<s>[INST] I have had really bad pains in neck, shoulder and headaches for over 6 months. I got an MRI done and it shows the following: Multilevel disc osteophyte complexes cause no significant central stenosis. There is severe right neural foramina narrowing at C3- C4 from prominent facet degenerative change and a right foramina disc osteophyte complex. There is severe right neural foramina narrowing at C5-C6 from uncovertebral joint degenerative changes. Mild neural foramina narrowing is present at other levels. Mild grade 1 anterolisthesis of C3 on C4 and mild grade 1 retrolisthesis of C5 on C6. Do you think this would call for surgery? [/INST] Hi there, thanks for your question at Chat Doctor. Cervical spine related problems are usually more manageable than lumbar spine issues. If your pain is manageable and not disturbing your daily routine. I think you can wait. I suggest you to try physiotherapy, isometric cervical exercises, pain medications in a step wise fashion. Injection shots also can give considerable relief. In the spine pain ladder there are a lot of steps to be taken before you land at the step of surgery. Surgery should be the last resort. Your MRI findings look manageable. Urgent surgery would be indicated in case of any weakness, un relenting pain, no response to the steps and balance related issues. Hope this helps. All the best. Regards.  Chat Doctor.  </s>