Backward Slip of C6 over C7

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 15 min read
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Article Summary

Backward slip of C6 over C7, also known as C6–C7 retrolisthesis, is a condition in which the sixth cervical vertebra (C6) shifts backward relative to the seventh cervical vertebra (C7). This misalignment can compress nerves, reduce normal spine movement, and cause pain or neurological symptoms. Anatomy of the C6–C7 Motion Segment The C6–C7 motion segment consists of the sixth and seventh cervical vertebrae and the...

Key Takeaways

  • This article explains Anatomy of the C6–C7 Motion Segment in simple medical language.
  • This article explains Types of Cervical Spondylolisthesis in simple medical language.
  • This article explains Causes in simple medical language.
  • This article explains Symptoms in simple medical language.
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Definition

Backward slip of C6 over C7, also known as C6–C7 retrolisthesis, is a condition in which the sixth (C6) shifts backward relative to the seventh cervical vertebra (C7). This misalignment can compress nerves, reduce normal spine movement, and cause or neurological symptoms.

of the C6–C7 Motion Segment

The C6–C7 motion segment consists of the sixth and seventh cervical and the intervertebral disc between them. These vertebrae sit at the base of the neck, just above the spine, and bear much of the head’s weight while allowing extensive flexion, extension, rotation, and lateral bending Spine-health. Each vertebra has a vertebral body anteriorly and a vertebral arch posteriorly, forming the vertebral foramen through which the passes Physiopedia.

  • Origin/Insertion: The vertebrae themselves do not “originate” or “insert” like muscles, but they articulate via superior and inferior articular facets: the inferior facets of C6 articulate with the superior facets of C7, and C7’s inferior facets articulate with T1. These facet joints guide movement and limit excessive rotation.

  • Blood Supply: Segmental branches of the vertebral and ascending cervical supply the C6–C7 vertebrae and intervertebral disc. Small nutrient arteries penetrate the vertebral bodies, while posterior elements receive branches from muscle perforators Kenhub.

  • Nerve Supply: Each motion segment receives innervation from the medial branches of the dorsal rami of spinal nerves exiting at that level (C6–C7). These nerves carry pain signals from the facet joints and to the central nervous system NCBI.

  • Functions:

