@melissa711 You do not need to agree to steroid shots. Doctors use them to postpone surgery and sometimes because they don't want to offer surgery to a patient. The shot will not cure anything and it takes about 6 weeks for the body to clear out the steroid. If you need a new MRI, it will conflict because the steroid will obscure the imaging results and you would need to wait 6 weeks.

The question to ask the surgeon is if this required for your insurance company to authorize spine surgery.

I had an adverse reaction to a steroid shot in the neck and it was the most pain I have ever felt in my life. As a result, I had electric burning zaps in my fingers for about 6 weeks. I think I was allergic to component in the injection, likely polyethylene glycol. When a doctor brought it up again, I said no. You are correct that there are some serious risks. I did recover, but had cold sensitivity in my hand for a year and a half. The steroid shot may help by buying a little bit of space by lowering inflammation. If it doesn't help, you may have more pressure due to compression than can be helped with lowering inflammation.

PT can help somewhat, but when it fails to help with improvement, that is a reason for insurance to decide to cover surgery. Your surgeon knows because of your imaging what is wrong and how to fix it. Ask your surgeon how much risk you have now of loosing functioning of nerves because of the compression. If you feel you should address it now with surgery, speak up. You don't need to wait for the surgeon to make you jump through all the hoops. You are living with this, and it may get worse and cause permanent damage.

It would also be to your benefit to get opinions from other surgeons and you may need to wait a while for those appointments. You then have a choice among what has or hasn't been offered to you. It's an important decision, so make sure you find the surgeon who is right for you.