Right foraminal narrowing c5-c6 and bilateral neural foraminal narrowing l4-l5 and cervical stenosis) all mild, but symptomatic, can surgery help a 43yo, no relief from conservative treatment?

You need a consultation from a spinal surgeon . Yes surgery can and should help if it is indicated by the consultant. Dont hesitate to ask her /him all pertinent questions you have. Good luck.

Not surprising to have pain and stiffness from the described "wear and tear" findings. Typically, surgery would be indicated if spinal cord compression risk, arm progressive weakness and muscular atrophy, issues with urination such as urgency. Risk here is that surgery may eventuate in your pain worsening, such as post-operative scarring and arachnoiditis. Neurosurgical consultation advised.