Suggest Treatment For Pain In Neck, Back And Arms

I had a cervical fusion at c5-6 five years ago. There was no acute injury. The pain prior to surgery was horribly painful and radiculapathy was excruciating on my R neck back and arm. I underwent conservative treatment (PT) for greater than 12 months, including a injejection in c5-6. All of this to no avail. I began lossing function in my r hand. The results from my c5-6 fusion was awesome. Awoke completely pain free. Have been pretty much pain free since. Last two weeks have been different. I thought I just turned the wrong way, twisting my neck. My neck now is very painful from my right in my upper back and R shoulder. I am in my third week of PT. I am not feeling better. I will include my MRI for you to read. Do I need to be concerned my recent problem is coming from c4-5?