Cervical Disc Protrusion at C6–C7

A cervical disc protrusion at the C6–C7 level happens when the fibrous outer layer of the intervertebral disc between the sixth and seventh neck vertebrae (C6 and C7) bulges outward. This bulge can press on nearby nerves or the spinal cord, causing pain, numbness, or weakness in the neck, shoulders, arms, or hands. Deuk SpineNCBI

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Anatomy of the C6–C7 Motion Segment

Structure & Location

The C6–C7 segment comprises the sixth and seventh cervical vertebrae and the intervertebral disc between them. It sits at the base of the neck, just above the junction with the upper back (thoracic spine). Spine-Health

Origin & Insertion

• Vertebral Bodies: Each vertebra has a cylindrical body.

• Facet Joints: The inferior facets of C6 articulate with the superior facets of C7, allowing controlled movement. Kenhub

Blood Supply

• Vertebral Arteries: Branch from the subclavian artery, travel through transverse foramina (holes) in the C6 transverse processes to supply the spinal column’s front and sides via cervical radicular arteries. Cortho

Nerve Supply

• C7 Nerve Root: Exits just below the C6–C7 disc, carrying sensory input from the back of the arm and motor signals to the triceps and wrist extensors. Deuk Spine

Functions

1. Load Bearing: Carries the weight of the head. Spine-Health

2. Flexion & Extension: Allows nodding and looking up/down. Physiopedia

3. Lateral Flexion: Enables side-to-side tilting. Physiopedia

4. Rotation: Permits head turning. Physiopedia

5. Shock Absorption: Disc nucleus pulposus cushions impacts. Spine-Health

6. Protection: Shields the spinal cord and nerve roots within the vertebral canal. Physiopedia

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Types of Cervical Disc Protrusion

