Cervical Instability is NOT what it always seems to be - Upper Cervical Chiropractor Spokane

Dr Jeffrey Hannah
Blair Upper Cervical Chiropractor
@ Clear Chiropractic Spokane

https://clearchirospokane.com
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Chronic Neck Pain: Making the Connection Between Capsular Ligament
Laxity and Cervical Instability

https://www.ncbi.nlm.nih.gov/pmc/arti...

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In the past year, I've had more people reach out to my practice for "craniocervical instability," "C1-C2 subluxation" and "ehlers danos syndrome" than I have had in the entire preceding decade.

Personally, I suspect that one of the major reasons is thanks to this particular article, which is an excellent review of cervical spine anatomy, the origin of neck pain, vertigo, headaches, and other neurological symptoms related to whiplash and head posture disorders. Nevertheless, there is a small yet VERY SIGNIFICANT detail that I where I want to disagree in this article.

The authors first explain how it is your cervical spine that provides the bulk of movement of your vertebral column. The exchange for flexibility, however, is stability. Nowhere in your entire spine is this more important than at the intersection between your skull and neck at the C0-C1-C2 complex, which is otherwise known as the craniocervical junction.

There are no discs to lock the vertebrae in place up here. Instead, the area is suspended by muscles and ligaments. The trade is that this area is especially susceptible to injury as it is the weakest link in the chain that is your spine. Any injury - whether a whiplash injury or even a fall on your tailbone - will direct the force to the point of least resistance. Because your C1 supports the weight of your skull, if these ligaments are injured, your brain will cause muscle and posture distortions everywhere beneath your C1 in order compensate. This can ultimately lead to pain and other problems elsewhere in your body you would never think are connected with your neck. In addition, because your C1 has a direct, intricate relationship with your brainstem, it can also cause a wide array of neurological problems as well.

The authors contend that ligament instability or stretching, which is especially common at the C1-C2 space is particularly important in the development of chronic neck pain, headaches and vertigo-dizziness disorders.

They propose that in order to identify cervical instability that a digital motion x-ray (DMX) is the best way to identify the problem, and that prolotherapy (an injection into the ligament designed to tighten the connective tissues) may be an effective solution.

In this regard, I do not disagree with anything that the authors have outlined. However, I should like to add and clarify a few important points.

1. The C1-C2 is your body's universal compensation joint. When you have a problem either above or below, your body will use the C1-C2 space to compensate for it. Therefore, unless that underlying issue is resolved, prolotherapy alone may not solve the issue.

2. Entrapment of the joint ligaments, which decreases the motion at particular joints is what, in my opinion, precedes compensatory excessive movement in other areas. I agree with the authors that you do NOT want any extra motion through areas already moving too much. However, I disagree with them on the sole underlying mechanism that can produce excessive ligament motion. In my experience, the C1-C2 area should be left alone until the C0-C1 and C2-C3 joints are first verified to be moving properly.

3. DMX studies are not the only way to study the cervical joints. Scans known as digital articular x-rays (DAX) or CBCT scans can also demonstrate exactly how the joints of your spine are designed to fit together, as well as if there is any disrelationship.

In the end, what we find is that many issues of supposed cervical instability, subluxation and ehlers-danos are not actually the genuine thing. Fortunately, that means that there are many treatment options available that can still get to the root of the problem to offer long term relief.

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Dr Jeffrey Hannah
Blair Upper Cervical Chiropractor
@ Clear Chiropractic Spokane

https://uppercervicalspokane.com
https://clearchirospokane.com