C6–C7 facet joint syndrome is a condition where the small, weight-bearing joints in the lower part of the neck become irritated, inflamed, or damaged. These joints, called facet joints or zygapophyseal joints, help the spine bend and twist. When the C6–C7 facet joints stop working smoothly, people often feel neck pain, stiffness, and sometimes pain that shoots into the shoulder or arm. This article explains, in simple plain English, everything you need to know: how the joints work, why they get hurt, how doctors find out what is wrong, and how to treat and prevent problems.
Anatomy of the C6–C7 Facet Joint
Structure and Location
The facet joints sit at the back of the spine. At the C6–C7 level, each joint connects the lower part of the sixth cervical vertebra (C6) to the upper part of the seventh cervical vertebra (C7). These joints are covered by a smooth layer called cartilage, which lets the bones glide over each other without pain.
Origin and Insertion
Rather than muscles, facet joints form where one bone surface (the inferior articular process of C6) meets another bone surface (the superior articular process of C7). These two surfaces “insert” into each other and are held together by a tough capsule.
Blood Supply
Small blood vessels called the vertebral artery branches and ascending cervical artery branches bring oxygen and nutrients to the C6–C7 facet joint capsule and surrounding tissues.
Nerve Supply
Sensations, including pain, travel from the C6–C7 facet joint to the brain through tiny nerve branches called the medial branches of the dorsal rami. At this level, the C7 dorsal ramus supplies the joint.
Key Functions
Load Bearing: The facet joints share weight with the discs, helping the neck carry the head’s weight.
Stability: They keep the vertebrae aligned, preventing one bone from sliding over another.
Movement Guidance: By their shape, they guide how much you can bend forward, backward, or sideways.
Motion Limiting: They stop the spine from moving too far, protecting the spinal cord and nerves.
Shock Absorption: Along with discs, they help absorb forces when you move or lift.
Protection of Neural Structures: By limiting harmful movements, they protect the spinal cord and nerve roots from pinching.
Types of C6–C7 Facet Joint Syndrome
Acute Traumatic Facet Syndrome
Injury from a sudden force, like a car accident or fall, causes sprains or small fractures around the joint.Degenerative Facet Syndrome
Over many years, normal wear and tear cause the cartilage to thin, leading to arthritis-like changes.Facet Joint Arthritis
Inflammatory arthritis (for example, rheumatoid arthritis) affects these joints, causing pain, swelling, and stiffness.Facet Joint Hypertrophy
The joint margins grow extra bone (bone spurs) in response to stress, narrowing the joint space and causing pain.
Causes
Aging: Natural cartilage wear over years reduces smooth joint movement.
Repetitive Strain: Repeating the same neck motions—like computer work—puts stress on C6–C7.
Acute Injury: Whiplash or a direct blow to the neck can sprain or injure the facet joint.
Poor Posture: Forward head position increases pressure on the lower cervical joints.
Genetics: Some people inherit weaker joint cartilage or a spine shape that stresses the joints.
Osteoarthritis: Generalized joint arthritis often affects facet joints.
Rheumatoid Arthritis: Autoimmune attack on joint lining damages the facet joints.
Spinal Instability: When one vertebra moves too much on another, the facet joint bears extra load.
Disc Degeneration: Loss of disc height increases pressure on facet joints.
Obesity: Extra body weight adds force across the neck joints.
Smoking: Tobacco use reduces blood flow and speeds joint wear.
Occupational Risk: Jobs with heavy lifting or vibration (like jackhammer use) stress the joints.
Previous Surgery: Scar tissue around a surgically treated neck may irritate the facet joint.
Sports Injuries: Contact sports or diving accidents can strain or fracture the joint.
Inflammatory Conditions: Conditions like ankylosing spondylitis can involve the facet joints.
Tumors: Abnormal growths near the spine may press on or invade the joint.
Infections: Rarely, bacteria can infect the joint, causing severe pain and fever.
Congenital Abnormalities: Some are born with joint shapes that impair smooth motion.
Hormonal Changes: Low estrogen in menopause may weaken joint cartilage.
Nutritional Deficits: Lack of vitamins D and C impairs cartilage health and repair.
Symptoms
Neck Pain: Local pain around the lower neck, often dull or aching.
Stiffness: Difficulty turning or bending the neck fully.
Radiating Pain: Pain or ache spreading into the shoulder blade or upper arm.
Headaches: Often at the base of the skull, called cervicogenic headaches.
Muscle Spasm: Tight, hard neck muscles around the joint.
Tenderness: Soreness to touch directly over the C6–C7 area.
Reduced Range of Motion: Inability to look over the shoulder or tilt the head.
