Treatment of the C5-C6 spinal motion segment typically begins with nonsurgical methods. In cases where the neck pain and other symptoms do not improve with nonsurgical treatments, or if the health of a nerve root or the spinal cord worsens, surgery may be considered.

Nonsurgical Treatment for C5-C6

Nonsurgical treatments of the C5-C6 motion segment include:

  • Medication. Both prescription and over-the-counter (OTC) medications are used to help relieve C5-C6 vertebral and nerve pain. Common medications include non-steroidal anti-inflammatory drugs (NSAIDs), pain-relieving medication such as opioids and tramadol, and/or corticosteroids. Some doctors may also prescribe calcium and vitamin D supplements for bone strengthening.
  • Neck brace. A brace helps immobilize and protect the neck during the initial week or two of an acute injury to the C5-C6 vertebral levels, such as a fracture or while recovering from surgery. Immobilization may help promote healing of the vertebrae and surrounding soft tissues such as ligaments and blood vessels.
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  • Manual therapy. Manual therapy in combination with therapeutic exercise may help improve neck function, decrease pain, and increase the range of motion of the C5-C6 level. This treatment also helps improve head and neck balance and prevent falls.,

    See Physical Therapy for Neck Pain Relief

  • Injection. Injecting steroids into the epidural space, neuroforamen, or in the facet joints may be recommended for the treatment of radicular pain from herniated discs and whiplash injury., Studies estimate 3 to 11 months of pain relief from these injections, with maximum relief periods for those with cervical herniated discs. The epidural injections, in general, may carry a risk of hematoma, bleeding, and nerve damage when administered in the cervical region.

    Watch Cervical Epidural Steroid Injection Video

  • Self-care. Following certain self-care measures may help prevent cervical vertebral and/or spinal nerve pain from starting or getting worse. A few tips include avoiding:
    • Repeated bending the neck forward and/or backward
    • Sudden, abrupt, and/or jerking movements to the neck, such as from jumping
    • High-intensity exercise and heavy weight lifting

It is advised to maintain good posture by sitting tall with the shoulders back and without protruding the head forward in order to avoid stress on C5-C6. A doctor can help estimate the degree of movements permissible on the neck to avoid further injury to the C5-C6 vertebral level.

See How Poor Posture Causes Neck Pain

Surgical Treatment for C5-C6

The goals of surgically treating the C5-C6 motion segment include one or more of the following:

  • Improve neck stability in the load-bearing C5-C6 vertebral level.
  • Relieve compression of the spinal cord and/or C6 spinal nerve(s).
  • Prevent further injury to the nerve root(s) and/or spinal cord.

Surgery is more likely to be recommended for those who have persistent pain and neurological and/or muscular deficits, preventing the ability to function in everyday life.

See Surgery for Neck Pain

Surgical methods used in the C5-C6 vertebral levels are described below.

The type of surgery chosen for C5-C6 may depend on the extent and location of the damage, as well as how many vertebral levels are involved. In some cases, more than one surgery type may be combined.

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Commonly, after surgery at C5-C6, signs and symptoms related to the compressed nerve such as reduced pain, tingling, numbness, and/or weakness in the arm may be relieved. Reduced neck pain may also be experienced.

As with any surgery, there is always a small risk of serious complications such as infection, neurologic injury, excessive bleeding, allergic reaction, or death following these surgical procedures. It is important to speak to your surgeon about these risks, the alternatives to surgery, as well as risks if surgery is not performed.

Dr. Jack Zigler is an orthopedic surgeon at the Texas Back Institute and Co-Director of its Spine Fellowship Program. He has more than 30 years of experience performing spine surgery. He serves as the Co-Director of the Center for Disc Replacement at the Texas Back Institute and teaches around the work on surgical techniques for artificial disc replacement surgery.

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