1) It is a bit difficult to say without actually being able to see your MRI images, but if it is minor changes at C5-6, then yes, I would expect the pain to get much better.
2) It is impossible to know when in the past you may have developed that disc bulge, since many people have them without any symptoms. So it is possible that this occurred 6 years ago, but there is no way to prove this. It is similarly impossible to put the blame on lifestyle issues.
3) No, this does not sound like bad management, and no, that would not make a condition chronic.
4) I would have a neurosurgeon review the actual images of the cervical spine MRI, to ensure that there is no significant "foraminal stenosis", which could be pinching a nerve to the side. In addition, a test called a EMG, performed by a neurologist or physiatrist, can help to determine if there is nerve root irritation as the cause for your pains in the neck and down the arms.
Thanks for the answer. Number (4) sounds useful advice; do you have any suggestions on how to choose the right neurosurgeon/neurologist? I live in London, so there are many to choose from.
With regard to (3), in that case, why would my condition have worsened after starting the programme of physio exercises? I went to the physio complaining of tightness of the neck causing difficulty swallowing, the physio worked on it for half an hour and it seemed much better, but at the end of the session she told me to pull my shoulder blades together so that she could tape them up to improve my posture, and immediately the neck tightness came back worse. A lot of their exercises involved pulling my shoulder blades together. On the other hand, my condition started improving as soon as I stopped the exercises, as well as swimming and running. It is really important to me that I understand what has been making my condition worse, as I don't want to keep suffering relapses.
Others have also told me they expect the pain to get much better, but I am not convinced that it is improving at the moment. Do you have any comments on how rapidly things might improve, and what I might expect along the way?
Relist: Incomplete answer. I am keen to get a more detailed answer to some parts of my question, which is why I asked the follow-up and opened it up to other experts. I was pleased to get the initial reply so quickly, and disappointed that no-one answered my follow-up.
Dear Dr Mark,
Thanks for getting back to me.
I've been advised to "listen to my body" before, and I've been trying to do this for two and a half months already. When I get stiffness in my back or neck, I usually first notice it when I wake up in the morning. When the "nerve" pain flares up, it is always just after some motion of my neck or shoulders, such as a turn of my neck, or lifting an arm, but this might happen while I'm lying in bed, or walking, or eating, and it's surely not these things that are the cause, so it must be something I've done earlier, but I often can't figure out what.
If I knew more about what causes the pain, in particular why it is that sometimes I feel one thing and sometimes another, then it would be easier to know what I should be changing. I don't think I'm getting better, and I don't know why doctors are so confident about my recovery when they can't explain my symptoms. I fear there may be something else wrong with me as well as the disc bulge (e.g., overtraining, chronic fatigue, or some more serious condition): do you think this is likely (I understand you can't possibly rule it out) or is my pattern of symptoms consistent with other patients you've seen?