Cervical radiculopathy at the C6–C7 level occurs when the nerve root exiting between the sixth and seventh cervical vertebrae is compressed or irritated, leading to characteristic pain, numbness, and weakness along its distribution.
Anatomy of the C6–C7 Segment
Structure & Location
The C6–C7 intervertebral segment lies at the base of the neck, where the sixth (C6) and seventh (C7) cervical vertebrae meet.
This region connects the mobile neck to the more stable thoracic spine.
Origin & Insertion (Vertebral Components)
Vertebral body: C6 and C7 bodies stack above each other, separated by the intervertebral disc.
Facet joints: Paired joints on each side guide motion and provide stability.
Ligaments: The anterior and posterior longitudinal ligaments, ligamentum flavum, and interspinous ligaments surround the segment, anchoring the vertebrae.
Blood Supply
Supplied by vertebral arteries, ascending through the transverse foramina of C6 and higher levels.
Small radicular arteries branch off to nourish the nerve roots.
Nerve Supply
The C7 nerve root exits just below the C6 pedicle, passing through the C6–C7 intervertebral foramen.
It carries motor fibers to muscles like the triceps and sensory fibers from the middle finger.
Key Functions
Neck flexion/extension control via muscular attachments on C6 and C7.
Rotation and side-bending guidance through facet joint orientation.
Load transmission from head to thoracic spine.
Protection of spinal cord within the vertebral canal.
Conduit for vertebral artery ensuring blood flow to the brain.
Pathway for C7 nerve root, enabling upper limb movement and sensation.
Types of C6–C7 Radiculopathy
Discogenic: Herniated disc material compresses the C7 nerve root.
Spondylotic: Bony overgrowth (osteophytes) from wear‐and‐tear narrows the foramen.
Traumatic: Acute injury (e.g., whiplash) causes ligament or bone displacement.
Tumoral: Tumors within the foramen invade or press on the nerve.
Infectious: Abscess or osteomyelitis around the foramen inflames the nerve.
Congenital: Naturally narrow foramen leads to early nerve compression.
Causes
Herniated cervical disc: Tear in the disc’s outer ring lets the inner gel press on C7.
Degenerative disc disease: Disc height loss narrows foramen, squeezing the nerve root.
Osteoarthritis: Facet joint spurs encroach on the nerve pathway.
Ligamentum flavum hypertrophy: Thickening of ligament behind the vertebrae pushes forward.
Spondylolisthesis: Forward slip of C6 onto C7 alters alignment and compresses the nerve.
Cervical stenosis: General canal narrowing traps multiple nerves.
Trauma: Fracture or dislocation shifts bony fragments into the foramen.
Whiplash injury: Rapid neck movement strains ligaments, leading to inflammation.
Spinal tumor: Growth within bone or soft tissue invades nerve root space.
Epidural abscess: Pus accumulation around the spine inflames and compresses nerves.
Rheumatoid arthritis: Autoimmune inflammation erodes bone and widens joint spaces irregularly.
Paget’s disease: Abnormal bone remodeling thickens vertebrae.
Calcified ligament: Calcium deposits within ligaments stiffen and encroach on foramen.
Congenital canal narrowing: Underdeveloped foramina predispose to early compression.
Spinal metastases: Cancer spread to vertebrae causes local bone destruction.
Cervical myelopathy overlap: Spinal cord swelling secondarily affects roots.
Disc calcification: Hardened disc bulges more aggressively.
Facet joint cyst: Fluid‐filled sac protrudes into the foramen.
Repetitive microtrauma: Overuse in certain occupations gradually inflames the nerve.
Post‐surgical scarring: Scar tissue after cervical surgery tethers or compresses the nerve.
Symptoms
Sharp neck pain radiating toward the shoulder blade.
Burning sensation in the back of the arm.
Numbness or tingling in the middle finger.
Weakness of triceps muscle on the affected side.
Reduced grip strength making it hard to hold objects.
Pain worsened by neck extension or looking up.
Pain relieved by tilting head away from the affected side.
Muscle spasms in the neck or upper back.
Headaches at the base of the skull.
Shoulder girdle pain mimicking rotator cuff injury.
Pins-and-needles in forearm.
Difficulty straightening the elbow fully.
Atrophy of hand muscles over time.
Sleep disturbance due to nighttime pain.
Electric shock sensations down the arm.
Cold sensitivity in the fingers.
Radiating pain when coughing or sneezing (positive Spurling’s sign).