Grinding Sensation: Feeling or hearing a grating noise when moving the neck.
Nerve Pain: Sharp, electric-like shocks if a nerve root is irritated.
Numbness: Loss of feeling in parts of the arm or hand served by C7 nerve root.
Pins and Needles: Tingling in the fingers, often the middle finger.
Weak Grip: Difficulty holding objects due to nerve involvement.
Balance Issues: Feeling unsteady when standing, in rare severe cases.
Sleep Disturbance: Pain worsens at night, making sleep hard.
Pain on Extension: Bending the neck backward often worsens pain.
Pain on Rotation: Turning the head increases discomfort.
Activity-Related Pain: Pain comes and goes with specific movements.
Chronic Discomfort: Lasts more than three months without full rest.
Muscle Atrophy: Long-term nerve irritation may shrink arm muscles.
Emotional Stress: Ongoing pain can cause anxiety or low mood.
Diagnostic Tests
Medical History Review: Discussing when and how pain started.
Physical Exam: Palpating the facet area and testing motion.
Spurling’s Test: Gently pressing on the head in a tilted position to reproduce pain.
Neck Range of Motion Test: Measuring how far you can turn and tilt the neck.
Facet Joint Injection: Injecting anesthetic into the joint to see if pain eases.
Medial Branch Block: Numbing the nerves that serve the joint to confirm the source of pain.
X-ray Imaging: Revealing arthritis, bone spurs, or joint space narrowing.
CT Scan: Detailed photos of bone that can show joint alignment and spurs.
MRI Scan: Images of soft tissues, including cartilage and nerves.
Bone Scan: Detects inflammation or infection in the joint.
Ultrasound: Real-time images to guide injections or see fluid in the joint.
Electromyography (EMG): Checks nerve function if there is arm weakness or numbness.
Nerve Conduction Study: Measures speed of nerve signals in the arm.
Diagnostic Analgesic Block: Using longer-acting anesthetic to confirm pain relief.
Fluoroscopy-Guided Injection: Real-time X-ray guides accurate needle placement.
Standing X-ray: Shows how gravity affects joint alignment and spacing.
Upright MRI: Scans in standing position to see motion-related changes.
Inflammatory Marker Blood Tests: Rule out rheumatoid or infectious causes.
Vitamin D Levels: Check for deficiencies that affect joint health.
CT Arthrogram: Contrast dye injected into joint before CT for clear images of cartilage.
Non-Pharmacological Treatments
Rest and Activity Modification: Avoiding painful movements.
Heat Therapy: Warm packs to relax stiff muscles.
Cold Therapy: Ice packs to reduce swelling.
Physical Therapy: Guided exercises to improve motion and strength.
Posture Correction: Training to keep neck in a neutral position.
Ergonomic Adjustments: Proper desk, chair, and monitor setup.
Manual Therapy: Hands-on joint mobilization by a therapist.
Massage Therapy: Relieves muscle tightness around the joint.
Traction: Gentle pulling to separate the joint surfaces.
Cervical Pillow: A pillow that supports natural neck curve.
Neck Brace: Short-term support to limit movement and allow healing.
Taping Techniques: Kinesiology tape to support muscles.
Dry Needling: Thin needles into tight muscle spots.
Acupuncture: Traditional Chinese practice to reduce pain.
Chiropractic Adjustment: Controlled force to improve joint motion.
Yoga: Gentle stretches and strengthening in a safe range.
Pilates: Focuses on core stability, including neck support.
Alexander Technique: Teaching better movement patterns.
Pilates: Improves posture and muscle balance.
Hydrotherapy: Warm water exercises to ease movement.
Ultrasound Therapy: Sound waves to promote healing.
Electrical Stimulation (TENS): Mild electrical pulses to block pain.
Heat-Magnet Therapy: Combined heat and magnet fields for blood flow.
Biofeedback: Learning to control muscle tension.
Mind-Body Techniques: Relaxation, breathing, and meditation.
Cognitive Behavioral Therapy: Coping strategies for chronic pain.
Weighted Traction Device: Over-door pulley for home traction.
Isometric Exercises: Gentle muscle contractions without joint movement.
Cervical Strengthening: Targeted exercises for neck muscles.
Education: Teaching safe body mechanics for daily activities.
Pharmacological Treatments
Acetaminophen: Over-the-counter pain relief.
Ibuprofen: Reduces inflammation and pain.
Naproxen: A stronger over-the-counter anti-inflammatory.
Diclofenac Gel: Topical anti-inflammatory to apply over the joint.
Celecoxib: Prescription COX-2 inhibitor with less stomach upset.
Ketorolac: Short-term prescription NSAID for moderate pain.
