C5–C6 Nerve Root Compression

C5–C6 nerve root compression, often called C5–C6 cervical radiculopathy or a “pinched nerve,” happens when the nerve root exiting between the fifth (C5) and sixth (C6) cervical vertebrae in your neck is irritated, compressed, or inflamed. This irritation can cause pain, numbness, tingling, or weakness that travels from the neck into the shoulder, arm, and hand along the pathway of that nerve NCBIWebMD.

---

Anatomy of the C5–C6 Nerve Root

Understanding the exact anatomy helps explain why symptoms appear where they do.

1. Structure & Location

   • The C5 and C6 nerve roots are formed by the anterior (motor) and posterior (sensory) rootlets arising from the spinal cord at the level of the C5–C6 intervertebral foramen.

   • They exit the spinal canal through paired openings (foramina) between the C5 and C6 vertebral bones, just above the corresponding vertebrae Cleveland Clinic.

2. Origin

   • Each nerve root begins as small bundles (rootlets) on the front (ventral) and back (dorsal) of the spinal cord. These rootlets unite to form a mixed spinal nerve containing both sensory and motor fibers Cleveland Clinic.

3. Insertion (Distribution)

   • After exiting the foramen, C5 and C6 fibers join the upper trunk of the brachial plexus and branch out to supply muscles and skin. Key target muscles include: deltoid, biceps brachii, brachioradialis, and wrist extensor group TeachMeAnatomyCleveland Clinic.

4. Blood Supply

   • The vertebral arteries travel through small holes in the transverse processes of C1–C6 vertebrae and give off small radicular (segmental) arteries that supply the nerve roots and spinal cord segments at each level Cleveland Clinic.

5. Nerve Supply

   • Ventral (anterior) roots carry motor signals to muscles; dorsal (posterior) roots carry sensory information (touch, pain, temperature) back to the spinal cord.

   • The C5 root provides sensation to the upper arm down to the elbow; C6 to the thumb side of the forearm and hand Cleveland Clinic.