    1. Protecting the spinal cord and nerve roots

    2. Supporting head weight and maintaining posture

    3. Allowing flexion/extension (nodding)

    4. Permitting rotation and lateral bending of the neck

    5. Transmitting load between head and thoracic spine

    6. Housing and protecting vertebral blood vessels

Types of Cervical

  1. Degenerative: Age-related facet joint and disc wear causing vertebral slip Cleveland ClinicCleveland Clinic.

  2. Isthmic (Lytic): A defect (spondylolysis) in the pars interarticularis allows slippage.

  3. Traumatic: of posterior elements leads to instability.

  4. Dysplastic (): Abnormal facet joint formation from birth.

  5. Pathological: Bone disease (e.g., , ) weakens vertebrae.

  6. Post-surgical: Instability following prior cervical spine surgery.

Causes

  1. Age‐related degeneration of discs and facets Cleveland Clinic

  2. Repetitive flexion‐extension activities (e.g., gymnastics)

  3. High-impact (e.g., falls, motor vehicle accidents)

  4. Congenital facet malformation

  5. Spondylolysis (pars defect)

  6. weakening vertebrae

  7. causing laxity

  8. Tumors (primary or metastatic)

  9. Infections (, discitis)

  10. Post-operative instability

  11. Smoking-induced disc degeneration

  12. predisposition to connective tissue laxity

  13. Poor posture over years

  14. Obesity increasing spinal load

  15. Occupational (e.g., heavy lifting)

  16. Whiplash injuries

  17. Metabolic bone diseases (e.g., Paget’s)

  18. Disc herniation with facet overload

  19. Facet joint arthropathy

  20. Inflammatory (e.g., ) Mayo ClinicHospital for Special Surgery

Symptoms

  1. Neck pain (often worse with movement)

  3. Radicular arm pain following the C7 dermatome

  4. / in the index and middle fingers

  5. in triceps and wrist extensors

  6. Headaches at the base of the skull

  7. Shoulder pain

  8. Reduced range of motion

  9. Muscle spasm

  10. Balance difficulties

  11. Gait disturbances with myelopathy

  12. Hyperreflexia if spinal cord is compressed

  13. Clonus (rhythmic muscle contractions)

  14. Lhermitte’s sign (electric shock–like sensation)

  15. Fine motor dysfunction (e.g., buttoning shirts)

  16. Bowel/bladder changes (in severe myelopathy)

  17. Sensory loss below the level of lesion

  18. Fatigue from chronic pain

  19. Pain radiating between shoulder blades

  20. Poor hand coordination Mayo ClinicCleveland Clinic

Diagnostic Tests

  1. Physical/neurological exam (reflexes, strength, sensation)

  2. Posture and gait assessment

  3. Cervical range-of-motion measurement

  4. Plain X-rays (AP, lateral, flexion/extension) Mayo Clinic

  5. MRI (soft tissue, spinal cord visualization) Patient Care at NYU Langone Health

  6. CT scan (detail of bony anatomy)

  7. CT myelogram (with contrast to assess canal)

  8. Electromyography (EMG)

  9. Nerve conduction studies

  10. Bone scan (for occult fractures, infection)

  11. DEXA scan (bone density)

  12. Ultrasound (muscle/soft-tissue evaluation)

  13. Facet joint injection (diagnostic block)

  14. Discography (disc pain source)

  15. Myelography

  16. SPECT scan

  17. Dynamic (upright) MRI/X-ray

  18. Blood tests (inflammatory markers)

  19. Tumor markers (if malignancy suspected)

  20. Provocative tests (Spurling’s maneuver) Mayo ClinicNewYork-Presbyterian

Non-Pharmacological Treatments

  1. Physical therapy (strengthening, stabilization)

  2. Cervical traction

  3. Manual therapy (mobilization)

  4. Chiropractic manipulation

  5. Posture correction

  6. Ergonomic workstation adjustments

  7. Heat therapy

  8. Cold packs

  9. Ultrasound therapy

  10. Transcutaneous electrical nerve stimulation (TENS)

  11. Acupuncture

  12. Yoga (neck-friendly poses)

  13. Pilates

  14. Swimming

  15. Cervical collar/brace (short-term use)

  16. Activity modification

  17. Weight management

  18. Hydration and nutrition optimization

  19. Smoking cessation

  20. Relaxation/biofeedback

  21. Cognitive behavioral therapy

  22. Massage therapy

  23. Soft tissue mobilization

  24. Stretching exercises

  25. Proprioception training

  26. Ergonomic pillow/bed support

  27. Isometric neck exercises

  28. Low-impact aerobic exercise

  29. Functional electrical stimulation

  30. Neck bracing during flare-ups Hospital for Special SurgeryCleveland Clinic

Drugs

Drug Class Typical Dosage Timing Common Side Effects
Ibuprofen NSAID 200–400 mg orally every 4–6 h With meals GI upset, renal impairment
Naproxen NSAID 250–500 mg orally twice daily Morning & evening GI bleeding, edema
Celecoxib COX-2 inhibitor 100–200 mg orally daily Any time Cardiovascular risk, GI upset
Diclofenac NSAID 50 mg orally three times daily With food Liver enzyme elevation, GI issues
Ketorolac NSAID 10 mg IV/IM every 6 h (≤5 days) Hospital use Bleeding, renal toxicity
Acetaminophen Analgesic 500–1 000 mg every 6 h (≤4 g/day) As needed Hepatotoxicity (overdose)
Tramadol Opioid agonist 50–100 mg every 4–6 h (≤400 mg/day) As needed Dizziness, constipation
Gabapentin Anticonvulsant/neuropathic 300 mg orally three times daily With or without food Sedation, peripheral edema
Pregabalin Anticonvulsant 75 mg orally twice daily Morning & evening Dizziness, weight gain
Cyclobenzaprine Muscle relaxant 5–10 mg orally three times daily Bedtime if sedating Drowsiness, dry mouth
Methocarbamol Muscle relaxant 500 mg four times daily With food Sedation, GI upset
Baclofen Antispasticity agent 5 mg orally three times daily With meals Drowsiness, weakness
Amitriptyline TCA antidepressant 10–25 mg at bedtime Bedtime Anticholinergic effects, sedation
Duloxetine SNRI antidepressant 30 mg orally daily Morning Nausea, headache
Prednisone Corticosteroid 5–10 mg daily (taper as needed) Morning Weight gain, hyperglycemia
Methylprednisone Corticosteroid (dose pack) 4 mg taper pack over 6 days Morning Insomnia, mood changes
Hydrocodone/APAP Opioid combination 5/325 mg every 6 h as needed As needed Respiratory depression, constipation
Oxycodone Opioid agonist 5 mg every 4–6 h as needed As needed Addiction risk, sedation
Tizanidine Muscle relaxant 2 mg every 6–8 h as needed With meals Hypotension, dry mouth
Clonazepam Benzodiazepine 0.5 mg twice daily Morning & evening Dependence, sedation

