From the Guidelines
Based on your cervical X-ray results, the best first-line treatment approach for your moderate degenerative disc disease at the C5-6 level and mild anterolisthesis of the C3 vertebra on C4 and C4 on C5 is to start with conservative treatment measures, including over-the-counter pain relievers and physical therapy, as most cases of acute cervical neck pain with radicular symptoms resolve spontaneously or with conservative treatment measures 1.
The X-ray findings indicate that you have moderate degenerative disc disease at the C5-6 level, which means that the disc between these two vertebrae is worn out and may be causing pain and stiffness in your neck. Additionally, you have mild anterolisthesis of the C3 vertebra on C4 and C4 on C5, which is likely due to age-related degeneration. These findings are common as we age and can explain your neck pain and stiffness.
Some key points to consider in your treatment approach include:
- Avoiding activities that worsen pain
- Maintaining good posture
- Using an ergonomic pillow that supports your neck's natural curve
- Applying heat for 15-20 minutes several times daily to relax muscles
- Considering gentle neck stretches and exercises to improve mobility
It's also important to note that in the absence of red flag symptoms, imaging may not be required at the time of initial presentation, and spondylotic changes are commonly identified on radiographs and MRI in patients over 30 years of age and correlate poorly with the presence of neck pain 1.
If your pain is severe or you develop numbness, weakness, or problems with coordination, please contact me for further evaluation as more advanced treatments may be needed. However, most people with these findings improve with conservative treatment over 4-6 weeks, and it is essential to prioritize conservative treatment measures before considering more invasive options 1.
From the Research
Cervical X-ray Results
The cervical x-ray results show:
- Moderate degenerative disc disease at C5-6
- Mild anterolisthesis C3 on 4 and C4 on 5, likely degenerative
Meaning of the Results
These results indicate that the patient has degenerative changes in the cervical spine, which can cause neck pain and other symptoms 2. The degenerative disc disease at C5-6 and the mild anterolisthesis at C3-4 and C4-5 are likely contributing to the patient's symptoms.
First Line Treatment Approach
The first line treatment approach for degenerative disc disease and anterolisthesis typically involves conservative management, including:
- Activity modification
- Neck immobilization
- Isometric exercises
- Medication 2
- Cervical manipulation may also be considered as an intervention to address acute, subacute, and chronic symptoms 3
- Physical therapy and epidural steroid injections may also be considered as part of the conservative management strategy 4
Additional Considerations
In some cases, surgical intervention may be necessary, especially if the patient has severe or progressive neurologic deficits 2. However, conservative management is usually the first line of treatment, and surgery is typically considered only if the patient's symptoms persist or worsen despite conservative treatment. Cervical arthroplasty may be a viable option for patients with moderate to severe disc degeneration, and clinical and radiological assessments have shown promising results after a minimum follow-up of 18 months 5.