Hey Snap,

Congratulations on getting a reasonable diagnosis......finally. The C1 thinng is likely irrelevant. The degenerative changes are the cause of your arm pain (as X said), and are treatable. Depending on the degree, many times with conservative measures.

I'd assume you've been on anti-inflams for awhile since you were diagnosed with tendonitis before. So it's unlikely that NSAIDS will do the trick for you. They may try to put you on a stronger anti-inflammatory but those have some significant side effects you need to discuss thoroughly with the Doc or PA before taking them.

Other options include more PT but this time for your neck, not your arms. Mechanical traction is a very good option for a lot of people. At our clinic we loan out traction units on trial and patients buy them if they work well to manage the symptoms. Here's a link to check out:

http://www.medicalproductsonline.org/sacehode.html

I have many clients with the same diagnosis that do very well with a home traction unit, exercises and a little caution to aviod activities that irritate the neck.

As for the injections and denervations. The steroid injections do help and sometimes they can be effective long term. Denervations are helpful in cases where a lot of the pain is coming from the facet joints themselves. This is less likely to be the case for you. Also, they tend to be less effective in the cervical spine than they are in the lumbar spine.

The pain Docs that I work with would normally send you out for traction, preferrably a home unit, on trial and PT. Then if that didn't work they would do a steroid injection, trying different sites until they found the most effective location - this also gives them a far more specific diagnosis. If the primary area causing the pain is/are the degenerated facets, they would then do a radio frequency cauterization to allow for longer term pain relief. If the pain is predominently coming from the nerve roots, they would then consult with a neurosurgeon on other, more aggressive options.

Good luck and keep us posted. Rest assured that this is not an uncommon problem and there are effective treatments available to you now that you have an accurate diagnosis.