Prolapsed Cervical Intervertebral Disc at the C6–C7

A prolapsed (herniated) cervical intervertebral disc at the C6–C7 level occurs when the soft inner core (nucleus pulposus) of the disc between the sixth and seventh cervical vertebrae pushes through a tear in the outer ring (annulus fibrosus). This can press on nearby nerves or the spinal cord, causing pain, numbness, or weakness in the neck, shoulders, arms, and hands. Herniations at C6–C7 are among the most common cervical disc problems because this level endures significant movement and load during daily activities.

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Anatomy of the C6–C7 Intervertebral Disc

1. Structure
   The intervertebral disc is made of two main parts:

   • Annulus Fibrosus: Tough fibrous outer ring composed of concentric collagen layers that contain and protect the inner core.

   • Nucleus Pulposus: Gel-like center rich in water and proteoglycans that absorbs shock and distributes pressure evenly across the disc.

2. Location
   The C6–C7 disc sits between the bodies of the C6 and C7 vertebrae in the lower portion of the neck (cervical spine). It lies just above the first thoracic bone (T1).

3. Origin/Insertion

   • Origin: The annulus fibrosus anchors to the inferior endplate of the C6 vertebral body.

   • Insertion: It attaches to the superior endplate of the C7 vertebral body. These endplates interface with the vertebrae’s cancellous bone to transfer loads.

4. Blood Supply
   Small blood vessels from the adjacent vertebral bodies penetrate the outer third of the annulus fibrosus. The inner annulus and nucleus pulposus are largely avascular and receive nutrients by diffusion through the endplates.

5. Nerve Supply
   The disc’s outer annulus receives sensory fibers from the sinuvertebral (recurrent meningeal) nerves, which relay pain signals when the outer ring is torn or inflamed.

6. Functions

   1. Shock Absorption: The nucleus pulposus cushions impacts from daily movements.

   2. Load Distribution: Spreads load evenly across the vertebral bodies.

   3. Spinal Flexibility: Allows bending, twisting, and extension of the neck.

   4. Stability: Maintains proper spacing and alignment of vertebrae.

   5. Foraminal Height Maintenance: Keeps intervertebral foramen open for nerve roots.

   6. Protection of Neural Structures: Prevents direct bone-to-bone contact and shields the spinal cord and nerve roots.

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Types of Disc Prolapse at C6–C7

• Protrusion: Nucleus pushes into, but remains contained by, the annulus.

• Extrusion: Nucleus breaks through the annulus but stays connected.

• Sequestration: A fragment of the nucleus separates and may migrate in the spinal canal.

• Bulging Disc: Annular fibers weaken and bulge symmetrically without focal tear.

• Contained Herniation: Inner material herniates but remains within overall disc outline.

