Sevier Right C2 and C3 Facet Arthropathy

hey Joey, it doesn't sound like the full report. It should tell what is causing the arthrorpy. If it's bone spurs (osteophyte complex) you can have those sharp little spurs removed. If it is disc disease, you might have the disc modified or removed. Some patients have radiofrequency to block pain transmission through the medial branch nerve. Call the radiology office that ran the MRI and ask them to send you the full report.

@joeythompson If that was the report I received, I would call the physician who ordered the test for an explanation. Do you have a follow up appointment with the doctor to discuss the results?

@gently The Report states:
Exam: MRI Cervical Spine WO Cont. Date of Exam: 7-21-2026
The Impression:
Severe Right C2-C3 Facet Arthropathy, A potential Therapeutic Target.
Cervical Spondylosis with spinal stenosis as detailed below.
Mild C2-C3 Right Canal and Ipsilateral Foraminal Stenosis.
Mild C4-C5 Through C6-C7 Canal and Moderate Bilateral Foraminal Stenosis

Technique: Sagittal STIR, sagittal T1 TSA, Axial T2 * GRE, and Sagittal and bilateral sagittal oblique sequences of the cervical spine without IV contrast.

Findings: Cervical vertebral alignment remains anatomic, and the heights of the vertebrae are maintained. Severe right C2-C3 facet arthropathy with prominent T2 signal subcortical marrow and periarticular soft tissue edema (sagittal STIR series 17, image 18). Disc space loss and type 1Modic marrow endplate changes at C6-C7. Normal atlantooccipital and atlantoaxial joints.

C2-C3: A right [paracentral disc osteophyte complex results in mid-right canal and foraminal stenosis. No left foraminal stenosis.

C3-C4: No disc osteophyte complex or herniation. No canal foraminal stenosis.

C4-C5: A mild loss in disc space height and broad disc osteophyte complex results in mild canal and moderate bilateral foraminal stenosis.

C5-C6: A mild loss in disc space height and broad disc osteophyte complex results in mild canal and moderate bilateral foraminal stenosis.

@sueinmn She did not know much. She was just a general practitioner at a local walk-in clinic. I am in otherwise great shape and usually don't go to doctors. I've never carried insurance... So, I'm a little out of my comfort zone for more than one reason besides the pain. 59 years old. She did make an appointment with a spine specialist to discuss treatment options, but I would rather treat it myself, if I can. But if I have to go the specialist route, I really would like to know what works and doesn't work from those who might have a similar story.

That’s a lot and hard to understand. Certainly not any definitive info but here is an AI interpretation of those results.