6. Key Functions (Six)

   1. Shoulder abduction via the deltoid muscle (axillary nerve branch, C5–C6)

   2. Elbow flexion via biceps brachii (musculocutaneous nerve branch, C5–C6)

   3. Forearm supination via biceps brachii and supinator (radial nerve branch, C5–C6)

   4. Wrist extension via extensor carpi radialis longus and brevis (radial nerve branch, C6)

   5. Biceps reflex (C5–C6) and brachioradialis reflex (C6)

   6. Sensation to the lateral (outer) arm, forearm, and thumb region Cleveland Clinic.

---

Types of C5–C6 Nerve Root Compression

1. Herniated Disc: Gel-like disc material bulges into the foramen, pinching the root WebMD.

2. Degenerative Disc Disease: Disc wear-and-tear narrows the space around the nerve WebMD.

3. Osteophyte (Bone Spur) Formation: Bony overgrowths reduce foramen size Cleveland Clinic.

4. Cervical Foraminal Stenosis: Narrowing of the nerve exit canals, often from arthritis WebMD.

5. Facet Joint Hypertrophy: Enlarged facet joints encroach on nerve roots.

6. Congenital Spinal Canal Stenosis: Naturally narrow canals compress roots.

7. Traumatic Injury: Fractures or dislocations pinch nerve roots.

8. Post-Surgical Scar Tissue: After neck surgery, scar can trap the nerve.

9. Intervertebral Synovial Cysts: Fluid-filled sacs compress foramen.

10. Spinal Tumors: Benign or malignant growths press on roots WebMD.

11. Infections (Discitis, Abscess): Swelling from infection squeezes roots WebMD.

12. Rheumatoid Arthritis: Inflammatory pannus narrows foramina.

13. Calcified Disc Herniation: Hard disc fragments compress roots.

14. Post-Traumatic Osteophytes: Bone spurs from old injury.

15. Spondylolisthesis: Forward slippage of a vertebra narrows space.

16. Ligamentum Flavum Hypertrophy: Thickened ligament presses on root.

17. Spinal Cord Cavernoma: Vascular malformation near root exit.

18. Post-Radiation Fibrosis: After radiation therapy, tissue stiffening.

19. Anterior Cervical Osteophyte Complex: Combined disc and bone spur impingement.

20. Synovitis of Facet Joint: Joint swelling encroaching on foramen.

---

Common Causes

1. Age-related Wear (degenerative changes) WebMD

2. Disc Herniation (bending, lifting injury) WebMD

3. Osteoarthritis (bone spur growth) Cleveland Clinic

4. Spinal Stenosis (narrow canal) WebMD

5. Repetitive Strain (poor posture) WebMD

6. Heavy Lifting (acute trauma) WebMD

7. Whiplash Injuries (sudden neck motion) WebMD

8. Tumors (benign/malignant) WebMD

9. Infections (discitis, epidural abscess) WebMD

10. Congenital Narrow Canal (stenosis)

11. Rheumatoid Arthritis (inflammatory narrowing) WebMD

12. Disc Protrusion (partial herniation)

13. Calcified Discs (hard disc fragments)

14. Facet Joint Cysts

15. Scar Tissue (post-surgery)

16. Spondylolisthesis (vertebral slippage)

17. Ligament Thickening (flavum hypertrophy)

18. Osteomalacia (weakened bone fractures)

19. Vertebral Fractures (trauma)

20. Spinal Vascular Malformations

---

Symptoms

1. Neck Pain (often sharp or burning) WebMD

2. Radiating Arm Pain (down the shoulder) WebMD

3. Shoulder Pain

4. Arm Weakness (grip loss) WebMD

5. Numbness/Tingling (thumb and index finger) WebMD

6. Reflex Changes (diminished biceps reflex) Cleveland Clinic

7. Muscle Spasms

8. Headaches (base of skull)

9. Neck Stiffness

10. Worsening with Movement (looking up/down) WebMD

11. Pain Relief by Tilting Away

12. Sensory Loss (in dermatome) Cleveland Clinic

13. Arm Coldness

14. Weak Grip

15. Clumsiness in Hand

16. Sleep Disturbance

17. Shoulder Atrophy (chronic)

18. Arm Fatigue

19. Balance Issues (rare)

20. Neck Crepitus

---

Diagnostic Tests

1. Patient History & Physical Exam (Spurling’s test) WebMD

2. X-rays (alignment, osteophytes) Cleveland Clinic

3. MRI (nerve root, disc, soft-tissue detail) Cleveland Clinic

4. CT Scan (bone detail, foraminal size) Cleveland Clinic

5. EMG (electromyography for muscle activity) Cleveland Clinic

6. Nerve Conduction Study (speed of impulses) Cleveland Clinic

7. Myelogram (contrast around spinal canal) Cleveland Clinic

8. CT Myelogram

9. Discography (pain reproduction)

10. Ultrasound (rare for nerve visualization)

11. Bone Scan (tumor/infection detection)

12. Flexion/Extension X-rays (instability)

13. Laboratory Tests (infection markers)

14. Somatosensory Evoked Potentials

15. Vertebral Artery Doppler (vascular)

16. Facet Joint Injections (diagnostic block)

17. Selective Nerve Root Block (pain relief test)

18. CT Angiography (vascular lesions)

19. MRI Neurography

20. Positron Emission Tomography (PET) (tumor detection)

---

Non-Pharmacological Treatments

1. Rest & Activity Modification (avoid aggravating tasks)

2. Heat Therapy (muscle relaxation)

3. Cold Packs (reduce inflammation)

4. Cervical Collar (temporary support)

5. Physical Therapy (strengthening, stretching) AAFP

6. Cervical Traction (gentle decompression) AAFP

7. Manual Therapy (mobilization)

8. Postural Training (ergonomics)

9. TENS (Transcutaneous Electrical Nerve Stimulation)

10. Massage Therapy AAFP

11. Ultrasound Therapy

12. Acupuncture

13. Chiropractic Adjustments

14. Yoga & Pilates

15. Neural Mobilization (“flossing”)

16. Isometric Neck Exercises Verywell Health

17. Neck Extension/Flexion Exercises Verywell Health

18. Shoulder Blade Squeezes Verywell Health

19. Ergonomic Workstation Setup

20. Hydrotherapy

21. Spinal Decompression Table

22. Education on Body Mechanics

23. Mind-Body Techniques (relaxation training)

24. Biofeedback

25. Traction at Home Devices

26. Scapular Stabilization Exercises

27. Weighted Neck Exercises

28. Prolotherapy

29. Kinesio Taping

30. Ergonomic Pillow for Sleep

---

Pharmacological Treatments (Drugs)

