An injury to the spine can have devastating effects, leading to everything from paralysis to chronic neck pain. The exact impact of a spinal injury depends on a range of factors, including which part of the spine is injured. The C5-C6 area is located in the lower neck and helps to support the neck and provide flexibility to the head, so an injury can mean it is difficult to carry out simple tasks like using a computer and driving. Understanding exactly how the cervical spine functions and what these injuries mean can help you understand what recovery time may look like.
The Spine’s Structure
Rather than one long bone, the spine is made up of a series of 33 smaller bones, called vertebrae, that are stacked vertically on top of one another. This allows the spine to move and curve as needed, as the vertebrae shift and interlock. To avoid friction and absorb shock, between each set of bones is a small, gel-like disc that provides cushion.
Each vertebra has an individual name, made up of a letter and a number. The numbers count from the top, and the letters reference which segment of the spine they are in. These segments are as follows:
- Cervical Spine: This area is also known as the neck and is composed of 7 vertebrae, C1 to C7. The lowest, C7, is at the bottom of the neck.
- Thoracic Spine: The upper back contains 12 vertebrae, T1 to T12, which are attached to the rib bones and the sternum. This attachment makes this the most stable part of the spine.
- Lumbar Spine: These vertebrae, L1 to L5, have a great deal of motion and flexibility to allow the lumbar spine to bear most of the body’s weight. This also means the lumbar spine is the most commonly affected by back injuries and strain.
- Sacral Region: The sacrum is a series of five tiny bone segments, S1 to S5, that are fused together to create a triangular bone, which serves as the base of the spine and is part of the pelvis. Four small bones extend down from this area to form the tailbone.
The C5-C6 Spinal Motion Segment
In the lower cervical spine, the vertebrae C5 and C6 make up something known as the C5-C6 motion segment. This area provides flexibility and support to much of the neck and head, and because it is load-bearing, it is often impacted by chronic issues such as poor posture, degeneration, disc herniation, radicular pain, and trauma.
The C5-C6 motion segment is composed of these parts:
- C5 and C6 Vertebrae: Each vertebra contains a vertebrae body, a vertebral arch, and two transverse processes. Together, they form paired, synovial facet joints with a gliding movement. Cartilages on the joints’ surfaces provide smooth motion and prevent friction between C5 and C6, and ligaments attach them to one another.
- C5 and C6 Intervertebral Disc: The disc between each vertebra is made up of a gel-like nucleus pulposus surrounded by a thick fibrous ring called the annulus fibrosus. This disc provides cushioning and shock absorption while preventing the vertebral bodies from grinding during motion.
- C6 Spinal Nerve: Between C5 and C6, the C6 spinal nerve exits the spinal cord via a small, bony opening on each side of the spinal canal, known as the intervertebral foramen. The C6 nerve has both a sensory root and a motor root.
- The C6 dermatome is an area of skin that receives sensations through the C6 nerve. This dermatome includes the skin on the inner arm and thumb.
- The C6 myotome is a group of muscles controlled by the C6 nerve. This group includes the wrist extensor muscles, which allow the wrist to bend backward, and the biceps and supinator muscles in the upper arm, which allow the elbow to bend and the forearm to rotate.
The spinal cord is protected within the spinal canal, with vertebral bodies to the front and vertebral arches in the rear. The vertebral arteries are protected by bony tunnels that go up both sides of the vertebrae.
Common Problems in C5-C6 Region
Because it bears a lot of weight and strain, this area of the cervical spine is particularly prone to injuries and disorders.
Disc problems are extremely common in the C5-C6 intervertebral disc. This can result from the shearing forces placed on the disc as the head leans forward due to poor posture or from aging-related wear and tear. Sudden jolts to the neck and back, like whiplash, can also cause traumatic degeneration in which the disc is rapidly damaged. Herniations and rupturing of these discs is often a cause for radicular nerve pain and other symptoms related to this area of the next.
Spondylosis is a kind of degeneration that occurs in certain vertebrae and discs more rapidly than others, which is often true of C5, C6, and their shared disc. This can result in the formation of bone spurs that eventually cause stenosis, a narrowing of the intervertebral foramina or the spinal canal, which can cause severe nerve pain.
Fractures are a common traumatic injury at C5-C6. Research indicates that about one-fifth of traumatic neck fractures occur at C6, and another 15% at C5. Car accidents and other trauma that causes a forceful bending of the neck backward or forward, like whiplash, are common causes of these fractures. This leads to instability of the neck and injury to the nerve roots or spinal cord.
Congenital stenosis is an inherited genetic trait that causes narrowing in the spine. C5 is at greater risk for this condition than other vertebrae lower in the spine.
In rare cases, tumors or infections could affect this spinal segment as well.
