C5–C6 Facet Joint Arthropathy

C5–C6 facet joint arthropathy is a degenerative condition affecting the small synovial joints (facet or zygapophysial joints) that link the fifth and sixth cervical vertebrae. These joints bear load, guide neck motion, and help stabilize the cervical spine. When they degenerate or become inflamed, patients often experience neck pain, stiffness, and sometimes nerve-related symptoms. This article offers an evidence-based, plain-English overview—fully structured for readability and SEO—covering anatomy, types, causes, symptoms, diagnostics, treatments, prevention, “when to see a doctor,” and FAQs about C5–C6 facet joint arthropathy.


Anatomy of the C5–C6 Facet Joint

Structure & Location

The C5–C6 facet joint is one of two paired synovial, plane-type joints at the rear of the cervical spine. It is formed by the inferior articular process of C5 meeting the superior articular process of C6. Each joint has smooth articular cartilage, a fibrous capsule, and a synovial membrane that secretes lubricating fluid WikipediaRadiopaedia.

Origin & Insertion

Unlike muscles, joints don’t “originate” or “insert,” but the key articulating surfaces here are:

  • Inferior articular facet of C5

  • Superior articular facet of C6
    These bony processes interlock to allow and guide neck motion Wikipedia.

Blood Supply

Tiny arterial branches from the vertebral artery and ascending cervical artery penetrate the joint capsule, nourishing the synovium and cartilage Radiology Key.

Nerve Supply

The C5–C6 facet is innervated by the medial branches of the dorsal rami of C5 and C6 spinal nerves. These sensory fibers relay pain and proprioceptive information from the joint Wikipedia.

Key Functions

  1. Guide Flexion/Extension: Controls forward and backward bending.

  2. Limit Rotation: Prevents excessive twisting.

  3. Prevent Shear Forces: Protects against vertebral slippage.

  4. Load Bearing: Shares weight with intervertebral discs.

  5. Proprioception: Provides sensory feedback about neck position.

  6. Joint Stability: Maintains alignment of cervical vertebrae WikipediaRadiology Key.


Types of C5–C6 Facet Joint Arthropathy

  1. Degenerative Osteoarthritis: Wear-and-tear cartilage loss with osteophyte (bone spur) formation Mayo Clinic Sports Medicine.

