The C5-C6 spinal segment, consisting of the C5 and C6 vertebrae along with the C5-C6 disc in between, is located just beneath the middle of the cervical spine, and helps provide the neck with structural support and flexibility.

The C5-C6 level is located in the cervical spine. See Cervical Spine Anatomy and Neck Pain

It’s also the location where the C6 nerve root branches off from the spinal cord and travels down the arm to enable the elbow to flex and rotate, and the wrist to extend, as well as providing sensation along the side of the forearm and into the thumb side of the hand.

Due to its key roles in both neck mobility and support, the C5-C6 spinal segment is susceptible to developing painful conditions from age-related degeneration or injuries. It is the most commonly herniated disc level.

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Common Causes of C5-C6 Pain

Some common ways that cervical spine conditions can develop in the C5-C6 spinal segment and cause symptoms include:

Common cervical spine conditions.

C5-C6 degenerative disc disease
If the disc between the C5 and C6 vertebrae loses hydration and degenerates, either through the normal aging process or accelerated by an injury, then the disc itself can become painful, the nearby C6 nerve can become irritated, and/or muscle spasms may develop in response to spinal instability.

See Cervical Degenerative Disc Disease

C5-C6 disc herniation
A herniated disc occurs if the jelly-like inner portion of the disc leaks out—or herniates—through a tear in its protective outer layer (the annulus). This can cause pain and may possibly cause neurological symptoms in the adjacent C6 nerve root.

See Cervical Herniated Disc Symptoms and Treatment Options

If the nerve root becomes pressed or irritated, then cervical radiculopathy can result with pain, tingling, numbness, or weakness radiating down the shoulder and arm, usually along the side of the forearm and into the thumb and index finger. Pain may be worsened by certain positions of the head and neck.

C5-C6 osteoarthritis
If one or both of the facet joints that connect the C5 and C6 vertebrae lose enough protective cartilage and become arthritic, then pain can result from bone-on-bone grinding movements, inflammation, or bone spurs that grow big enough to impinge a nearby nerve.

See Cervical Osteoarthritis (Neck Arthritis)

C5-C6 spinal stenosis with myelopathy
If the C5-C6 spinal segment degenerates enough, arthritic changes in the facet joints and along the back portion of the disc space could lead to a narrowing of the spinal canal, potentially putting the spinal cord at risk.

See Cervical Stenosis with Myelopathy

When the spinal cord becomes compressed, myelopathy with damage to the spinal cord can result. Neurological symptoms of myelopathy are many—some of which include weakness or problems with coordination in the arms, hands, legs, or feet, as well as loss of bladder and bowel control.

See Symptoms of Cervical Stenosis with Myelopathy

If myelopathy starts to affect the spinal cord and its function, this can represent a situation that should be addressed surgically sooner rather than later. There are no nonsurgical treatments available for myelopathy from external compression.

C5-C6 foraminal stenosis
If either of the foramina—holes where the nerve roots branch off from the spinal cord and exit the spinal canal—becomes narrowed at the C5-C6 spinal segment, that can cause impingement of the C6 nerve root that runs through it, resulting in radiculopathy, causing pain, tingling, weakness, or numbness radiating down the shoulder and arm, along the side of the forearm and into the thumb side of the hand.

See Cervical Foraminal Stenosis

Cervical radiculopathy symptoms usually occur on one side of the body or the other, and not both sides at the same time.

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Less common C5-C6 conditions

A number of less common conditions can also cause problems in this segment of the cervical spine, including:

  • Spondylolisthesis. This condition occurs when the C5 vertebra slips forward over the C6 vertebra. Spondylolisthesis is less common in the cervical spine than the lumbar spine, but it can still result from degeneration or injury. It is commonly seen in rheumatoid arthritis of the cervical spine.
  • Tumor. If a tumor, such as from cancer that starts in another part of the body, starts growing in the cervical spine, it can cause impingement of a nerve or of the spinal cord, in a manner similar to a herniated disc or bone spur.
  • Infection. While rare, an infection could happen at the C5-C6 spinal segment, involving the disc or vertebrae.
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C5-C6 treatment

Most problems identified at the C5-C6 spinal segment can be treated or managed with nonsurgical medical care, such as medication and physical therapy. As a general rule, if neck pain doesn’t improve with 3 to 6 months of nonsurgical treatments, or if neurological symptoms don’t improve after 6 weeks or worsen or persist, then surgical evaluation should be considered.

Read more about Treatment for Neck Pain

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