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Causes

1. Age-Related Degeneration: Discs lose water and elasticity over time, making them prone to herniation.

2. Poor Posture: Slouching or forward head posture increases pressure on cervical discs.

3. Repetitive Neck Motions: Jobs or sports that involve frequent bending/twisting can wear down discs.

4. Heavy Lifting: Sudden strain from lifting heavy objects can tear the annulus.

5. Trauma: Car accidents or falls can force disc material outward.

6. Genetics: Family history may predispose to weaker disc structure.

7. Smoking: Reduces blood flow and disc nutrition, accelerating degeneration.

8. Obesity: Extra weight increases spinal load and disc wear.

9. Vibrations: Long-term exposure (e.g., truck driving) can damage discs.

10. High-Impact Sports: Football, gymnastics, or contact sports risk acute injury.

11. Sedentary Lifestyle: Weak neck and back muscles fail to support discs.

12. Occupational Hazards: Repeated overhead work stresses cervical spine.

13. Sudden Twisting Injuries: Rapid rotation can tear annulus fibers.

14. Inflammatory Conditions: Arthritis can weaken disc integrity.

15. Nutritional Deficiencies: Poor diet leads to weak collagen in annulus.

16. Dehydration: Insufficient hydration reduces disc cushioning ability.

17. Hormonal Changes: Menopause may accelerate connective tissue degeneration.

18. Previous Spinal Surgery: Altered biomechanics increase adjacent disc stress.

19. Congenital Spine Abnormalities: Structural anomalies can overload discs.

20. Poor Ergonomics: Unsupportive chairs or pillows increase neck strain.

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Symptoms

1. Neck Pain: Often localized at the base of the neck.

2. Radiating Arm Pain: Sharp pain traveling down the shoulder into the arm.

3. Numbness: Loss of sensation in arm, forearm, or fingers.

4. Tingling (“Pins and Needles”): Often felt in specific fingers (e.g., middle finger).

5. Muscle Weakness: Reduced strength in shoulder, arm, or hand muscles.

6. Reflex Changes: Diminished biceps or triceps reflexes.

7. Reduced Neck Mobility: Stiffness or difficulty turning the head.

8. Headaches: Tension headaches at the base of the skull.

9. Scapular Pain: Aching between shoulder blades.

10. Shoulder pain: Localized around the deltoid.

11. Gripping Difficulty: Trouble holding objects due to hand weakness.

12. Balance Issues: Rarely, if spinal cord is compressed.

13. Muscle Spasms: Sudden involuntary contractions in the neck.

14. Sleep Disturbance: Pain worsens at night, disrupting rest.

15. Radiating Chest Pain: Rare, may mimic heart pain if dermatomes overlap.

16. Nerve Root Pain (Radiculopathy): Sharp, shooting sensations along nerve path.

17. Discogenic Pain: Deep, aching pain worsened by sitting or forward bending.

18. Radiation to Fingers: Commonly index and middle fingers for C6–C7.

19. Torticollis: Abnormal head tilt to relieve pain.

20. Cough/Sneeze Pain Increase: Increases in intradiscal pressure exacerbate pain.

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Diagnostic Tests

1. Patient History & Physical Exam: Initial assessment of symptoms and reflexes.

2. Neurological Exam: Tests muscle strength, sensation, and reflexes.

3. Spurling’s Test: Neck extension with rotation to reproduce radicular pain.

4. Range of Motion (ROM) Assessment: Measures neck flexibility limits.

5. Cervical X-Ray: Rules out fractures, arthritis, or alignment issues.

6. MRI (Magnetic Resonance Imaging): Gold standard for visualizing disc herniation.

7. CT Scan (Computed Tomography): Detailed bone images; often paired with myelography.

8. Myelogram: Contrast dye injected to highlight spinal cord compression on X-ray or CT.

9. Electromyography (EMG): Assesses nerve and muscle electrical activity.

10. Nerve Conduction Study (NCS): Measures speed of electrical impulses in nerves.

11. Discography: Contrast injected into disc to provoke pain and confirm disc source.

12. Ultrasound: Limited use but can assess soft-tissue swelling.

13. Flexion/Extension X-Rays: Detects instability between vertebrae.

14. Bone Scan: Identifies inflammation or fractures.

15. Cervical Traction Test: Temporary relief under traction suggests discogenic pain.

16. Upper Limb Tension Test (ULTT): Stretches nerve roots to reproduce symptoms.

17. Provocative Testing: Pressing on specific areas to pinpoint pain source.

18. Functional Capacity Evaluation: Assesses ability to perform work-related tasks.

19. Blood Tests: Rule out infection or inflammatory arthritis.

20. Psychosocial Assessment: Evaluates for pain-related anxiety or depression.

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Non-Pharmacological Treatments

