Yes, problems at the C5-C6 level of the cervical spine can cause swallowing difficulties, a condition known as dysphagia. The C5-C6 segment sits directly behind your esophagus and near the cricoid cartilage at the base of your throat, making it one of the most likely spinal levels to interfere with swallowing when bone spurs, disc problems, or other structural changes develop there.
Why C5-C6 Is Especially Vulnerable
Your esophagus runs just in front of your cervical spine, separated by only a thin layer of soft tissue. At the C5 and C6 level, the esophagus is physically anchored to the cricoid cartilage, a ring of firm cartilage at the top of your windpipe. This anchoring means the esophagus can’t simply shift out of the way when something pushes against it from behind.
Research published in the American Journal of Roentgenology found that even small bone spurs can cause obstruction when they press against this specific spot where the esophagus meets the cricoid cartilage, most often at C5 and C6. Larger bone spurs, those exceeding 10 mm in thickness, cause aspiration (food or liquid entering the airway) in about 75% of affected patients, compared to 34% for smaller spurs. But size isn’t the only factor. Location matters just as much, and C5-C6 is the location where even modest changes can create problems.
How C5-C6 Problems Block Swallowing
There are several ways that spinal changes at this level interfere with the swallowing process:
- Direct compression. Bone spurs or a bulging disc physically narrow the space the esophagus needs to pass food through.
- Inflammation and muscle spasm. Friction between bone spurs and the soft tissue of the esophagus triggers local inflammation, which tightens the surrounding muscles and further narrows the passage.
- Restricted movement of the epiglottis and larynx. Your epiglottis (the flap that covers your airway when you swallow) needs to tilt freely. Bone growths at C3 through C6 can physically limit this motion, increasing the risk of choking or aspiration.
- Food retention. When the throat wall narrows, food can pool in pockets rather than moving smoothly downward.
Anterior disc herniations at C5-C6 can also contribute, though this is far less common. The front portion of a cervical disc has no nerve structures nearby, and the esophagus is flexible enough that it usually tolerates mild pressure. It typically takes severe forward disc herniation pressing against the cricoid cartilage to produce noticeable swallowing trouble.
What It Feels Like
The most common symptom is difficulty swallowing solid foods, particularly large bites or dry, dense textures. Some people describe a sensation of food getting stuck in the throat or a persistent feeling of a lump that won’t clear. Other symptoms that can accompany the swallowing difficulty include neck pain (present in roughly 40% of reported cases), voice changes or hoarseness (about 15%), and in more severe situations, breathing difficulty or stridor (about 11%).
Weight loss is a real concern. Among reported cases of cervical spine-related dysphagia, about 11% of patients lost more than 10 kilograms between the onset of symptoms and the time they sought treatment, simply because eating became so uncomfortable they ate less. Aspiration pneumonia, caused by food or liquid repeatedly entering the lungs, occurred in about 5% of cases.
DISH and Bone Spur Growth
One of the most common underlying conditions behind cervical dysphagia is diffuse idiopathic skeletal hyperostosis, sometimes called Forestier disease. This condition causes excessive bone growth along the front of the spine, and it most frequently affects the C3 through C6 region, with C4 and C5 being the most commonly involved levels. The bone spurs can span multiple vertebrae, sometimes stretching from C2 all the way down to C7, creating a shelf-like ridge that pushes into the esophagus from behind.
DISH tends to affect people over 50 and is more common in men. It progresses slowly, so swallowing problems often develop gradually over months or years rather than appearing suddenly. Many people adapt by unconsciously switching to softer foods before realizing how much their diet has changed.
How It’s Diagnosed
If you’re experiencing swallowing problems alongside neck stiffness or pain, imaging of the cervical spine is the key diagnostic step. A lateral X-ray of the neck can reveal large anterior bone spurs, but a CT scan provides much more detail about the size and location of bony growths. A barium swallow study, where you swallow a contrast liquid while being filmed under fluoroscopy, shows exactly where and how the esophagus is being compressed in real time. In some cases, an endoscopy (a camera passed down the throat) helps rule out other causes like tumors or strictures in the esophagus itself.
The combination of imaging the spine and observing the swallow in motion gives the clearest picture. Bone spurs alone don’t always explain the symptoms, since many people have cervical osteophytes on imaging without any swallowing trouble at all. The functional swallow study confirms whether the structural changes are actually causing the problem.
Swallowing Problems After C5-C6 Surgery
It’s worth noting that swallowing difficulties can also result from surgical treatment of C5-C6 problems. Anterior cervical discectomy and fusion, the most common surgery for herniated discs and spinal cord compression at this level, involves approaching the spine through the front of the neck, which means retracting the esophagus and trachea to one side.
A prospective study tracking patients after anterior cervical surgery found dysphagia rates of about 50% at one month, dropping to 32% at two months, 18% at six months, and 13% at one year. The good news: by six months, only about 5% of patients still had moderate or severe swallowing symptoms. Most post-surgical dysphagia is mild and resolves on its own as the tissue swelling goes down.
The more serious surgical risk is injury to the recurrent laryngeal nerve, which runs close to the esophagus and trachea. This nerve controls the vocal cords, and damage to it can cause hoarseness, difficulty swallowing, and aspiration. It can be injured by direct contact during the procedure, by retraction pressure, or even by the breathing tube pressing against it during surgery. Vocal cord weakness was still present in about 1.3% of patients a full year after surgery. In some cases, the nerve recovers on its own over several months; in others, the damage is permanent.
Managing Symptoms Without Surgery
For mild to moderate swallowing difficulty caused by C5-C6 bone spurs, non-surgical approaches are typically tried first. Switching to softer foods, cutting food into smaller pieces, and eating slowly with plenty of liquid can reduce the sensation of food getting stuck. Anti-inflammatory medications can help when swelling around the bone spurs is contributing to the narrowing. Some people benefit from working with a speech-language pathologist who specializes in swallowing therapy, learning techniques to position the head and neck in ways that open up the narrowed passage during meals.
Surgery is generally reserved for cases where swallowing is severely impaired, where aspiration pneumonia has developed, or where breathing is affected. The procedure involves removing the offending bone spurs from the front of the vertebrae. When the bone growths span multiple levels or are associated with spinal instability, fusion of the affected segments may also be necessary. Recurrence of bone spur growth after surgery is possible, particularly in people with DISH, so long-term follow-up is important.