From the Research
The treatment plan for mild cervical degenerative disc disease at C4-C5 and C5-C6 with radicular symptoms should begin with conservative management, prioritizing physical therapy and medication to reduce inflammation and alleviate pain.
Initial Treatment Approach
- A short course of NSAIDs, such as ibuprofen 400-600mg three times daily with food for 1-2 weeks, can help reduce inflammation 1.
- Physical therapy focusing on cervical strengthening and posture correction should be started for 6-8 weeks, with 2-3 sessions weekly, as it has been shown to be effective in managing chronic low back pain and can be applied to cervical cases as well 2.
- A cervical pillow for proper neck alignment during sleep is also beneficial.
Pain Management
- For pain management, acetaminophen 500-1000mg every 6 hours as needed can be used, not exceeding 4000mg daily.
- If symptoms persist, a short course of oral steroids like methylprednisolone dose pack may be prescribed, starting at 24mg and tapering over 6 days.
Advanced Treatment Options
- For persistent symptoms beyond 6-8 weeks of conservative treatment, epidural steroid injections may be considered, as they deliver anti-inflammatory medication directly to the affected nerve roots 3.
- Surgery is typically reserved for cases with progressive neurological deficits or intractable pain despite conservative measures.
Rationale
This stepped approach is recommended because most cervical radiculopathy cases improve with non-surgical interventions, as the symptoms result from nerve root compression and inflammation caused by disc degeneration and potential herniation. The use of exercise therapy, as supported by studies on chronic low back pain 2, can be adapted for cervical degenerative disc disease, focusing on exercises that improve range of motion, function, and reduce pain, similar to those effective in treating frozen shoulder 4.