Difficulty performing fine motor tasks, e.g., buttoning clothes.
Balance issues if mild myelopathy overlaps.
Chronic stiffness in neck and shoulder.
Diagnostic Tests
Clinical history & exam: Evaluating pain pattern, reflexes, strength, and sensory changes.
Spurling’s test: Gentle downward pressure on the head with neck extended and rotated toward painful side reproduces symptoms.
Neck distraction test: Lifting the head gently off the shoulders relieves pain if radiculopathy is present.
Upper limb tension test: Stretches nerve roots to elicit symptoms.
X-ray cervical spine: Visualizes bone spurs, alignment, and disc height.
MRI scan: Gold standard for soft tissue detail, showing disc herniation or nerve compression.
CT myelogram: CT with contrast in the spinal fluid highlights foraminal stenosis.
EMG/NCS (electromyography/nerve conduction): Detects nerve injury and distinguishes radiculopathy from peripheral neuropathy.
Ultrasound: In some cases, to assess superficial soft‐tissue masses.
Bone scan: Identifies infection, tumor, or stress fractures.
Flexion-extension X-rays: Assess instability between vertebrae.
CT scan: Detailed bone anatomy for surgical planning.
Selective nerve root block: Injection of anesthetic under fluoroscopy to confirm the symptomatic level.
Pain provocation discography: Injecting dye into discs to reproduce pain and identify symptomatic disc.
Blood tests (CBC, ESR, CRP): Rule out infection or inflammatory arthritis.
Rheumatoid factor/anti-CCP antibodies: Assess for rheumatoid arthritis.
Vitamin D levels: Low levels can contribute to bone weakness.
Calcium/phosphate levels: Evaluate metabolic bone disease.
Spinal cord evoked potentials: Assess for concomitant myelopathy.
Psychosocial assessment: Screen for depression or anxiety that may amplify pain.
Non-Pharmacological Treatments
Rest and activity modification: Avoid aggravating movements.
Cervical collar (soft): Short-term support to limit motion.
Physical therapy: Strengthening stabilizers, improving posture.
Traction therapy: Gentle stretching to relieve nerve compression.
Manual therapy: Mobilization techniques by a trained therapist.
Heat therapy: Increases blood flow, relaxes muscles.
Cold packs: Reduces inflammation and numbs pain.
TENS (transcutaneous electrical nerve stimulation): Alters pain signals.
Ultrasound therapy: Deep heating for soft-tissue healing.
Acupuncture: May relieve pain via endorphin release.
Massage therapy: Loosens tight muscles around the neck.
Ergonomic adjustments: Optimizing workstation height and screen position.
Postural education: Training to keep the neck in neutral alignment.
Yoga/stretching: Gentle exercises to maintain flexibility.
Pilates: Core strengthening to support the cervical spine.
Biofeedback: Teaches muscle relaxation techniques.
Mindfulness meditation: Reduces perception of pain.
Cervical spine kinesiology taping: Supports muscles and reminds proper posture.
Spinal decompression tables: Mechanical unloading of discs.
Hydrotherapy: Exercises in warm water for low-impact movement.
Posture braces: Reminder devices to avoid slouching.
Scar tissue mobilization: After surgery or injury to prevent adhesions.
Prolotherapy: Injecting irritant to stimulate ligament healing.
Cupping therapy: May enhance local blood circulation.
Chiropractic adjustments: Careful manipulations to improve joint mobility.
Nutritional counseling: Anti-inflammatory diet rich in omega-3s.
Weight management: Reduces mechanical stress on the spine.
Stress management: Techniques to reduce muscle tension.
Ergonomic sleep setup: Cervical pillows that maintain neutral spine.
Activity pacing: Balancing rest and gradual increase in activity.
Pharmacological Treatments
NSAIDs (e.g., ibuprofen, naproxen): Reduce inflammation and pain.
Acetaminophen: Pain relief when NSAIDs contraindicated.
Oral corticosteroids: Short course to decrease nerve root swelling.
Muscle relaxants (e.g., cyclobenzaprine): Alleviate muscle spasms.
Gabapentin/pregabalin: Neuropathic pain modulators.
Tricyclic antidepressants (e.g., amitriptyline): Manage chronic nerve pain.
Serotonin–norepinephrine reuptake inhibitors (e.g., duloxetine): Adjunct for neuropathic pain.
Opioids (e.g., tramadol): Short-term use for severe pain under supervision.
