On examination, she has got restricted cervical spine movements especially rotations to the left which is 25%,, to the right is 75%. Flexion and extension is 50%. She has got full range of movement bilateral shoulders. Grip strength bilateral is 4/5. Sensation is reduced left c5/c6 and some patchy loss in c7. Hoffman testing was negative. However, she showed some positive signs of Rombergism. Her MRI scan, as you know, has shown multi - level lumber cervical spondylosis where there is moderate exit foraminal stenosis bilaterally at c4/5, c5/6 as well as c6/7. Clinically this explains her symptoms in the neck as well as the intermittent bilateral arm symptoms. I have explained this to her and I have also discussed her case with her surgeon who has recommended a course of acupuncture and some physiotherapy and then we will bring her back in 3 months time to discuss whether she would benefit from surgical intervention.