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How do you decide on a treatment approach?
That depends upon the degree of nerve impingement (pinching), if any. Nerves can regenerate if they are not pinched too long or too severely. Surgery is the first choice if the cervical spine has become unstable or serious nerve damage is occurring. That degree of nerve impingement ('pinching') should be evident on an MRI or a CT with myelogram, and then verified with an EMG and/or a Sensory Evoked Potential. Even if all these results are positive, most doctors will recommend a period of conservative care before surgery. This normally involves medication management up to and including opioid management, and physical therapy 3 times a week. It can include anything you want to try that might relieve your pain. Techniques such as Acupuncture or PENS aim at shutting off the pain messages the nerves are sending out. Epidural steroids act by reducing inflammation of the spinal nerves and cord. Biofeedback can teach you how to relax the tension in the muscles of your neck. Manipulation can help, especially Osteopathic Manipulation, by reducing the pressure on the nerve roots from the surrounding structures.
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