C5-C6 Disc Herniation: Symptoms and Treatment
The C5-C6 level in the neck has a lot of movement and is one of the most common sites of cervical disc herniation. Disc material can compress the C6 nerve root and cause cervical radiculopathy.
Typical symptoms
- Neck pain radiating to the shoulder, outer arm and forearm
- Numbness or tingling in the thumb and index finger
- Weakness of the biceps or wrist extensors
- Symptoms worse when looking up or turning the head
Clumsiness of the hands, gait problems or bladder problems may indicate spinal cord compression (myelopathy) and need urgent assessment.
Further reading: the guide “Cervical Disc Herniation” and the articles Shoulder Blade Pain: Causes and Treatment and Supraspinatus Tendinitis (Rotator Cuff Tendinopathy).
Diagnosis
Neurological examination is central [3]. MRI shows the herniation; EMG and nerve conduction studies help distinguish radiculopathy from other causes such as carpal tunnel syndrome or shoulder problems.
Treatment
Most cervical radiculopathy improves with non-surgical care [1]. Options include:
- Exercise and physiotherapy
- Manual therapy combined with exercise [2]
- Pain medicines and, in selected cases, injections
- Short-term activity modification
Surgery is considered for progressive weakness, myelopathy or persistent severe pain.
What a C5–C6 disc herniation is
The spine in the neck (cervical spine) has seven vertebrae separated by intervertebral discs, which act as shock absorbers. Each disc has a tough outer ring and a soft inner core. In a herniation, part of the core pushes through the ring and can press on a nerve root (radiculopathy, irritation of the nerve as it leaves the spine) or, less often, on the spinal cord itself (myelopathy). The C5–C6 level is one of the most commonly affected because it moves a lot. At this level the C6 nerve root is usually involved, which explains the typical pattern of pain and tingling towards the thumb.
Typical course
The natural course is often favourable. In many people, arm pain eases over weeks to a few months as inflammation settles and the herniated material shrinks. Numbness may take longer to resolve than pain, and mild weakness often recovers gradually. A minority have persistent or recurrent symptoms. The course of myelopathy is different: it can progress and requires prompt specialist assessment.
What the examination looks at
Your physical medicine and rehabilitation (PM&R) specialist examines neck movement, posture, the distribution of pain and numbness, muscle strength, reflexes (for example the biceps and brachioradialis reflexes) and signs of spinal cord involvement such as hand clumsiness, brisk reflexes in the legs or gait disturbance. The shoulder, elbow and wrist are also examined, because shoulder problems and nerve entrapment at the wrist can cause similar symptoms. Imaging findings are interpreted together with the examination, because disc changes are also common in people without symptoms.
Rehabilitation in general terms
- Education and activity guidance: staying active within comfortable limits rather than prolonged rest.
- Exercise: gentle range-of-motion exercises, deep neck flexor and shoulder blade stabilising exercises, and gradual strengthening.
- Posture and ergonomics: screen at eye level, regular breaks, supportive pillow.
- Manual therapy combined with exercise in suitable patients.
- Pain relief with medication and, in selected cases, image-guided injections.
The programme is planned by your physical medicine and rehabilitation specialist and the physiotherapist and adjusted according to symptoms and examination findings.
What you can do at home
- Avoid sustained positions with the head bent forward or tilted back; change position often.
- Keep the phone at eye level rather than looking down for long periods.
- Use a pillow that keeps the neck in a neutral position during sleep.
- Apply heat or cold for short periods if it relieves pain.
- Do the prescribed exercises regularly and slowly; stop an exercise that clearly increases arm pain and report it.
- Avoid heavy lifting overhead and contact sports until symptoms have settled.
When to consult your PM&R specialist
Seek review if arm pain persists beyond a few weeks, disturbs sleep or limits work, or if numbness or weakness is increasing. Seek urgent assessment for loss of hand dexterity (for example dropping objects or difficulty with buttons), unsteady walking, bladder or bowel problems, or weakness in both arms or legs, because these may indicate spinal cord compression.
Frequently asked questions
Is a neck collar useful? Short-term use may relieve pain, but long-term use is not recommended.
Why does a neck problem cause arm pain? The nerve root that leaves the neck supplies the arm. See Neck pain radiating to the shoulder.
How long does recovery take? Many people improve significantly within 6–12 weeks, although numbness can take longer. The time frame varies with the size of the herniation and individual factors.
Can I keep working at a desk? Usually yes, with regular breaks, a well-adjusted workstation and gradual return to full duties as pain allows.
Assessment and contact
You can request an appointment or a second-opinion review of existing reports and imaging: Contact & second opinion (WhatsApp). This page is general health information. Diagnosis and treatment decisions are made individually after examination.
Sources
- Plener J, et al. Conservative Management of Cervical Radiculopathy: A Systematic Review. Clin J Pain. 2023. PMID: 36599029
- Borrella-Andrés S, et al. Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review. Biomed Res Int. 2021. PMID: 34189141
- Yousif MS, et al. Neurological examination for cervical radiculopathy: a scoping review. BMC Musculoskelet Disord. 2025. PMID: 40188056