Hi Ventura,
I think I would opt for the epidurals to start, especially since the herniation is fairly recent and sudden as you state in your first post. Older herniations (>6mo) have a lesser probability to respond to the steroid medication. I think steroid shots into knees and hips act somewhat differently than ESI's, which could to a certain extent maybe help to shrink the disc somewhat. From the MRI report it looks like the C5-6 could also be a pain generator and a good interventional pain management doc could help you determine if it is. When deciding on your surgery option, if any, I think the condition of that disc should be taken into account as well.
When I was finally offered an ESI, it was too late (6mo after and a year after the herniation). It had no effect so didn't proceed on to the second injection. A newer herniation may have a good response after 3 ESI's. It may buy time as well as comfort while considering options/insurance issues.
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*C4-5 and C5-6 Mild & moderate posterior broad-based disc bulges w/small posterior end plate osteophytes, mild spinal canal stenosis.
*C6-7 Broad-based posterior disc bulge w/small focal posterior central protrusion mildly indenting the anterior thecal sac, no canal or neural foraminal stenosis.
*SI Joint issues, Fibromyalgia, Chronic Myofascial Pain, Neurogenic Thoracic Outlet Syndrome
*Tx's-PT, 2 ESI's Interlaminar & transforaminal, 2 SI Joint steroid injections, Failed LBB for SI Joint
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