C4-C5 Spine: Joint, Disc & Nerve Care in Kuala Lumpur

The C4-C5 segment is a critical motion and stability zone in the mid-cervical spine. This level connects upper neck movement to the lower cervical spine, enabling forward bending, backward extension, and smooth side motion. It houses one of the largest cervical discs — a common site for bulging, herniation, or degeneration seen on MRI or X-ray reports.

Because C4-C5 directly influences the C5 nerve root, changes here can affect not only neck motion but also shoulder strength, arm function, and nerve health. Problems at this level may also have cascading effects — stressing the upper cervical spine above and lower segments below, and in severe cases, even altering balance and gait.

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Takeaway: Key Points on C4-C5 Spine Care in Kuala Lumpur

• Movement & Support – C4–C5 is a key motion segment for head and shoulder movement.
• High-Risk Site – Among the top two or three cervical levels for disc herniations and degenerative changes.
• Nerve Connection – Protects the C5 nerve root, influencing shoulder and upper arm strength.
• Safe, Integrated Care – CSC combines non-rotatory chiropractic with targeted physiotherapy and rehabilitation tools for segment-specific recovery.
• Whole-Neck Impact – Dysfunction here often affects both upper cervical balance and lower cervical load distribution.

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Understanding the C4-C5 Segment

• Disc Structure – C4-C5 has one of the thickest cervical discs, designed to absorb shock and distribute load.
• Facet Joints – Direct smooth movement, prevent excessive rotation, and provide stability.
• Nerve Pathways – The C5 nerve root exits between C4 and C5, controlling the deltoid and contributing sensation to the upper arm.
• Load Sharing – Works with C5-C6 below (the most mobile level) and C3-C4 above to maintain posture and range of motion.

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Spinal Disc Bulges and Herniations at C4-C5

C4-C5 disc problems are common findings on MRI reports, often described as:

• Bulging Disc – Outer annulus weakens and pushes outward, narrowing nerve pathways.
• Herniated Disc – Inner nucleus pulposus pushes through an annular tear; can compress the C5 nerve or spinal cord.
• Extrusion or Sequestration – Advanced herniations where disc fragments migrate, increasing risk of cord compression.

Why this matters:
The C4-C5 disc can degenerate over time due to poor posture, repetitive strain, or trauma. Once weakened, it is more susceptible to tears, leading to nerve irritation, shoulder weakness, tingling in the arm, or loss of reflexes.

→ Please visit our related spinal disc posts and page on Disc Degeneration, Spinal Disc, Canal Stenosis, and of course ohow to take care of them by visiting our Slipped Disc

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Cervical Spondylosis at C4-C5

Cervical spondylosis is a general term describing degenerative changes in discs, vertebrae, and joints. At C4-C5, this can mean:

• Disc dehydration and height loss.
• Bone spur formation along vertebral edges and facet joints.
• Thickening of ligaments that can narrow the spinal canal or nerve openings.

These changes may reduce flexibility and increase stiffness, with symptoms ranging from mild motion loss to nerve compression.

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Spondylolisthesis at C4-C5

Spondylolisthesis is the forward or backward slippage of one vertebra over another. At C4-C5, it can:

• Narrow nerve pathways.
• Strain supporting ligaments.
• Accelerate degenerative changes in nearby discs and joints.

Elderly patients, those with trauma history, or those with congenital defects (spondylolysis) are more at risk. While these terms are confusing, it might be of help to you to learn the differences between them, so please visit an excellent post where the difference between spondylolisthesis, spondylolysis and spondylosis are discussed.

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Cervical Canal Stenosis and C4C5 Measurements

A healthy cervical spinal canal is generally 14–18 mm in diameter, though individual anatomy varies. Stenosis at C4-C5 means narrowing that may compress the spinal cord or nerve roots.

Signs may include:

• Neck stiffness or Neck Discomfort or pain
• Arm weakness or tingling
• Balance problems or changes in gait
• In severe cases, signs of spinal cord compression (myelopathy)

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Whiplash and C4-C5 Injuries

C4-C5 is the second most mobile segment after C5-C6, making it vulnerable in whiplash from motor vehicle accidents, sports collisions, or falls. Hyperflexion and hyperextension forces or whiplash injuires can:

• Injure discs and ligaments.
• Strain facet joints.
• Cause microscopic tears that may lead to degeneration years later.

Some symptoms appear immediately; others may remain hidden for months before surfacing.

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Unsafe Neck Techniques to Avoid

Techniques such as the Ring Dinger®, Y-Strap, towel jerks, and high-force twisting can:

• Overstretch ligaments.
• Aggravate disc injuries.
• Endanger vertebral arteries.

Even if they feel relieving at the moment, they can accelerate degeneration or trigger new injuries. CSC does not use these methods.

