Hi, I am an American Board Certified Neurologist and I am very glad to help you with your health concerns.
I will try to answer your questions one by one below here;
1) I had a Cervical spine MRI that showed shallow central disc bulging at C6-C7 and Facet degenerative changes at C7-T1. What does this mean?
First of all I want to reassure you these are not serious changes, many people have these, these are degenerative changes associated with the wear and tear phenomenon and as age advances most of us will develop these changes. Some people develop these early some develop late but many people develop these changes related to the aging process which are due to the wear and tear phenomenon of the body.
Disc is a normal semisolid substance located between two adjacent spinal bones called as vertebra. A disc bulge is a small bulge of this disc which is directed backwards towards the spinal cord or spinal canal. A disc bulge is not a disc herniation. A disc herniation is more serious issue whereas a disc bulge is minor issue related with the disc.
Facet joints are the joints formed between two structures called as superior and inferior articular facets of two adjoining vertebrae. As age advances some people develop degenerative arthritic changes of these joints like people may develop degenerative arthritic changes in the knees or hip joints etc.
2) And how much pain can it cause?
There are lots of individual variations as to the extent these changes can cause pain. Some patients may not experience much pain or only mild pain, and some experience moderate pain, and some experience severe pain too. As you see there is huge individual variation in this regard.
3) What's the best course of action to start with?
The following measures are taken to help with the above mentioned two conditions (disc bulge and facet degenerative changes) and the symptoms associated with these changes in the spine;
Cold Laser therapy
Interferential therapy - a type electrotherapy
TENS (Transcutaneous Electrical Nerve Stimulation) – another type of electrotherapy
Pain medications (examples include NSAIDs, Muscle relaxants, Nerve-pain pills, Narcotic pain killers etc)
Complementary and Alternative medicine treatments like Acupuncture
ESI (Epidural steroid injections) etc
I am not sure what you have already tried to help with these spinal findings on your MRI scan and also how much pain you are having but these above are the various options that are commonly used to help with your spinal condition; if you see any of the treatments mentioned in the above list you have not yet tried then you may consider trying them. I am not telling all these above treatments are required in your case, I am just providing you with a list of several different treatment options that are available for your spinal condition seen on in the MRI scan of cervical spine.
Please let me know if you have any further questions; and if you feel you have received the answer to your question please rate me so that I can receive credit for the time and effort put by me in answering your question.