1. Contained Protrusion: Inner disc pushes against outer layer without rupture.

2. Non-Contained Protrusion: Annulus fibrosus tears, but nucleus pulposus stays partially contained.

3. Sequestered Protrusion: Fragmented nucleus pulposus escapes into the spinal canal.

4. Central: Bulge toward the center of the spinal canal, possibly affecting the spinal cord.

5. Posterolateral: Bulge toward the side, commonly compressing a nerve root.

6. Foraminal: Bulge into the nerve exit canal (foramen).

7. Lateral: Extends directly sideways, affecting exiting nerves.

8. Broad-Based: Broad annular bulge affecting more than 25% of disc circumference.

9. Focal: Localized bulge affecting less than 25% of disc circumference.

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Causes

1. Age-Related Degeneration: Natural wear of the disc’s proteins Best Hospital Hyderabad

2. Repetitive Strain: Frequent neck bending or twisting Best Hospital Hyderabad

3. Poor Posture: Forward head posture increases disc load Spine-Health

4. Trauma: Whiplash from car accidents Mayfield Brain & Spine

5. Heavy Lifting: Lifting overhead or with poor technique Best Hospital Hyderabad

6. Vibration Injury: Long-term exposure (e.g., heavy machinery) Best Hospital Hyderabad

7. Smoking: Reduces blood flow to discs NCBI

8. Obesity: Extra load on cervical spine NCBI

9. Genetics: Family history of early disc degeneration NCBI

10. Sedentary Lifestyle: Weak neck muscles, poor spinal support Spine-Health

11. Occupational Stress: Desk jobs with poor ergonomics Spine-Health

12. Sports Injuries: Contact sports or falls Mayfield Brain & Spine

13. Inflammatory Conditions: Rheumatoid arthritis in cervical spine Kenhub

14. Tumors: Space-occupying lesions weaken discs Kenhub

15. Infections: Discitis can damage disc integrity NCBI

16. Osteoporosis: Vertebral collapse alters disc load NCBI

17. High-Impact Events: Falls from height Mayfield Brain & Spine

18. Repetitive Microtrauma: Small, repeated injuries Best Hospital Hyderabad

19. Metabolic Disorders: Diabetes affecting disc nutrition NCBI

20. Dehydration: Disc loses water and height NCBI

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 Symptoms

1. Neck Pain: Local ache or sharp pain Spine-Health

2. Radiating Arm Pain: Follows the C7 dermatome Deuk Spine

3. Numbness: Common in middle finger Deuk Spine

4. Tingling: “Pins and needles” in arm Deuk Spine

5. Muscle Weakness: Triceps or wrist extensors Deuk Spine

6. Headaches: From neck muscle spasm Spine-Health

7. Stiffness: Reduced neck range of motion Spine-Health

8. Shoulder Pain: Due to nerve referral Deuk Spine

9. Chest Pain: Rare, when stellate ganglion irritated Deuk Spine

10. Muscle Spasm: Protective tightening Spine-Health

11. Balance Issues: If spinal cord compressed Spine-Health

12. Gait Changes: Unsteady if myelopathy develops Spine-Health

13. Fine Motor Loss: Difficulty with buttoning shirts Spine-Health

14. Reflex Changes: Hyperreflexia or diminished reflexes Spine-Health

15. Pain at Night: Worsens when lying down Spine-Health

16. Pain with Cough/Sneeze: Increases spinal pressure Spine-Health

17. Visual Disturbances: Rare, via vertebrobasilar insufficiency Spine-Health

18. Autonomic Symptoms: Uncontrolled sweating Deuk Spine

19. Difficulty Swallowing: Very rare, if large bulge Deuk Spine

20. Bowel/Bladder Changes: Rare, with severe cord compression Spine-Health

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Diagnostic Tests

1. Physical Exam: Assess range, reflexes, strength Spine-Health

2. Spurling’s Test: Neck turned and pressed to reproduce pain Spine-Health

3. Straight Leg Test (Cervical): Axial loading to check nerve irritation Spine-Health

4. Dermatome Mapping: Pinprick sensation test Spine-Health

5. Myotome Testing: Muscle strength per nerve level Spine-Health

6. Reflex Testing: Biceps, triceps reflexes Spine-Health

7. X-Ray: Alignment and disc space narrowing NCBI

8. MRI: Gold standard for soft-tissue detail NCBI

9. CT Scan: Bone detail, when MRI contraindicated NCBI

10. CT Myelogram: Contrast in spinal canal NCBI

11. Electromyography (EMG): Nerve conduction study NCBI

12. Nerve Conduction Velocity: Measures signal speed NCBI

13. Discography: Contrast injected into disc to reproduce pain NCBI

14. Bone Scan: Detects fractures or infection NCBI

15. Blood Tests: Rule out infection/inflammation NCBI

16. Ultrasound: Guide for injections NCBI

17. Epidural Injection Trial: Temporary relief to confirm diagnosis Spine-Health

18. Facet Joint Block: Distinguish source of pain Spine-Health

19. Posture Analysis: Ergonomic evaluation Spine-Health

20. Dynamic X-Ray: Flexion/extension views for instability NCBI

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Non-Pharmacological Treatments