1. Rest & Activity Modification: Brief rest then gradual return to activity.

2. Physical Therapy (PT): Targeted exercises to strengthen neck muscles.

3. Cervical Traction: Gentle stretching to relieve nerve compression.

4. Posture Correction: Ergonomic advice for sitting and standing.

5. Heat Therapy: Warm packs to relax muscles.

6. Cold Therapy: Ice packs to reduce inflammation.

7. Cervical Collar: Short-term immobilization for severe pain.

8. Transcutaneous Electrical Nerve Stimulation (TENS): Mild electrical pulses for pain relief.

9. Ultrasound Therapy: Deep tissue heating to promote healing.

10. Massage Therapy: Manual release of muscle tension.

11. Chiropractic Manipulation: Gentle spinal adjustments (with caution).

12. Acupuncture: Needle therapy to modulate pain signals.

13. Yoga: Neck-friendly poses to improve flexibility.

14. Pilates: Core strengthening for spinal support.

15. Water Therapy (Aquatic Exercise): Low-impact movement in water.

16. Tai Chi: Gentle balance and movement training.

17. Ergonomic Workstation: Proper monitor height and chair support.

18. Stress Management: Relaxation techniques to reduce muscle tension.

19. Biofeedback: Learn to control muscle tension consciously.

20. Cognitive Behavioral Therapy (CBT): Address pain perception and coping.

21. Mindfulness Meditation: Reduces stress and improves pain tolerance.

22. Weight Management: Reduces spinal load.

23. Neck Stretching Exercises: Targeted stretches for flexibility.

24. Strengthening Exercises: Focus on trapezius and deep neck flexors.

25. Balance Training: Improves proprioception and reduces fall risk.

26. Ergonomic Sleep Support: Proper pillow and mattress.

27. Educational Programs: Learn safe spine mechanics.

28. Activity Pacing: Balance rest and activity to prevent flare-ups.

29. Posture-Correcting Braces: Gentle reminders to maintain alignment.

30. Hot/Cold Contrast Therapy: Alternating temperatures for circulation.

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Drugs

1. Ibuprofen: NSAID for pain and inflammation.

2. Naproxen: Longer-acting NSAID option.

3. Aspirin: Mild analgesic and anti-inflammatory.

4. Acetaminophen (Paracetamol): Pain relief without anti-inflammatory effect.

5. Diclofenac: Prescription NSAID for moderate pain.

6. Celecoxib: COX-2 selective NSAID with fewer gastric side effects.

7. Cyclobenzaprine: Muscle relaxant for spasms.

8. Tizanidine: Short-acting muscle relaxant.

9. Methocarbamol: Central muscle relaxant.

10. Gabapentin: Neuropathic pain modulator.

11. Pregabalin: Similar to gabapentin for nerve pain.

12. Duloxetine: SNRI antidepressant with pain-modulating effects.

13. Amitriptyline: Low-dose tricyclic for neuropathic pain.

14. Opioids (e.g., Tramadol): Short-term use for severe pain.

15. Oral Corticosteroids (e.g., Prednisone): Short-term inflammation reduction.

16. Topical NSAIDs: Direct application to neck area.

17. Lidocaine Patch: Local anesthetic for focal pain.

18. Capsaicin Cream: Depletes substance P to reduce pain signals.

19. Muscle Spasm Injections (e.g., Botulinum Toxin): For refractory spasms.

20. Epidural Steroid Injection: Targeted anti-inflammatory delivery.

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Surgical Options

1. Anterior Cervical Discectomy and Fusion (ACDF): Remove disc, fuse C6–C7 with bone graft and plate.

2. Cervical Disc Arthroplasty (Artificial Disc Replacement): Preserves motion by implanting an artificial disc.

3. Posterior Cervical Foraminotomy: Widen nerve root exit by removing bone/ligament from behind.

4. Laminoplasty: Expand spinal canal space by reshaping the lamina.

5. Laminectomy: Remove lamina to decompress spinal cord and nerve roots.

6. Microdiscectomy: Minimally invasive removal of herniated disc fragments.

7. Endoscopic Discectomy: Small-incision technique using an endoscope.

8. Posterior Fusion: Stabilize spine via rods and bone graft from the back.

9. Ose relieving Osteophytectomy: Remove bone spurs contributing to nerve compression.

10. Expandable Cage Fusion: Maintains disc height with an adjustable implant.

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 Prevention Strategies

1. Maintain Good Posture: Keep ears over shoulders, shoulders over hips.

2. Ergonomic Workstation: Screen at eye level, chair with lumbar and cervical support.

3. Proper Lifting Techniques: Bend at knees, keep load close to body.

4. Regular Neck Exercises: Stretch and strengthen deep neck flexors.

5. Weight Control: Lower body mass to reduce spinal load.

6. Smoking Cessation: Improves disc nutrition and healing.

7. Balanced Diet: Adequate protein, vitamins C and D, and minerals for connective tissue health.

8. Hydration: Drink enough water for optimal disc function.

9. Avoid Prolonged Static Positions: Take breaks every 30–60 minutes.

10. Stress Reduction: Relaxation techniques to prevent muscle tension.

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When to See a Doctor

• Severe or Worsening Pain: Especially if unrelieved by rest or medication.

• Numbness or Weakness: In arm or hand that affects daily activities.

• Loss of Bowel/Bladder Control: Rare but urgent (“red flag” for spinal cord compression).

• High Fever with Neck Pain: Possible infection.

• Trauma History: After a fall or accident.

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Frequently Asked Questions

1. What is a prolapsed cervical disc?
   A prolapsed (or herniated) disc happens when the soft inner gel of the disc pushes out through a tear in its tough outer ring, potentially pressing on nerves.

2. Why is C6–C7 a common site?
   The C6–C7 joint endures strong forces during neck flexion, extension, and rotation, making it prone to wear and injury.

3. Can rest alone heal a herniated disc?
   Brief rest helps with acute pain, but active rehabilitation (exercises, posture correction) is crucial for long-term recovery.

4. Is surgery always needed?
   No. Most people improve with non-surgical treatments within 6–12 weeks. Surgery is reserved for severe or persistent symptoms.

5. How long does recovery take?
   With conservative care, many improve in 2–3 months. Surgical recovery may take 3–6 months for full healing.

6. Can a prolapsed disc re-herniate?
   Yes, if underlying risk factors (poor posture, lifting techniques) aren’t addressed.

7. Is a cervical collar helpful?
   Short-term use (1–2 weeks) can relieve pain, but prolonged immobilization may weaken neck muscles.

8. What exercises help?
   Gentle neck stretches, deep neck flexor strengthening, and scapular stabilization are key.

9. Are steroid injections safe?
   Epidural or oral steroids can reduce inflammation but carry risks if overused.

10. Can I drive with a herniated disc?
    Only if you have adequate range of motion and pain control; otherwise, limit until you can turn safely.

11. Will my herniated disc show on an MRI even if I’m pain-free?
    Possibly. Some asymptomatic individuals also have disc bulges or herniations on imaging.

12. Does weight lifting worsen it?
    Improper technique can worsen the herniation; use proper form and lighter loads initially.

13. What role does diet play?
    A balanced diet with sufficient protein, vitamins, and hydration supports disc health.

14. Is chiropractic adjustment risky?
    When performed by a qualified practitioner, it can help; avoid high-velocity neck thrusts if severe herniation is present.

15. How can I prevent recurrence?
    Maintain posture, strengthen supporting muscles, practice safe lifting, and avoid smoking.

A prolapsed C6–C7 disc can significantly impact quality of life, but with a clear understanding of anatomy, causes, symptoms, and a comprehensive treatment plan—including conservative care and, when needed, surgical options—most people achieve lasting relief. Early diagnosis, active rehabilitation, and preventive habits are key to maintaining a healthy cervical spine and preventing future herniations.

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: April 28, 2025.

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