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Patient-, Condition-, and Age-Specific C4-C5 Care

C4–C5 care at CSC is customized for:

• Children – No rotatory adjustments; focus on gentle mobilization, posture correction, and soft tissue work.
• Elderly – Gentle positioning to avoid stressing arthritic joints and fragile tissues.
• Women – Adapting force and positioning for smaller neck structures.
• Athletes – Sport-specific rehab to restore strength and motion without overloading healing tissues.

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Upper Cervical Health and C4–C5

C4–C5 is influenced by the biomechanics of the upper cervical spine (C0–C3). Poor upper neck alignment can:

• Increase mid-cervical strain.
• Alter shoulder mechanics.
• Affect balance and head posture.

CSC addresses upper cervical tension through gentle suboccipital muscle release, occipital glides, and postural correction.

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Integrated, Non-Invasive C4–C5 Care at CSC

Our programs may include:

• Spinal Decompression – Reduces disc pressure without rotation or force.
• NSD Therapy® – A highly focused and non-surgical protocols in helping spinal joint and spinal disc patients recover without surgery
• High-Intensity Laser Therapy (HILT) – Stimulates deep tissue repair.
• Therapeutic Ultrasound – Applied to posterior and lateral neck to target SCM and supporting muscles.
• Shockwave Therapy – For trapezius and rhomboid tension.
• Electrotherapy & Biothermal Devices – Improve circulation and reduce muscle guarding.
• Gentle Chiropractic – Using Activator®, Thompson drop, or flexion-distraction — all non-rotatory.
• Soft Tissue & Fascia Therapy – Gentle release for trigger points, suboccipitals, and upper back stabilizers.

Why Aggressive Neck Methods Are Unsafe (Y-Strap, Ring Dinger®, Magic Hug, Occipital Lifts, Towel Pulls)

Forceful neck manipulations like the Y-Strap, Ring Dinger®, Magic Hug, occipital lifts, and towel pulls create uncontrolled traction or rotation in delicate cervical structures. These methods can overstretch ligaments, strain muscles, or place sudden pressure on discs, facet joints, and the vertebral arteries.

Risks increase for those with disc herniations, canal stenosis, vascular issues, or age-related degeneration. Even if they provide temporary relief, these techniques may accelerate wear, cause instability, or trigger new symptoms months or years later.

At CSC, we never use these methods. Instead, we rely on controlled, non-rotatory chiropractic adjustments and evidence-based physiotherapy for safe, lasting results.

Where to post: After your “Non-Invasive Solutions for C4–C5” section, before the “Summary.”

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Why Aggressive Neck Methods Are Unsafe (Y-Strap, Ring Dinger®, Magic Hug, Occipital Lifts, Towel Pulls)

Forceful neck manipulations like the Y-Strap, Ring Dinger®, Magic Hug, occipital lifts, and towel pulls create uncontrolled traction or rotation in delicate cervical structures. These methods can overstretch ligaments, strain muscles, or place sudden pressure on discs, facet joints, and the vertebral arteries.

Risks increase for those with disc herniations, canal stenosis, vascular issues, or age-related degeneration. Even if they provide temporary relief, these techniques may accelerate wear, cause instability, or trigger new symptoms months or years later.

At CSC, we never use these methods. Instead, we rely on controlled, non-rotatory chiropractic adjustments and evidence-based physiotherapy for safe, lasting results.

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Summary

C4-C5 is a high-importance motion segment that affects both neck and shoulder function. When injured or degenerated, it can lead to pain, weakness, and reduced quality of life. CSC’s approach combines precision assessment, gentle chiropractic, and targeted physiotherapy for safe, lasting recovery.

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Neck Care: From C0–C1 to C7–T1

The cervical spine is made up of seven vertebrae from C0–C1 (occiput–atlas) down to C7–T1, where the neck meets the upper back. Each segment has a unique role in movement, stability, and nerve protection.

• C0–C1 & C1–C2: Allow most of the head’s nodding and rotation, closely tied to balance and coordination.
• C2–C3: Supports neck turning and side bending, often linked to tension headaches.
• C3–C4: Assists in stability and protects nerves to the upper chest and shoulders.
• C4–C5: A high-motion segment vital for head, neck, and shoulder movement — often affected by disc herniations or joint degeneration that may weaken the shoulder or alter sensation in the upper arm.
• C5–C6: Common site for degenerative changes; impacts arm strength and wrist extension.
• C6–C7: Influences grip strength and hand coordination.
• C7–T1: Connects to the upper back, supporting load transfer between the neck and thoracic spine.

At Chiropractic Specialty Center®, care for all neck segments is tailored to the patient’s condition, age, and structural needs, combining gentle chiropractic, physiotherapy, and rehab — without high-force twisting or risky methods.