Dosing should be individualized; consult guidelines. Mayo ClinicCleveland Clinic

Dietary and Regenerative Supplements

  1. Glucosamine sulfate – 1 500 mg/day; supports cartilage formation by supplying substrate for glycosaminoglycans.

  2. Chondroitin sulfate – 1 200 mg/day; inhibits cartilage-degrading enzymes.

  3. Omega-3 fatty acids – 1 000 mg/day; anti-inflammatory via COX and LOX pathway modulation.

  4. Vitamin D₃ – 1 000 IU/day; promotes calcium absorption and bone health.

  5. Calcium citrate – 1 000 mg/day; essential for bone mineralization.

  6. Curcumin – 500 mg twice daily; downregulates NF-κB inflammatory signaling.

  7. Type II collagen – 40 mg/day; may induce immune tolerance to joint collagen.

  8. Methylsulfonylmethane (MSM) – 1 500 mg/day; may reduce oxidative stress in joints.

  9. Vitamin C – 500 mg twice daily; cofactor in collagen synthesis.

  10. Boron – 3 mg/day; supports bone metabolism and steroid hormone balance. KenhubScienceDirect

Surgical Options

  1. Anterior cervical discectomy and fusion (ACDF) – removal of disc, fusion with graft.

  2. Posterior cervical fusion – rods and screws posteriorly to stabilize.

  3. Cervical laminectomy – decompress spinal cord by removing lamina.

  4. Laminoplasty – hinge-opening of lamina to enlarge canal.

  5. Foraminotomy – enlarge neural foramen to relieve nerve root pressure.

  6. Total disc replacement – artificial disc insertion to maintain motion.

  7. Corpectomy – removal of vertebral body and reconstruction.

  8. Vertebral osteotomy – cutting bone to realign spine.

  9. Occipitocervical fusion – fusion from occiput to upper cervical spine.

  10. Posterior instrumentation with cage – restore disc height, stabilize. Mayo ClinicHome

Prevention Strategies

  1. Maintain good posture

  2. Use ergonomic workstations

  3. Perform regular neck strengthening exercises

  4. Practice neck flexibility/stretching

  5. Avoid heavy lifting or use proper technique

  6. Keep a healthy weight

  7. Quit smoking

  8. Warm up before sports

  9. Use protective gear in high-impact activities

  10. Schedule regular spinal check-ups if at risk Hospital for Special SurgeryCleveland Clinic

When to See a Doctor

  • Persistent or severe neck pain lasting > 2 weeks

  • Neurological deficits (weakness, numbness)

  • Balance or coordination issues

  • Loss of bladder/bowel control

  • Symptoms worsening despite conservative care

  • Significant trauma to the neck Cleveland ClinicPatient Care at NYU Langone Health

Frequently Asked Questions

  1. What is a backward slip (retrolisthesis) at C6–C7?
    It’s when C6 moves backward relative to C7, reducing canal space and potentially compressing nerves or the spinal cord Cleveland ClinicOHSU.

  2. How is it diagnosed?
    By clinical exam and imaging (X-ray flexion/extension, MRI, CT) to assess alignment and neural compromise Mayo ClinicPatient Care at NYU Langone Health.

  3. Is it the same as cervical spondylosis?
    No; spondylosis refers to degenerative changes, while retrolisthesis is actual backward displacement of a vertebra.

  4. Can it heal on its own?
    Mild cases may stabilize with physical therapy and lifestyle measures, but bone slip rarely “reverses.”

  5. What activities worsen it?
    Heavy lifting, repetitive hyperextension or flexion, and high-impact sports without proper conditioning.

  6. What conservative treatments work best?
    A combination of physical therapy, traction, posture correction, and ergonomic adjustments often provides relief Hospital for Special Surgery.

  7. When is surgery necessary?
    If neurological deficits, severe pain, or spinal cord compression persist despite months of conservative care.

  8. What are surgical risks?
    Infection, bleeding, nerve injury, nonunion of fusion, adjacent segment disease Home.

  9. Can supplements help?
    Supplements like glucosamine, omega-3, and vitamin D may support joint health but won’t reverse slip.

  10. How long is recovery after ACDF?
    Most patients improve over 3–6 months, with fusion solidifying by 12 months Home.

  11. Is retrolisthesis painful in all cases?
    No; many people have it incidentally on X-ray without symptoms.

  12. Does it affect life expectancy?
    No; it’s a mechanical issue manageable with proper care.

  13. Can posture correction tools help?
    Temporary bracing and ergonomic devices can reduce stress but should be combined with active therapy.

