weeks ago. Mentioned the neck issue to current pain doc, said I had EMG and MRI (ordered by primary care doc), and results were pinched nerve at C6, bulging discs from C3-C6, some degeneration. Without asking any questions or anything at all, he said, ok, i'll write an order for PT.

Then a few days ago, had a consult with a new pain doc (I have been wanting to switch for some time now. I like my current doc, but the clinic is run really poorly, I don't like the PA--and I only see the actual doc for a few minutes before a procedure, which is a couple times a year). So, the new pain doc, recommended by my headache specialist, was very friendly, asked some questions, actually looked at the MRI and report, then told me that he would recommend an injection. I was really caught off guard, but I believe the words epidural and steroid were in the name of the injection. He said he would do a series of 3 injections over time. I asked about doing PT and whether he thought that might help. He said if the problem was brand new, he'd go that route for certain, but at this point, it may be better to just go right for the injections.

So, obviously I need to pick one pain doc to go with. The new guy, that I had the consult with, said he'd be fine taking over care for my back....do all pain docs do RFA? I've got to make a decision about which doc to go with very soon. I don't like this sort of being between two docs. I think my main concern is that I want to be sure which ever doc I go with is going to take the time to know what's going on with both the neck and back and follow thru with treating both problems.

Not sure I'm even making sense anymore. Very nervous about the whole situation.

thanks for listening.

I think I'd stick with the first doc. You like him. Yes, I hate talking to assistants no matter how well trained, but it can work if they get the right info - maybe take a typed page with you so they get it right.

The first doc seems to be more conservative, and that's the way to go. PT to start is what my pain doc would do. The second doc wants to give you 3 injections, which is what a lot of them do and also makes him more money. Do you really need 3 to start off with? I'm not sure how long this problem has been going on. Have you spoken to your regular pain doc in the past about it? Was there a reason he didn't prescribe the tests?

No, not all docs do RFA. Is he trained as an anesthesiologist? A physiatrist only works on lumbar and only does limited injections even there.

Did you ask if you'd actually see the doctor every visit? He may have a PA too.

Thanks for the great insights and feedback. I ended up writing out a pros/cons list for both doctors/clinic, and also wrote down what my needs were and what I wanted out of a doctor, what really mattered most.

Then I took the lists to my Mom, who has been with me thru all of the pain stuff and other health problems. We are very close and I trust her opinion. I didn't tell her which way I was leaning, just asked what she thought. She immediately said she thought I should stay with my original doc. It came down to the fact that my current pain doc's office is a real pain in the butt and frustrating at times, but bottom line is that I am getting the treatment i need to help my pain. I think the new pain doc made me nervous when he suggested the injections as the first line of treatment (and offered to do one right then and there), and his rush to take over treating my back pain and writing prescriptions without knowing anything at all about the problem. Not sure if I mentioned it before either, but the MA who I talked to initially mentioned that this doc works at several clinics, so they have communication problems sometimes too (I had mentioned I was unhappy with the current pain clinic's communication skills, or lack thereof).

I guess in the end, I went with my gut. I realized I was not thrilled with either one, but for now I will stick with what I've got. At least I know sort of what to expect with the staff, etc. Fingers crossed that I made the right decision.

Thanks again for all the input. Hope you all have a low pain weekend!