  2. Post-Traumatic Arthropathy: Secondary changes after a neck injury or fracture Verywell Health.

  3. Inflammatory Arthropathy: Due to rheumatoid arthritis or other systemic inflammations NCBI.

  4. Crystal-Induced Arthropathy: Gout or pseudogout depositing crystals in the joint Spine Connection.

  5. Septic Arthritis: Bacterial infection leading to rapid joint destruction NCBI.

  6. Congenital/Developmental Arthropathy: Resulting from abnormal facet formation Spine Surgeon – Antonio Webb, MD.

  7. Metabolic Arthropathy: Changes from diabetes or other metabolic disorders Wikipedia.

  8. Neuropathic (Charcot) Arthropathy: Joint breakdown due to nerve damage and loss of sensation Wikipedia.


Causes of C5–C6 Facet Joint Arthropathy

  1. Aging & Wear-and-Tear: Natural cartilage breakdown over time WikipediaWikipedia.

  2. Osteoarthritis: Primary joint degeneration with osteophytes Mayo Clinic Sports Medicine.

  3. Rheumatoid Arthritis: Autoimmune inflammation destroying cartilage NCBI.

  4. Psoriatic Arthritis: Inflammatory joint changes in psoriasis patients Spine Connection.

  5. Ankylosing Spondylitis: Fusion and stiffening of spinal joints Spine Connection.

  6. Whiplash (Trauma): Sudden hyperflexion–extension injury Verywell Health.

  7. Repetitive Stress: Occupational or sports overuse Spine Surgeon – Antonio Webb, MD.

  8. Poor Posture: Chronic forward head positioning Holistiq Spine & Orthopaedic.

  9. Congenital Facet Anomalies: Abnormal joint orientation at birth Spine Surgeon – Antonio Webb, MD.

  10. Previous Spinal Surgery: Altered biomechanics leading to adjacent-segment degeneration Radiopaedia.

  11. Disc Degeneration: Load transfer to facet joints increases stress Wikipedia.

  12. Spinal Instability: Spondylolisthesis or ligament laxity Wikipedia.

  13. Obesity: Excess weight accelerating joint wear Wikipedia.

  14. Smoking: Impaired blood flow and healing capacity Wikipedia.

  15. Septic Infection: Bacterial invasion of joint space NCBI.

  16. Gout/Pseudogout: Crystal deposition causes inflammation Spine Connection.

  17. Systemic Lupus: Immune complexes damaging joints NCBI.

  18. Diabetes-Related Changes: Microvascular damage to joint tissues Wikipedia.

  19. Metastatic Tumors: Bone invasion weakening joint integrity Spine Connection.

  20. Charcot Joint: Neuropathy-induced joint destruction Wikipedia.


Symptoms of C5–C6 Facet Joint Arthropathy

  1. Localized Neck Pain: Deep ache at the back of the neck Complete Physio.

  2. Stiffness: Difficulty turning or bending the neck Mayo Clinic Sports Medicine.

  3. Reduced Range of Motion: Limited flexibility Complete Physio.

  4. Radiating Pain: Pain that spreads to shoulders or upper back Wikipedia.

  5. Cervicogenic Headaches: Neck-origin headaches Verywell Health.

  6. Muscle Spasms: Sudden tightening of neck muscles Wikipedia.

  7. Tenderness: Pain when touching the facet area Complete Physio.

  8. Crepitus: Grinding or popping sounds on movement Wikipedia.

  9. Numbness/Tingling: If adjacent nerves are irritated Verywell Health.

  10. Weakness: Reduced arm strength from nerve compression Wikipedia.

  11. Pain with Extension: Worse when looking up Wikipedia.

  12. Pain on Rotation: Worse with head turning Wikipedia.

  13. Activity-Related Pain: Flare-ups on lifting or carrying Wikipedia.

  14. Standing/Walking Pain: Worsened by posture or gait Wikipedia.

  15. Sleep Disturbance: Pain interrupts sleep Complete Physio.

  16. Weather Sensitivity: Increased discomfort in cold or damp Mayo Clinic Sports Medicine.

  17. Loss of Neck Strength: Feeling of giving way Wikipedia.

  18. Balance Problems: Rarely, from high cervical involvement Wikipedia.

  19. Dysphagia: Difficulty swallowing if bone spurs press forward Mayo Clinic Sports Medicine.

  20. Tinnitus: Ringing in ears linked to upper cervical pain Complete Physio.


Diagnostic Tests

  1. Cervical X-Ray: Shows joint space narrowing and osteophytes Mayo Clinic Sports Medicine.

  2. MRI: Details soft-tissue swelling, synovitis, nerve compression Wikipedia.

  3. CT Scan: Best for visualizing bone changes and osteophytes Wikipedia.

  4. Bone Scan: Detects active inflammation (“hot joints”) Verywell Health.

  5. Ultrasound: Limited, but can guide injections Verywell Health.

  6. Medial Branch Block: Numbing the joint nerves to confirm pain source Wikipedia.

  7. Intra-articular Injection: Diagnostic anesthetic injection into joint Verywell Health.

  8. Flexion-Extension Films: Assess dynamic instability Mayo Clinic Sports Medicine.

  9. EMG/Nerve Conduction: Rules out peripheral neuropathy Verywell Health.

  10. Kemp’s Test: Physician-performed bending test Wikipedia.

  11. Spurling’s Test: Compression test for nerve root irritation Verywell Health.