Oral diazepam: For acute muscle spasm relief.
Calcitonin: May help in bone-related pain.
Topical NSAIDs (e.g., diclofenac gel): Local pain relief.
Topical lidocaine patches: Numb the painful area.
Capsaicin cream: Depletes substance P, reducing nerve pain over time.
Epidural steroid injection: Directly reduces inflammation at the nerve root.
Selective nerve root block: Local anesthetic plus steroid under imaging guidance.
Botulinum toxin: For refractory muscle spasm relief.
Calcitonin gene-related peptide (CGRP) inhibitors: Experimental for chronic neuropathy.
Bisphosphonates: If underlying bone loss contributes to instability.
Vitamin D supplementation: If deficient, to support bone health.
Magnesium supplements: May alleviate muscle tension.
Surgical Options
Anterior cervical discectomy and fusion (ACDF): Removal of disc and fusion to stabilize.
Posterior cervical foraminotomy: Widening the foramen from the back.
Cervical disc replacement: Maintains motion while removing a herniated disc.
Laminectomy: Removing the back of vertebra (lamina) to decompress nerve roots.
Laminoplasty: Reshaping lamina to enlarge the spinal canal while preserving stability.
Microendoscopic decompression: Minimally invasive for targeted foramen widening.
Transforaminal epidural endoscopy: Endoscopic removal of herniated disc fragments.
Posterior lateral mass fixation: Screws and rods to stabilize unstable segments.
Artificial disc insertion: Alternative to fusion for select patients.
Corpectomy with strut graft: Removal of vertebral body to decompress multiple levels.
Prevention Strategies
Maintain good posture: Head aligned over shoulders when sitting or standing.
Ergonomic workspace: Monitor at eye level, keyboard close, chair with neck support.
Regular neck stretches: Gentle side-to-side and forward-back movements.
Strengthen neck and shoulder muscles: Use resistance bands or light weights.
Avoid prolonged static positions: Take breaks every 30 minutes.
Use supportive pillows: Keep neck in neutral alignment during sleep.
Practice safe lifting: Bend at knees, not at the waist, to protect the spine.
Stay active: Regular low-impact exercise (walking, swimming).
Maintain healthy weight: Reduces mechanical stress on the cervical spine.
Quit smoking: Smoking impairs disc nutrition and healing.
When to See a Doctor
Severe arm weakness or loss of hand function
Unrelenting pain that does not improve with rest or over-the-counter medications
Loss of bladder or bowel control (urgent emergency evaluation)
Progressive numbness or tingling despite conservative care
Fever with neck pain (possible infection)
Sudden onset after trauma (e.g., motor vehicle accident)
Frequently Asked Questions
What exactly is C6–C7 radiculopathy?
It’s irritation of the C7 nerve root as it exits between the sixth and seventh cervical vertebrae, causing neck and arm symptoms.How is radiculopathy different from a pinched nerve?
“Pinched nerve” is a lay term; radiculopathy is the medical name for nerve root compression in the spine.Can it resolve on its own?
Yes—many cases improve with rest and conservative care within 6–12 weeks.What tests confirm the diagnosis?
MRI is the gold standard to visualize disc herniation or foramen narrowing; EMG can confirm nerve injury.Is surgery always needed?
No—only if severe weakness, intractable pain, or progressive neurological deficits occur.Will I need a neck brace?
Occasionally a soft collar for short-term relief; prolonged use is discouraged to avoid muscle weakness.Can I work with radiculopathy?
Many patients continue work with modifications and therapy; heavy lifting or overhead work may need to be limited.Is driving safe?
If arm pain or weakness impairs your ability to steer or brake, avoid driving until evaluated.Are there long-term complications?
Rarely, chronic nerve damage can lead to persistent weakness or numbness if untreated.Does weight loss help?
Yes—reducing overall weight can lower spine stress and improve symptoms.Can physical therapy worsen it?
When guided by a trained therapist and avoiding painful movements, therapy helps rather than harms.Are injections safe?
Generally yes, when performed under imaging guidance by specialists; risks are low but include bleeding or infection.Is radiculopathy hereditary?
Spinal degeneration can run in families, but nerve root compression is related more to wear and tear than genes.How long is recovery after surgery?
Most patients see significant relief within 6–8 weeks, with full recovery by 3–6 months.What lifestyle changes help prevent recurrence?
Regular exercise, posture awareness, ergonomic work habits, and smoking cessation are key.
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.