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C4-C5 Spine: Key Statistics

• High Prevalence of Degeneration – Imaging studies show that over 35–40% of adults above 40 years have measurable C4-C5 disc degeneration, even if they have no symptoms. By age 60, that number rises to more than 65%.
• Common Herniation Site – C4-C5 ranks among the top three cervical segments for disc herniations, with 14–18% of all cervical herniations occurring at his level.
• Disc Height & Size – The average C4-C5 disc height is 4.0–4.5 mm in adults, with the anterior portion slightly taller than the posterior. This disc is typically the second-thickest in the neck after C5-C6, making it a primary load-bearing structure.
• Nerve Involvement – C5 nerve root compression from C4-C5 changes is found in up to 25% of cervical radiculopathy cases reported in clinical series.
• Canal Stenosis Rates – Cervical spinal canal narrowing at C4–C5 is seen in about 15% of asymptomatic adults over 50, and in over 35% of patients with myelopathy.
• Facet Joint Hypertrophy – C4–C5 facet enlargement or osteoarthritis appears in more than 30% of cervical spondylosis patients, often contributing to nerve compression.

References – C4-C5 Statistics

1. Matsumoto M, Fujimura Y, Suzuki N, et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg Br. 1998;80-B(1):19-24.
2. Teresi LM, Lufkin RB, Reicher MA, et al. Asymptomatic degenerative disc disease and spondylosis of the cervical spine: MR imaging. Radiology. 1987;164(1):83-88.
3. Morishita Y, Naito M, Hymanson H, et al. The kinematic relationships of the upper and lower cervical spine: the effect of age and degeneration. Spine. 2009;34(2):E72-E78.
4. Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. Brain. 1994;117(2):325-335.
5. Kang Y, Lee JW, Koh YH, et al. New MRI grading system for the cervical canal stenosis. AJR Am J Roentgenol. 2011;197(1):W134-W140.
6. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine. 1986;11(6):521-524.

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References for C4-C5 Spinal Segment & Care

1. Bogduk N, Mercer S. Biomechanics of the cervical spine. I: Normal kinematics. Clin Biomech. 2000;15(9):633-648.
2. Adams MA, Dolan P. Spinal biomechanics. J Biomech. 2005;38(10):1972-1983.
3. Ghiselli G, Wang JC, Bhatia NN, Hsu WK, Dawson EG. Adjacent segment degeneration in the cervical spine. J Bone Joint Surg Am. 2004;86(7):1497-1503.
4. Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. Brain. 1994;117(2):325-335.
5. Suri P, Hunter DJ, Rainville J, Guermazi A, Katz JN. Cervical spine stenosis: anatomy, pathophysiology, and clinical implications. PM R. 2010;2(7):640-653.
6. Iatridis JC, Setton LA, Foster RJ, Rawlins BA, Weidenbaum M, Mow VC. Degeneration affects the anisotropic and nonlinear behaviors of human annulus fibrosus in compression. J Biomech. 1998;31(6):535-544.
7. Chiu TT, Lam TH, Hedley AJ. A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain. Spine. 2005;30(1):E1-E7.
8. Graham N, Gross AR, Goldsmith CH, et al. Mechanical traction for neck pain with or without radiculopathy.Cochrane Database Syst Rev. 2008;(3):CD006408.
9. Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain. Lancet. 2009;374(9705):1897-1908.
10. Notarnicola A, Maccagnano G, Gallone MF, et al. Extracorporeal shockwave therapy in the treatment of chronic neck pain. Muscles Ligaments Tendons J. 2016;6(1):81-86.

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Meet the Author: C4–C5 Spinal Joint & Disc Care in Kuala Lumpur

Written by Y. Zafer, this article on C4–C5 Spine: Joint, Disc & Nerve Care in Kuala Lumpur draws from nearly three decades of clinical experience integrating chiropractic and physiotherapy for cervical spine health.

Last Updated: C4–C5 Spine: Joint, Disc & Nerve Care in Kuala Lumpur

This page was last updated on August 10, 2025, to provide the most current and accurate guidance on C4–C5 care.

FAQ – C4–C5 Spinal Joint, Disc & Nerve Care

Conclusion

C4–C5 health is essential for comfortable neck and shoulder movement. CSC’s integrated, non-invasive approach protects discs, joints, and nerves while restoring mobility.

Summary Table – C4–C5 Spine

Feature	Details
Segment	C4–C5 – central cervical mobility zone
Key Functions	Neck flexibility, shoulder movement, nerve protection
Common Issues	Disc herniation, facet degeneration, foraminal narrowing
CSC Approach	Gentle chiropractic, physiotherapy, posture rehab

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