1. NSAIDs (e.g., ibuprofen, naproxen) AAFP

2. Acetaminophen

3. Oral Corticosteroids (short course) WebMD

4. Epidural Steroid Injection Cleveland Clinic

5. Neuropathic Pain Agents (gabapentin, pregabalin)

6. TCAs (amitriptyline)

7. SNRIs (duloxetine)

8. Muscle Relaxants (cyclobenzaprine) AAFP

9. Opioids (short-term, tramadol)

10. Topical NSAIDs (diclofenac gel)

11. Capsaicin Cream

12. Lidocaine Patch

13. Oral Steroid Burst/ Taper

14. Calcitonin (off-label)

15. Dexamethasone Injection

16. Methylprednisolone Injection

17. Ketorolac Injection

18. Pregabalin

19. Carbamazepine (if neuralgia)

20. Botulinum Toxin (off-label for muscle spasm)

---

Surgical Options

1. Anterior Cervical Discectomy & Fusion (ACDF) Cleveland Clinic

2. Posterior Cervical Foraminotomy Cleveland Clinic

3. Cervical Disc Replacement (arthroplasty)

4. Laminectomy (removal of lamina) Cleveland Clinic

5. Laminoplasty (expanding canal)

6. Corpectomy (removal of vertebral body)

7. Microdiscectomy (minimally invasive)

8. Osteophyte Removal (spur shaving)

9. Posterior Decompression & Fusion

10. Endoscopic Discectomy

---

Prevention Strategies

1. Maintain Good Posture (neutral neck)

2. Ergonomic Workstation (screen at eye-level)

3. Regular Neck & Shoulder Exercises

4. Safe Lifting Techniques (bend knees, not back)

5. Maintain Healthy Weight

6. Quit Smoking (improves disc health)

7. Use Supportive Pillows (neck alignment)

8. Frequent Breaks During Repetitive Tasks

9. Stay Hydrated (disc nutrition)

10. Balanced Diet with Calcium & Vitamin D

---

When to See a Doctor

• Severe, Unrelenting Pain unrelieved by rest or medication.

• Progressive Weakness in your arm or hand.

• Loss of Bladder or Bowel Control (rare but urgent).

• Symptoms Lasting > 6 Weeks despite self-care.

• New Symptoms such as significant numbness or reflex loss.

---

Frequently Asked Questions

1. What exactly is a “pinched nerve”?
   A pinched nerve means pressure on a nerve root, disrupting its normal function and causing pain or numbness WebMD.

2. Why is C5–C6 so commonly affected?
   This level bears high mechanical load and allows a wide range of motion, making it prone to degeneration WebMD.

3. Can C5–C6 compression heal on its own?
   Mild cases often improve with rest and therapy over 4–6 weeks WebMD.

4. How is it diagnosed?
   Through patient history, physical exam (e.g., Spurling’s test), and imaging (MRI, X-ray) Cleveland Clinic.

5. What exercises help recovery?
   Neck isometrics, chin tucks, shoulder blade squeezes, and neural mobilization Verywell Health.

6. Are injections safe?
   Epidural steroid injections are generally safe when done by specialists, but carry minor risk of infection or bleeding Cleveland Clinic.

7. When is surgery needed?
   If non-surgical measures fail after 6–12 weeks or if there is significant muscle weakness Cleveland Clinic.

8. Will I need fusion if I have surgery?
   Many surgeries (ACDF) include fusion; disc replacement preserves motion but isn’t suitable for all.

9. Can C5–C6 compression cause permanent damage?
   Prolonged severe compression may lead to lasting nerve damage, but rare if treated timely WebMD.

10. Is driving safe with this condition?
    Avoid if arm weakness or pain interferes with steering or reaction time.

11. How long is recovery after surgery?
    Typically 4–12 weeks for basic activities; full fusion may take 3–6 months Cleveland Clinic.

12. Do I need physical therapy after surgery?
    Yes—therapy helps restore strength, flexibility, and posture.

13. Can I prevent future episodes?
    Yes—by maintaining posture, exercise, and ergonomics.

14. Is massage helpful?
    Massage can reduce muscle spasm and improve blood flow but should be gentle.

15. Can this affect my sleep?
    Yes—neck pain often worsens at night; a supportive pillow helps.

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.

PDF Document For This Disease Conditions

References