  12. Facet Palpation: Tenderness on manual pressure Complete Physio.

  13. Thermography: Infrared mapping of inflamed areas Verywell Health.

  14. CT-Guided Injection Study: Confirms needle placement and effect Wikipedia.

  15. Discography: Excludes discogenic pain Wikipedia.

  16. SPECT-CT: Combines bone scan with CT for precise localization Wikipedia.

  17. ESR/CRP: Elevated in inflammatory or septic cases NCBI.

  18. Rheumatoid Factor/Anti-CCP: Screens for rheumatoid arthritis NCBI.

  19. Uric Acid: High in gouty arthropathy Spine Connection.

  20. Serum Calcium & Phosphate: Abnormal in crystal arthropathy Spine Connection.


Non-Pharmacological Treatments

  1. Physical Therapy: Tailored exercises for strength and flexibility Wikipedia.

  2. Cervical Stretching: Gentle lengthening of neck muscles Complete Physio.

  3. Strength Training: Targeting deep neck flexors Complete Physio.

  4. Manual Mobilization: Gentle joint gliding by a therapist Wikipedia.

  5. Massage: Reduces muscle spasm around the joint Wikipedia.

  6. Chiropractic Care: Spinal adjustments to improve alignment Wikipedia.

  7. Acupuncture: Needle therapy for pain modulation Spine Surgeon – Antonio Webb, MD.

  8. Heat Therapy: Increases blood flow and relaxes tissues Mayo Clinic Sports Medicine.

  9. Cold Therapy: Decreases inflammation and numbs pain Mayo Clinic Sports Medicine.

  10. Traction: Opens joint spaces gently Physio-pedia.

  11. Ergonomic Adjustments: Proper desk/chair setup Holistiq Spine & Orthopaedic.

  12. Posture Education: Techniques to avoid forward head posture Holistiq Spine & Orthopaedic.

  13. Yoga: Improves flexibility and posture Spine Surgeon – Antonio Webb, MD.

  14. Pilates: Core strengthening for spinal support Physio-pedia.

  15. Hydrotherapy: Warm water exercises to reduce load Verywell Health.

  16. TENS: Electrical stimulation for pain relief Verywell Health.

  17. Ultrasound Therapy: Deep-tissue heating for healing Verywell Health.

  18. Low-Level Laser: Photobiomodulation to reduce inflammation Wikipedia.

  19. Cervical Collar: Short-term support to rest joints Mayo Clinic Sports Medicine.

  20. Kinesio Taping: Proprioceptive support and pain relief Complete Physio.

  21. Mindfulness & Meditation: Lowers pain perception Wikipedia.

  22. Biofeedback: Teaches muscle relaxation techniques Wikipedia.

  23. Behavioral Therapy: Cognitive strategies for chronic pain Wikipedia.

  24. Ergonomic Workplace Assessment: Professional evaluation of work setup Holistiq Spine & Orthopaedic.

  25. Weight Management: Lowers mechanical stress Wikipedia.

  26. Nutritional Counseling: Anti-inflammatory diet advice Wikipedia.

  27. Education & Self-Management: Understanding and pacing activities Verywell Health.

  28. Sleep Hygiene: Supportive pillow and mattress Mayo Clinic Sports Medicine.

  29. Frequent Activity Breaks: Avoids static postures Holistiq Spine & Orthopaedic.

  30. Relaxation Techniques: Deep breathing to reduce muscle tension Wikipedia.


Drugs for Symptom Relief

  1. Acetaminophen: Mild pain relief with minimal GI risk Verywell Health.

  2. Ibuprofen: NSAID for inflammation and pain Mayo Clinic Sports Medicine.

  3. Naproxen: Longer-acting NSAID for chronic pain Verywell Health.

  4. Diclofenac: Potent topical or oral NSAID Mayo Clinic Sports Medicine.

  5. Celecoxib: COX-2 inhibitor with lower GI risk Mayo Clinic Sports Medicine.

  6. Indomethacin: Strong NSAID for severe inflammation Mayo Clinic Sports Medicine.

  7. Ketorolac: Short-term injectable NSAID Mayo Clinic Sports Medicine.

  8. Cyclobenzaprine: Muscle relaxant for spasm Wikipedia.

  9. Methocarbamol: Centrally acting muscle relaxant Wikipedia.

  10. Diazepam: Benzodiazepine for acute spasm relief Wikipedia.

  11. Gabapentin: Neuropathic pain modulator Wikipedia.

  12. Pregabalin: Similar to gabapentin for nerve pain Wikipedia.

  13. Duloxetine: SNRI for chronic musculoskeletal pain Wikipedia.

  14. Amitriptyline: Low-dose TCA for chronic pain Wikipedia.

  15. Tramadol: Weak opioid for moderate pain Verywell Health.

  16. Codeine: Mild opioid for breakthrough pain Verywell Health.

  17. Morphine: Strong opioid reserved for severe cases Verywell Health.

  18. Prednisone: Oral steroid for severe inflammation Wikipedia.

  19. Diclofenac Gel: Topical NSAID with local effect Wikipedia.

  20. Capsaicin Cream: Topical depletes pain neurotransmitter Wikipedia.


Surgical & Interventional Options

  1. Medial Branch Radiofrequency Ablation: Destroys pain fibers Wikipedia.

  2. Intra-articular Corticosteroid Injection: Reduces joint inflammation Verywell Health.

  3. Cryoablation of Medial Branch: Freezes nerve fibers for relief Wikipedia.

  4. Facet Joint Denervation (Rhizotomy): Cuts nerve supply Wikipedia.

