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Cervical Instability

A scan of cervical instability

Cervical Instability

Cervical instability, also called cervical instability of the cervical spine (CICS), is a health condition in which ligaments of the upper cervical spine (as opposed to the low back in sacroiliac joint pain) become loose and may lead to symptoms of pain, dizziness, vertigo, tinnitus, brain fog and in severe cases nerve damage. There are many more symptoms associated with cervical instability but these are the most common.

What Causes Cervical Instability?

There are several possible risk factors and causes of cervical instability:

  • Trauma: Any traumatic event, such as a road traffic accident, blow, or a similar impactful incident, may injure the cervical spine and sprain the ligaments, leading to chronic cervical instability.
  • Repetitive injuries: Repeated overuse leads to micro-tears in the ligaments and surrounding structures of the cervical spine, leading to laxity of the cervical ligaments.
  • Genetic disorder: People with certain syndromes such as Down Syndrome, and Ehlers-Danlos, frequently experience cervical instability as a symptom.
  • Rheumatoid arthritis (RA): Arthritic conditions such as RA can also cause cervical instability due to progressive deterioration in the joints and the neck vertebrae.

Symptoms Of Cervical Instability

Cervical instability symptoms often mimic other musculoskeletal, orthopaedic, and neurologic disorders. However, certain primary signs and symptoms show that the condition you are having is actually CICS. These include:

  • Dizziness
  • Vertigo
  • Tinnitus
  • Brain fog
  • Recurring headache
  • Stiff or tight neck
  • Pain and tenderness in the upper neck towards the skull base
  • Struggle to hold up your head for a prolonged period
  • Heaviness in the head
  • Pain aggravating to the shoulder
  • Balance issues
  • Shakiness in the head and neck

A lady with cervical instability holding her neck

How Do You Fix Cervical Neck Instability?

The following five treatment options are considered by evidence to be the most effective.

1. Chiropractic

A common treatment for cervical instability is chiropractic care. This is used to treat symptoms such as poor posture, headache, and spinal misalignment. This treatment utilized for the upper cervical region can potentially help the condition, but unfortunately can sometimes make it worse.

A 2020 study reported that chiropractic manipulative therapy of the spine is an effective therapy for the correction of cervical instability together with other disorders. Spinal manipulation is reported to be safe and efficacious when performed by an experienced chiropractor. 

2. Surgery

In rare severe cases of cervical instability surgery may be required. In most surgical approaches, the objective is the correction of craniocervical junction dysfunction at the junction between the skull and the upper spine.

Surgical treatments include:

  1. Cervical fusion spine surgery
  2. Screw-rod constructs
  3. Halifax clamp
  4. Posterior sublaminar wiring
  5. Transarticular screws

However, as surgical procedures are invasive and more expensive, doctors generally begin with more conservative treatments first.

3. Physical Therapy

Another effective method for CICS is physical therapy. Doctors generally suggest physical therapy along with chiropractic care. It involves:

  • Posture education
  • Strengthening exercises
  • Soft tissue mobilization
  • Joint mobilization
  • Spinal manipulation
  • Proprioception exercises

Your doctor might advise wearing a cervical collar or a brace depending on the severity of your condition.

4. Strengthening Exercises

You can try strengthening exercises to treat and prevent cervical instability such as:

  1. Chin tucks – support your posture and neck joints and are the most frequently used strengthening exercises used for the improvement of cervical instability.
  2. Isometric exercises – give strength to the neck area with its active range of motion.
  3. Rotating the neck – leads to a slow and periodic strengthening of the muscles and joints surrounding the upper cervical spine.
  4. Yes and no neck motions  aids in stretching the joints and muscles of the neck. Slow nodding is done in a yes motion. The head is shaken in no motion.
  5. Practising good posture – decreases pressure from the spine. Every day good posture should be practised for as long as possible. Every passing day you should be able to practice good posture for a longer duration.

You should consult your physician before starting any of these exercises and stop if any of them cause pain.

5. Prolotherapy and Prolozone Therapy      

Prolotherapy and Prolozone Therapy are deemed as the most effective treatment options for cervical instability.

They are classed as regenerative treatments that involve a series of injections to enhance the natural healing process of your body to strengthen and repair damaged ligaments and joints.

Several patients opt for a combination of chiropractic care, physical therapy and prolotherapy.

The following video is of a patient of ours who has had good results with the Prolotherapy we offer at the clinic:

How to Prevent Cervical Instability?

Generally, cervical instability occurs in people with connective tissue disorders. People who are at an increased risk, for example, Ehlers-Danlos syndrome, need to avert cervical instability.

For the prevention of cervical instability, you need to visit your chiropractor, practice strengthening exercises, mindfully sit in a good posture every day, and evade circumstances that can potentially cause whiplash or spinal trauma.

All patients should practice these tips for improved general health, especially those with connective tissue diseases or defects in the spine or neck.

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