  14. Are nerve blocks useful?
    Facet joint or epidural steroid injections can provide short-term relief of radicular pain.

  15. How often should I follow up?
    Typically every 3–6 months during active treatment, then annually if stable.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members

Last Updated: May 06, 2025.

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  19. https://onlinelibrary.wiley.com/journal/10974598
  20. https://medlineplus.gov/skinconditions.html
  21. https://en.wikipedia.org/wiki/Category:Kidney_diseases
  22. https://kidney.org.au/your-kidneys/what-is-kidney-disease/types-of-kidney-disease
  23. https://www.niddk.nih.gov/health-information/kidney-disease
  24. https://www.kidney.org/kidney-topics/chronic-kidney-disease-ckd
  25. https://www.kidneyfund.org/all-about-kidneys/types-kidney-diseases
  26. https://www.aad.org/about/burden-of-skin-disease
  27. https://www.usa.gov/federal-agencies/national-institute-of-arthritis-musculoskeletal-and-skin-diseases
  28. https://www.cdc.gov/niosh/topics/skin/default.html
  29. https://www.mayoclinic.org/diseases-conditions/brain-tumor/symptoms-causes/syc-20350084
  30. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep
  31. https://www.cdc.gov/traumaticbraininjury/index.html
  32. https://www.skincancer.org/
  33. https://illnesshacker.com/
  34. https://endinglines.com/
  35. https://www.jaad.org/
  36. https://www.psoriasis.org/about-psoriasis/
  37. https://books.google.com/books?
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  39. https://cms.centerwatch.com/directories/1067-fda-approved-drugs/topic/292-skin-infections-disorders
  40. https://www.fda.gov/files/drugs/published/Acute-Bacterial-Skin-and-Skin-Structure-Infections—Developing-Drugs-for-Treatment.pdf
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  45. https://www.nibib.nih.gov/
  46. https://www.nei.nih.gov/
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  52. https://consumer.ftc.gov/articles/w
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  64. https://www.nhlbi.nih.gov/health-topics
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Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Orthopedic doctor, spine specialist, neurologist, or physiotherapist depending on severity.

What to tell the doctor

  • Mark pain area and whether pain travels to leg.
  • Write numbness, weakness, bladder/bowel problem, fever, injury, or night pain if present.
  • Bring previous X-ray/MRI and medicine list.

Questions to ask

  • Is this muscle pain, disc problem, nerve pressure, arthritis, infection, or another cause?
  • Do I need X-ray or MRI now?
  • Which activities should I avoid and which exercises are safe?
  • When can I return to work?

Tests to discuss

  • Spine and neurological examination
  • Straight leg raise or similar nerve tension tests
  • X-ray if trauma/deformity/chronic pain is suspected
  • MRI if leg weakness, sciatica, or red flags are present

Avoid these mistakes

  • Avoid heavy lifting, long bed rest, and untrained spinal manipulation.
  • Avoid NSAIDs if ulcer, kidney disease, blood thinner use, pregnancy, or allergy unless doctor says safe.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Orthopedic / spine specialist, physical medicine doctor, or qualified clinician
Tests to discuss with doctor
  • Neurological examination for leg power, sensation, reflexes, and straight leg raise
  • X-ray only if injury, deformity, long-lasting pain, or doctor suspects bone problem
  • MRI discussion if severe nerve symptoms, weakness, bladder/bowel problem, or persistent symptoms
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Is physiotherapy, posture correction, or activity modification needed?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Backward Slip of C6 over C7

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

Internal learning pathway

Explore related RX articles

Related guides from RX Harun are grouped to help readers move from overview to symptoms, tests, treatment, and safe next steps.

Degenerative Bones, Joints, and Spine Care (A - Z)
  1. Undescended Shoulder Disease DefinitionUndescended shoulder disease is not the usual medical name. Doctors usually call this condition Sprengel deformity,…
  2. Sprengel Deformity DefinitionSprengel deformity is a birth condition in which one shoulder blade?, called the scapula?, stays higher…
  3. High Shoulder Blade DefinitionA high shoulder blade? usually means one shoulder blade sits higher than normal from birth. The…
  4. High Scapula DefinitionHigh scapula? is a condition where one shoulder blade? sits higher than normal on the back…
  5. Upward Displacement of the Scapula DefinitionUpward displacement of the scapula? usually means congenital? elevation of the scapula, which is most often…
  6. Congenital Elevation of Scapula DefinitionCongenital? elevation of scapula? means a baby is born with one shoulder blade? sitting higher than…