  5. Posterior Cervical Foraminotomy: Enlarges nerve exit foramen Desert Institute for Spine Care.

  6. Anterior Cervical Discectomy & Fusion (ACDF): Removes disc and fuses vertebrae to stabilize Wikipedia.

  7. Cervical Disc Replacement (Arthroplasty): Preserves motion with prosthesis Deuk Spine.

  8. Posterior Facetectomy & Decompression: Removes part of facet to relieve pressure Wikipedia.

  9. Epidural Steroid Injection: Targets nearby epidural space for inflammation Verywell Health.

  10. Interspinous Spacer Implantation: Keeps facet joints slightly apart Spine Connection.


Prevention Strategies

  1. Maintain Good Posture: Keeps facet load balanced Holistiq Spine & Orthopaedic.

  2. Regular Neck Exercises: Strengthens supporting muscles Complete Physio.

  3. Ergonomic Workstation: Reduces repetitive strain Holistiq Spine & Orthopaedic.

  4. Avoid Repetitive Neck Stress: Vary activities Orthopedic Pain Institute.

  5. Healthy Weight: Lowers mechanical wear Wikipedia.

  6. Quit Smoking: Improves joint nutrition Wikipedia.

  7. Safe Lifting Techniques: Protects spine from overload Spine Surgeon – Antonio Webb, MD.

  8. Frequent Breaks: Prevents static posturing Holistiq Spine & Orthopaedic.

  9. Supportive Sleep Setup: Pillow that maintains neutral neck Mayo Clinic Sports Medicine.

  10. Regular Check-ups: Early arthritis detection NCBI.


When to See a Doctor

If you experience persistent neck pain lasting more than 6 weeks, severe pain that limits daily activities, numbness or weakness in arms, or fever with neck pain (suggesting infection), seek medical evaluation promptly. Early assessment helps prevent progression and identifies serious causes like infection, fracture, or tumor Verywell HealthNCBI.


Frequently Asked Questions

  1. What exactly is C5–C6 facet joint arthropathy?
    It’s arthritis or degeneration of the small synovial joints connecting the fifth and sixth cervical vertebrae, causing pain and stiffness in the neck WikipediaWikipedia.

  2. What causes it?
    Age-related wear, injury (whiplash), inflammation (rheumatoid arthritis), or metabolic issues like gout can damage the joint cartilage, leading to arthropathy Mayo Clinic Sports MedicineNCBI.

  3. How is it diagnosed?
    Through clinical exam, imaging (X-ray, MRI, CT), and diagnostic injections (medial branch block) to confirm the facet as the pain source WikipediaWikipedia.

  4. Are there exercises I can do?
    Yes—gentle stretching, strengthening of deep neck muscles, and posture training under a physical therapist’s guidance help reduce pain and improve function Complete Physio.

  5. When are injections used?
    If conservative measures fail, corticosteroid or anesthetic injections into the joint or medial branch nerves can confirm the diagnosis and provide temporary pain relief Verywell Health.

  6. Is surgery always needed?
    No. Most patients improve with non-surgical care. Surgery or radiofrequency ablation is reserved for severe, persistent pain or neurological deficits Wikipedia.

  7. What are the risks of facet joint injections?
    Risks include bleeding, infection, nerve injury, and transient increased pain; serious complications are rare when performed under imaging guidance Wikipedia.

  8. How long does recovery take after radiofrequency ablation?
    Most return to normal activities within a day or two, while full pain relief may take two to four weeks as nerves degenerate Wikipedia.

  9. Does arthritis in C5–C6 cause headaches?
    Yes. Inflammation there can refer pain to the head (cervicogenic headaches) Verywell Health.

  10. Can lifestyle changes help?
    Absolutely. Weight management, posture correction, ergonomic modifications, and quitting smoking all slow joint degeneration Holistiq Spine & Orthopaedic.

  11. What pillow is best?
    A cervical-contoured pillow that maintains neck alignment during sleep reduces strain on the facet joints Mayo Clinic Sports Medicine.

  12. Will my neck crack or pop?
    Crepitus (popping) can occur from joint movement; it’s common in arthropathy but not always painful Wikipedia.

  13. Is facet joint arthropathy genetic?
    Family history of osteoarthritis can increase risk, but lifestyle and injury are main drivers Wikipedia.

  14. Can facet arthropathy worsen without symptoms?
    Yes—degeneration can progress silently, so regular check-ups are helpful if you have risk factors NCBI.

  15. When should I see a specialist?
    If you have persistent pain despite six weeks of conservative care, or if neurological signs (weakness, numbness) appear, consult a spine specialist Verywell Health.

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 04, 2025.

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