1. Rest & Activity Modification

2. Ergonomic Adjustments

3. Cervical Collar (Soft)

4. Physical Therapy: Strength and stretch

5. Manual Therapy: Joint mobilization

6. McKenzie Exercises: Extension-based

7. Traction Therapy

8. Transcutaneous Electrical Nerve Stimulation (TENS)

9. Massage Therapy

10. Acupuncture

11. Dry Needling

12. Heat Packs

13. Cold Packs

14. Ultrasound Therapy

15. Laser Therapy

16. Chiropractic Manipulation

17. Pilates

18. Yoga

19. Tai Chi

20. Scapular Stabilization Exercises

21. Neck Isometrics

22. Postural Training

23. Balance Training

24. Ergonomic Sleep Pillows

25. Cognitive Behavioral Therapy (for chronic pain)

26. Biofeedback

27. Mindfulness Meditation

28. Aquatic Therapy

29. Kinesio Taping

30. Education & Self-Management Programs Spine-Health

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Drugs

1. Acetaminophen (Paracetamol)

2. NSAIDs: Ibuprofen, naproxen

3. COX-2 Inhibitors: Celecoxib

4. Muscle Relaxants: Cyclobenzaprine

5. Oral Corticosteroids: Prednisone taper

6. Opioids: Short-term tramadol

7. Neuropathic Agents: Gabapentin, pregabalin

8. Antidepressants: Amitriptyline, duloxetine

9. Topical Analgesics: Lidocaine patches

10. Capsaicin Cream

11. Steroid Injections: Epidural corticosteroids

12. Botulinum Toxin (for spasm)

13. Calcitonin (rare, for bone pain)

14. Bisphosphonates (if osteoporosis involved)

15. Muscle Relaxant Topical Gels

16. NSAID Patches

17. Intravenous Steroids (acute severe)

18. SNRIs: Venlafaxine

19. Antispasmodics: Baclofen

20. NMDA Antagonists: Ketamine infusion (rare) Spine-Health

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Surgeries

1. Anterior Cervical Discectomy and Fusion (ACDF)

2. Posterior Cervical Foraminotomy

3. Cervical Disc Arthroplasty (Artificial Disc Replacement)

4. Laminectomy (posterior decompression)

5. Laminoplasty (spinal canal expansion)

6. Posterior Cervical Fusion

7. Microendoscopic Discectomy

8. Percutaneous Discectomy (laser or nucleoplasty)

9. Anterior Cervical Corpectomy (removal of vertebral body)

10. Hybrid Constructs (fusion + arthroplasty) Spine-Health

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 Prevention Strategies

1. Maintain Good Posture

2. Ergonomic Workstation

3. Regular Neck Exercises

4. Core Strengthening

5. Proper Lifting Techniques

6. Avoid Prolonged Static Positions

7. Stay Hydrated

8. Balanced Diet (bone and disc health)

9. Quit Smoking

10. Weight Management Spine-Health

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When to See a Doctor

• Severe Neck Pain not improving after a week of self-care

• Progressive Weakness in arms or hands

• Numbness or Tingling worsening or spreading

• Loss of Bowel/Bladder Control

• Unsteady Gait or coordination problems

• Unexpected Weight Loss with pain

• Fever and Pain (infection concern)

• History of Cancer plus new neck pain

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Frequently Asked Questions

1. Can a C6–C7 protrusion heal on its own?
   Many mild protrusions improve with non-surgical care over 4–6 months Spine-Health

2. Is surgery always necessary?
   No—most cases resolve without surgery unless serious neurological deficits occur Spine-Health

3. How long does recovery take after ACDF?
   Fusion takes 3–6 months; full recovery may last 6–12 months Spine-Health

4. Will an artificial disc replacement wear out?
   Modern devices last 10–20 years, but long-term data are still emerging Spine-Health

5. Can I drive with a cervical protrusion?
   If pain or weakness affects control, avoid driving until cleared Spine-Health

6. Are injections safe?
   Epidural steroids are generally safe but carry small risks of infection or bleeding Spine-Health

7. Can physical therapy worsen it?
   Properly guided therapy rarely worsens and usually helps pain and mobility Spine-Health

8. What pillow is best?
   A cervical-contour pillow supports natural neck curve Spine-Health

9. Can yoga help?
   Gentle neck stretches may relieve pain; avoid extreme positions Spine-Health

10. Is MRI always needed?
    MRI is ideal for soft-tissue detail but may not be needed if mild symptoms and clear exam NCBI

11. What’s the difference between bulge and protrusion?
    A bulge is broad and symmetric; a protrusion is more focal and can be sharper Spine-Health

12. Can discography confirm diagnosis?
    It can reproduce pain but is invasive and used selectively NCBI

13. Does hydration affect discs?
    Well-hydrated discs maintain height and cushioning better NCBI

14. Are there genetic tests?
    No standard genetic test; family history is the best indicator NCBI

15. When is fusion preferred over replacement?
    Fusion is chosen for severe degeneration or instability; replacement when motion preservation is prioritized

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

Last Updated: April 29, 2025.

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