Signs of a C5-C6 Problem
Disc and vertebral pain stemming from C5-C6 can occur suddenly after an injury or begin to gradually increase over time. It is common to feel a dull ache or sharp pain in the back of the neck or to notice a loss in the neck’s normal range of motion. You may also hear a snap, crackle, or pop sound when the neck moves.
Compression and inflammation of the C6 spinal nerve can also cause additional symptoms such as pain in the shoulders, arms, hands, and fingers, often made worse by neck movement. Numbness and weakness through the arms and hands is also a common sign of this issue. Symptoms may appear on one or both sides of the body.
A severe injury to the spinal cord at the C5-C6 level can cause pain and weakness or even paralysis in the arms and legs. Breathing problems and a loss of bladder or bowel control are common signs of these injuries.
Treating the C5-C6 Spinal Motion Segment
Most injuries in the C5-C6 motion segment can be treated with non-surgical intervention. Only when pain and symptoms do not improve with time, or if the health of the nerve and spine worsen, will surgery be considered.
Non-surgical methods may include:
- Medication: Both over-the-counter and prescription pain relief can be offered when this area of the spine is injured. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually the first medication recommended, and if the pain is not managed, a doctor may prescribe opioids or corticosteroids. Supplements like calcium and vitamin D can also help strengthen bones and promote recovery.
- Neck braces: In order to immobilize and protect the next during the first few weeks of an acute injury, a neck brace may be suggested. This is common for fractures or recovery from surgery, as it can help not only the bones heal but surrounding tissues like ligaments and blood vessels.
- Manual therapy: Chiropractic adjustments and therapeutic exercise can be combined to improve the function of the neck, decrease pain, and increase the range of motion at the C5-C6 level. This can also improve head and neck balance and prevent falls.
- Injections: When radicular pain is caused by herniated discs or whiplash, steroids can be injected into the epidural space or the facet joints for pain relief. These injections can offer up to 11 months of pain relief while recovery takes place.
- Self-care: Basic self-care measures can help avoid worsening of the nerve pain. It is important to both rest and perform gentle movements, as well as avoid strenuous activity and improve posture.
If these methods are not effective, it may be recommended that surgery is performed. The goal of surgery may be to improve neck stability, relieve compression, or prevent further injury. Surgery is most commonly recommended in those who have severe and persistent pain and neurological or muscular deficits that prevent normal functioning.
Surgical methods used in the C5-C6 region include:
- Anterior cervical discectomy and fusion (ACDF): A surgeon removes the C5-C6 intervertebral disc in order to relieve pressure on the C6 nerve root or the spinal cord. The disc is then replaced by an implant or bone graft, allowing for the biological fusion of the C5 and C6 vertebrae.
- Cervical artificial disc replacement (ADR): Surgery is performed to remove a damaged disc and replace it with an artificial disc. This maintains motion in the segment while removing the irritant.
Posterior cervical decompression: A small part of a herniated disc is removed from the back of the cervical spine to relieve the pressure on surrounding nerves.
- Laminectomy: This occurs when a portion of the vertebral arch in the posterior region is removed in order to widen the spinal canal and relieve pressure on the spinal cord. This can impact C5, C6, or both.
Foraminotomy: The removal of excess or overgrown bones in the intervertebral foramen can relieve pressure on the spinal nerves.
- Lamnoforaminotomy: When a laminectomy and a foraminotomy are performed at the same time in order to relieve C6 nerve root compression.
The type of surgery will depend on the extent, location, and cause of any injury, as well as how many vertebral levels are involved. A doctor may choose to do multiple procedures at once.
After surgery, it is common to feel immediate relief from symptoms such as reduced pain, tingling, numbness, or weakness. However, it may also be necessary to use physical therapy to regain strength and ensure that range of motion returns. About four to six weeks is a common timeframe to expect to be actively working on this, though full recovery may not come for months.
For most injuries that do not require surgery, relief may be less immediate. Simple injuries may begin to heal within the first couple of weeks, while others can take months of slow progress. Factors like age, overall health, and lifestyle may also influence the speed of your recovery.
It will be important to work directly with your doctor and medical team to understand what a recovery process may look like for you. It’s possible that you will feel relief after a few days but need to continue with physical therapy and chiropractic care to ensure the problem does not return.
At AICA Jonesboro, our team of experts will work with you to identify the root cause of your symptoms and develop an appropriate care plan. By offering chiropractors, physical therapists, orthopedists, neurologists, pain management specialists, and others at one location, you are able to receive a fully integrated course of treatment.
We will begin by having you meet with chiropractors and physical therapists who can assess your condition and the extent of your injuries. If they determine you need to undergo diagnostic imaging, we offer a full range of scans onsite. When the results indicate a need for more invasive treatment options, our surgeons can work with your existing team to present you with the best options for your condition. Physical therapists will work with you throughout this to ensure you are focused on continuous movement, while pain management specialists ensure you are able to manage your symptoms during recovery.
To begin healing your C5-C6 injuries, contact AICA Jonesboro today.