Brief Answer:
Doesn't warrant any extra treatment

Detailed Answer:
I read that report carefully, thank you for providing a scanned copy as well.

The report doesn't mention any hydromyelia, either their impression on the first exam was mistaken or it's remained unchanged and doesn't need any treatment.

The rest of the exam shows degenerative changes of the spine, similar to the prior MRI, again no change in treatment is necessary. Those changes can manifest with neck pain. These changes are a little premature for your age, making you predisposed in the future for neck and back pain. The reason for the premature changes might be the straight cervical spine, normally it is a little curved to better stabilize the vertebrae and absorb shock. Straight cervical spine can be often an inherited condition or related to trauma and bad posture.

For that reason apart form the treatment that you are taking I would advise also physiotherapy in order to learn exercises to improve posture and provide better support to the spine by your muscles.

As for medications if you still have pain or abnormal sensation you can continue with the Pregabalin.

I remain at your disposal for further questions.

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Brief Answer:
No hypertension.

Detailed Answer:
If by hypertension you mean high blood pressure, then no, it has no relationship with the pain.

The pain is due to the spine changes which can cause pain radiating to the shoulders as well as favoring muscle spasms which themselves cause pain.
The fact that it is relieved by painkillers confirms that.

Chances are that you are going to need some pain killers from time to time. In order to keep that to a minimum and prevent more spine changes advancing over the years, as I said physical therapy, simple as it may seem, is very important. I believe that that's more important than tests.

I hope to have been of help.

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Brief Answer:
I favor physio.

Detailed Answer:
Physiotherapy and chiropractics tend to overlap with each other. I don't think it's advisable to do them both because too many manipulations of the spine at the same period may actually over-burden your spine and muscular system and be harmful.

So since it is about choosing between the two it should be the one who has proved its efficacy in clinical studies and for now that is physiotherapy. While it has shown some benefit in back pain, efficacy of chiropractics is yet to be proven by studies for neck pain, results have been mixed.

So I maintain physiotherapy is the first choice.

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