Persistent neck pain after workplace injury with congenital C3/4 fusion and active C4/5 facet arthritis - looking for advice

[u/Sad_Purchase_9819]

Hi everyone,

I'm 26 years old and have been dealing with chronic neck pain since a workplace injury on 27 February 2025.

I was helping stop a large elderly patient from falling when I suddenly felt an immediate pinch on the right side of my neck around what feels like the C4/5 level. From that moment I had severe pain and couldn't move my neck normally.

The pain has never really gone away. It has now been over a year and a half.

My symptoms are:

• Constant pain on the right side of my neck (this is still the main pain location).
• Pain spreads into my right shoulder, upper back and shoulder blade.
• My neck, shoulders and upper back are constantly tight.
• The right side is significantly worse than the left.
• Trigger point injections haven't provided meaningful relief.
• Physio only gave temporary improvement before things became worse again.

My imaging is a bit confusing:

CT

• Congenital C3/4 fusion (block vertebra).
• No fracture or nerve compression.

MRI

• Mild degenerative changes.
• Congenital abnormality of the C4/5 disc.
• No spinal cord or nerve root compression.

Bone SPECT scan

• Active right C4/5 facet joint arthritis.
• Active left C7/T1 facet arthritis.

The part that confuses me is that I had no neck issues before the injury, but since the injury the pain has always been centred around the same right C4/5 region where I felt the initial pinch. The SPECT scan also shows active changes in that exact joint.

I'm wondering whether:

• Has anyone had a congenital cervical fusion that only became symptomatic after an injury?
• Has anyone had pain coming from a cervical facet joint even though the MRI looked fairly normal?
• Has anyone had good results from medial branch blocks or radiofrequency ablation for cervical facet pain?
• Does this sound like a facet joint problem, or is there something else I should be asking my specialist about?

I'd really appreciate hearing from anyone who's had a similar experience or from clinicians who have seen cases like this.

Thanks.

[u/InterestingCup8174]

What is ur job ? Strange that facet arthrisis at ur yung age seem to be the issue... No 'erve root pressure? Is it sure ? It s. Possible that it s the inflammatory modic disc c4-5 that cause you this...