C5-C6 Disc Bulge Charlotte NC | Symptoms, MRI Findings, Treatment Evidence | Clear Life Scoliosis

By Dr. Justin Dick, DC (ORCID 0009-0001-2794-2159) · Clear Life Scoliosis and Chiropractic Center, Charlotte, NC · Published November 10, 2026

C5-C6 is the disc level most often affected in the neck, and a bulge there is common in people with no symptoms. Nakashima and colleagues scanned 1,211 adults without neck symptoms and found disc bulging in 87.6 percent overall, most often at C5-C6 (41 percent of bulges) and C6-C7 (27 percent). A bulge becomes clinically important when it matches symptoms and exam findings, especially arm pain, numbness, or weakness in the C6 nerve distribution. In Radhakrishnan's Rochester population study of 561 people with cervical radiculopathy, 90 percent were asymptomatic or only mildly limited at a median follow-up of 4.9 years, and 26 percent had surgery.

I am Dr. Justin Dick, DC, at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. I hold CNMT and ARRT(N)(CT) imaging credentials and read neck MRIs for scoliosis and motor vehicle collision patients. This post explains what a C5-C6 finding does and does not mean.

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What a C5-C6 Bulge Is

A bulge is disc material extending beyond the vertebral edges over a broad area. A protrusion or extrusion is more focal. My post on disc terms on MRI reports defines each. The C6 nerve root exits at C5-C6. When it is compressed, the typical pattern is pain into the arm and forearm with numbness toward the thumb and index finger and weakness in elbow flexion or wrist extension. That distribution is standard clinical anatomy and varies between people.

Why It Is So Common Without Symptoms

In Nakashima's study, bulging appeared in 73.3 percent of men and 78.0 percent of women in their 20s and increased after 50. Spinal cord compression appeared in 5.3 percent and cord signal change in 2.3 percent of these symptom-free adults. A C5-C6 bulge on a report is not by itself an explanation for neck pain. See my post on MRI findings in people without pain.

Diagnosing Nerve Root Involvement

Wainner and colleagues studied 82 patients and found a four-item exam cluster had a positive likelihood ratio of 30.3 when all items were positive, with wide confidence intervals; the upper limb tension test was best for ruling the condition out. The MRI level and the exam need to agree. My post on pinched nerve vs herniated disc explains the difference.

What the Treatment Trials Show

Kuijper and colleagues randomized 205 people with recent-onset cervical radiculopathy to a collar, physiotherapy, or wait-and-see. Arm pain fell in all groups; the collar and physiotherapy groups had about 12 mm more reduction on a 100 mm scale by six weeks. Engquist and colleagues compared surgery plus physiotherapy with physiotherapy alone in 63 patients and found no difference in neck disability or arm pain at two years, with neck pain favoring surgery; they recommended structured physiotherapy before surgery. Progressive weakness or signs of spinal cord compression change that calculation and need surgical evaluation.

C5-C6 After a Car Accident

Because bulges are common before any injury, documenting whether a C5-C6 finding is new or pre-existing requires prior imaging when it exists, the timing of symptoms, and the exam. My post-collision cervical case report describes one patient with neurological change after a collision; it is a single case and cannot establish causation. Our personal injury program describes how these cases are documented.

How Dr. Justin Dick, DC Evaluates C5-C6 Findings at Clear Life

At our Charlotte office, the MRI is read alongside a dermatome, myotome, and reflex exam, flexion and extension films are used when instability is a question, and patients with progressive weakness or cord signs are referred for surgical opinion.

Comparison

Research and Evidence

Evidence tiering: Kuijper and Engquist are randomized trials; Radhakrishnan a population-based cohort; Nakashima a large cross-sectional MRI study; Wainner a diagnostic accuracy study with wide confidence intervals. The C6 symptom pattern is standard clinical anatomy.

My own published work: Radiographic Sagittal Alignment and Neurological Changes Following Conservative Cervical Structural Rehabilitation After Motor Vehicle Collision in a Patient With Pre-existing Scoliosis: A Case Report (Cureus, 2026, PMID 41783554), a single-patient report, and A Retrospective Cross-Sectional Analysis of Abnormal Cervical Mechanics in Patients With Scoliosis (Cureus, 2025, PMID 41018459), a retrospective study of cervical mechanics in scoliosis patients.

References

1. Nakashima H, Yukawa Y, Suda K, et al. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine. 2015;40(6):392-8. doi:10.1097/BRS.0000000000000775
2. Radhakrishnan K, Litchy WJ, O'Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117(Pt 2):325-35. doi:10.1093/brain/117.2.325
3. Wainner RS, Fritz JM, Irrgang JJ, et al. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003;28(1):52-62. doi:10.1097/00007632-200301010-00014
4. Kuijper B, Tans JT, Beelen A, Nollet F, de Visser M. Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial. BMJ. 2009;339:b3883. doi:10.1136/bmj.b3883
5. Engquist M, Löfgren H, Öberg B, et al. Surgery versus nonsurgical treatment of cervical radiculopathy: a prospective, randomized study comparing surgery plus physiotherapy with physiotherapy alone with a 2-year follow-up. Spine. 2013;38(20):1715-22. doi:10.1097/BRS.0b013e31829ff095
6. Dick JM, Paige P. Radiographic sagittal alignment and neurological changes following conservative cervical structural rehabilitation after motor vehicle collision in a patient with pre-existing scoliosis: a case report. Cureus. 2026;18(3):e104584. doi:10.7759/cureus.104584
7. Dick JM. A retrospective cross-sectional analysis of abnormal cervical mechanics in patients with scoliosis. Cureus. 2025;17(8):e91098. doi:10.7759/cureus.91098

Frequently Asked Questions

Service Area

Clear Life Scoliosis and Chiropractic Center sees patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, Fort Mill SC. Families from across the Charlotte region and the South Carolina border communities come to the Rachel Freeman Way office for radiographic scoliosis evaluation with Dr. Justin Dick, DC.

Related Pages

• Disc Terms on MRI Reports
• MRI Findings Without Pain
• Pinched Nerve vs Herniated Disc
• Neck Injury After a Car Accident
• Upper Extremity Symptoms After a Car Accident
• Cervical Alignment
• Tech Neck
• Cervical Rehabilitation After a Collision Case
• Personal Injury Program
• Cervical Mechanics in Scoliosis Study

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If your MRI shows a C5-C6 bulge, the next question is whether it matches your exam. Dr. Justin Dick, DC answers that at our Charlotte office.

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