Tramadol: Weak opioid for severe pain under doctor supervision.
Prednisone Taper: Short course oral steroid to reduce inflammation.
Gabapentin: Treats nerve pain if C7 nerve root is irritated.
Pregabalin: Similar to gabapentin for nerve-related pain.
Amitriptyline: Low dose for chronic pain and sleep improvement.
Cyclobenzaprine: Muscle relaxant for short-term spasm relief.
Methocarbamol: Another muscle relaxant option.
Topical Lidocaine Patch: Numbs skin over the painful joint.
Capsaicin Cream: Depletes pain chemicals near the joint.
Duloxetine: An SNRI antidepressant also used for chronic pain.
Botulinum Toxin Injection: Reduces muscle spasm around the joint.
Intra-articular Steroid Injection: Cortisone into the facet joint capsule.
Hyaluronic Acid Injection: Aims to improve joint lubrication.
Opioid-Sparing Combination Pills: Lower-dose opioid combined with acetaminophen.
Surgical Options
Facet Joint Denervation (Radiofrequency Ablation): Heats and destroys the nerves that send pain signals.
Radiofrequency Neurotomy: Similar to ablation but uses pulsed radio waves.
Facet Rhizotomy: Cutting the medial branch nerves surgically.
Cervical Fusion (ACDF): Removing the joint and fusing C6 to C7 with a bone graft.
Posterior Cervical Fusion: Joining the back parts of C6 and C7 with metal rods or screws.
Laminectomy: Removing part of the vertebral roof to relieve nerve pressure.
Foraminotomy: Widening the nerve exit canal near the joint.
Artificial Disc Replacement: Replacing the disc and stabilizing the joint above or below.
Disc Decompression: Removing disc material to reduce joint load.
Minimally Invasive Endoscopic Facet Surgery: Small-tube surgery to smooth joint surfaces.
Prevention Strategies
Maintain Good Posture: Keep ears over shoulders and shoulder blades back.
Ergonomic Workspace: Adjust desk and chair height to avoid neck strain.
Regular Exercise: Strengthen neck and shoulder muscles.
Stretching Routine: Gently stretch the neck daily.
Healthy Weight: Reduces load on all spine joints.
Quit Smoking: Improves blood flow to joint tissues.
Balanced Diet: Plenty of calcium, vitamin D, and antioxidants.
Lift Properly: Bend knees and keep objects close to the body.
Take Breaks: Stand and move every 30–60 minutes if sitting.
Use Supportive Pillow: A cervical pillow to maintain natural curve.
When to See a Doctor
If neck pain around C6–C7 lasts more than two weeks, worsens despite rest, or comes with arm weakness, numbness, fever, or loss of bladder/bowel control, see a doctor right away. Early evaluation can prevent long-term damage and help you get effective treatment.
Frequently Asked Questions
1. What exactly is a facet joint?
A facet joint is a small, stabilizing joint at the back of each spinal vertebra. It helps guide and limit motion between bones.
2. Why does C6–C7 hurt more than other levels?
The C6–C7 level bears extra load because it is at the lower end of the neck, where motion and weight transmission are highest.
3. Can I treat this without surgery?
Yes. Most people improve with rest, physical therapy, and injections or radiofrequency ablation.
4. How long does recovery take?
With proper treatment, many see relief in 6–12 weeks, though some chronic cases take longer.
5. Are steroid injections safe?
Yes, when used sparingly. They reduce inflammation but should not be done too often.
6. Will I need fusion surgery?
Only if conservative measures fail and the joint damage is severe.
7. Can posture training help?
Absolutely. Keeping the neck aligned reduces stress on the joints.
8. Is C6–C7 facet syndrome permanent?
It can become chronic, but many people manage pain well and return to normal activities.
9. Does weight lifting make it worse?
Heavy lifting with poor form can worsen the condition. Proper technique and lighter weights are key.
10. Can facet syndrome cause headaches?
Yes. Pain from C6–C7 can refer to the back of the head, causing headaches.
11. How is radiofrequency ablation done?
A needle heats the small nerves to stop them from sending pain signals, usually under X-ray guidance.
12. Will physical therapy help long term?
Yes. It strengthens muscles, improves flexibility, and teaches safe movement patterns.
13. Are there dietary supplements that help?
Glucosamine, chondroitin, and omega-3s may support joint health, but check with your doctor.
14. What’s the difference between facet syndrome and herniated disc?
Facet syndrome affects the joint surfaces; a herniated disc involves the soft cushion between vertebrae pushing out.
15. How can I sleep more comfortably?
Use a cervical pillow, sleep on your back or side, and avoid stomach sleeping to keep the neck in a neutral position.
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.