“The Big Picture
This person has age-related degenerative changes throughout the cervical spine — cervical spondylosis — with the most significant finding being severe right-sided facet arthropathy at C2-C3, plus multilevel stenosis from C4 through C7.
Breaking Down Each Finding
Severe Right C2-C3 Facet Arthropathy
This is the headline finding and flagged as a "potential therapeutic target." The facet joints are the small paired joints at the back of each vertebra that allow neck movement. Severe arthropathy means significant arthritic degeneration of that joint. The T2 signal and edema around it indicates active inflammation — this joint is angry right now, not just worn. This level is high in the cervical spine — C2-C3 is just below the skull base.
Symptoms this typically causes:
Upper neck pain
Base of skull headaches — occipital headaches
Pain radiating toward the ear or jaw
Neck stiffness especially with rotation
C2-C3 Right Canal and Foraminal Stenosis — Mild
The disc osteophyte complex (bone spur combined with disc bulge) is narrowing the right side of the spinal canal and the foramen — the opening where the nerve root exits. Mild means it's present but not severe compression.
C4-C5 Through C6-C7 — Multilevel Disease
This is where the bulk of the stenosis lives:
Mild canal stenosis at multiple levels
Moderate bilateral foraminal stenosis at C4-5 and C5-6 — this is the most clinically significant stenosis finding
Moderate bilateral foraminal stenosis at these levels typically causes:
Neck pain radiating into shoulders
Arm pain — classic cervical radiculopathy
Numbness or tingling into the arms or hands
Weakness in specific muscle groups depending on which nerve roots are compressed
C6-C7 Disc Space Loss with Modic Type 1 Changes
Modic Type 1 changes indicate active inflammation/edema in the vertebral endplates — the surfaces of the vertebrae adjacent to the disc. This is associated with active pain rather than just structural change. The disc space loss means the disc itself has degenerated and collapsed somewhat.
What's Normal
Vertebral alignment is maintained — no slippage (spondylolisthesis)
Vertebral heights maintained — no compression fractures
C3-C4 is completely clean
The atlantoaxial and atlantooccipital joints (skull-C1-C2) are normal — important safety finding
The "Potential Therapeutic Target" Comment
The radiologist specifically flagging the C2-C3 facet as a therapeutic target is a meaningful clinical suggestion. This typically points toward:
Facet joint injection — corticosteroid injection directly into the joint
Medial branch nerve block — blocking the nerve that carries pain from that facet
Radiofrequency ablation — if nerve blocks are effective, burning the nerve for longer lasting relief
This is the radiologist essentially saying "this is treatable and worth addressing."
The Overall Clinical Picture
This person has two distinct pain generators:
Upper cervical — the severe C2-C3 facet arthropathy causing upper neck and likely occipital headache symptoms
Mid-lower cervical — multilevel C4-C7 spondylosis with moderate foraminal stenosis causing potential arm/shoulder/hand symptoms
What This Person Should Be Asking Their Doctor
Is the C2-C3 facet injection/nerve block appropriate given the active inflammation?
Which symptoms map to the upper versus lower findings?
Is there any myelopathy — spinal cord involvement — given the canal stenosis at multiple levels?
Does physical therapy have a role alongside any interventional treatment?”

@joeythompson Well, let's start with -we're not medical professionals here, and cannot give advice. I understand wanting to manage it yourself, especially given the cost of care. But, severe pain with spinal involvement is not a do-it-yourself project until more analysis by a docotr determines that there is no pressure from the osteophytes (bone spurs) on your spinal cord.

Once that is ruled out, you can probably be referred for physical therapy to learn stretches to ease the pain, and proper posture.

My spinal MRI report looks a little like yours, if you add more arthritis and disk degeneration. So far I have managed with PT, stretching, and being careful. But I may eventually need injections to quiet the inflammation - keeping in touch with the orthopedist.

Are you willing to consult with a specialist and get some PT to help ease the pain?

@sueinmn First of all, your statement "with more arthritis and disk degeneration" made me cringe. Anyone with more pain than I'm going through gets my respect and sympathy. And yes, I am willing to consult a specialist.

@altilla Thank you, very much.

@joeythompson, it's good that you want to try and avoid surgical intervention because usually the doctors want you to try physical therapy, anti inflammatory medication, and posture correction. You may be offered spinal injections now or after the physical therapy
Eventually you may want minimally invasive surgery to either remove the spurs or widen the foraminal space where the nerves exit by removing part of the foramen. Any that's my someday plan for mine.
In your original post you only mentioned C2, C3. Is that because of the word damage or is that where you feel the most pain.
I've had those cervical bone spurs for many years, and have found the greatest relief from chiropractors. The manipulations might stop the progressive growth of the spurs as seems to be true for me. They will also help you understand postural correction and give you exercises to help. You have other things going on with your spine that I'm happy to discuss,
Meanwhile, sweet Atilla (not the hun) has done an AI search.
I leave you with these links
https://teachmeanatomy.info/neck/bones/cervical-spine/
https://www.merrittislandchiropractor.com/cervical-stretches-and-exercises-videos/

@joeythompson Don't feel sorry for me - I manage the pain with PT, exercise, stretching, medication (non-opioid) and ice so I can live a pretty normal life.
I have also learned that moving, moving, moving is crucial for me.