Hi, As you mentioned, it will be risky to have steroid injections while you have already osteoporosis, but apart from painkillers and regular PT, you have other options for your treatment: 1- To help decrease the pain and to some extent to prevent the progression of degenerative you should have a regular program for cervical exercise. You can start by isometric neck exercises. You will see the results after 4-6 weeks. Please note that you should not exercise during the days with severe pain. 2- Other treatment options to decrease your pain exist: for example, you can try an injection of Ozone instead of corticosteroid. Ozone has anti-inflammatory effects without the side effects of steroid, but it should be injected under the fluoroscopic guide by an experienced expert. A simpler option is dry needling. It is simple and sometimes a very effective method to reduce pain. I regularly use this method at my clinic. You have to find a Physical Medicine and Rehabilitation specialist (Physiatrist) or an expert physiotherapist in your area to do this. - another important issue is sometimes the pain originates from the structures around the vertebra (neck) but not the vertebra itself. So you should seek for tender spots (Trigger Points) in the muscles around the neck and shoulder and focus the physiotherapy, laser therapy, injection or dry needling techniques on them to reduce the neck pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Hooman Mahmoudi, Neurologist