Cervical spinal instability is a medical problem in which your ligaments lose in the upper cervical spine lead to neural damage and a larger list of symptoms. 

If you suffer from cervical instability, you may experience migraines, nausea or vertigo. Although this condition is not curable yet, it is treatable. 

A Cervical instability 

A cervical instability occurs when the ligaments between the skull and spinal cord are loose. These “lax ligaments” allow excess movement of the top couple of cervical vertebrae resulting in symptoms like headaches, fainting and even memory loss. 

Ligament laxity causes chronic pain and may affect specific parts or the whole body. You may experience a hyperextend finger, seeming unnaturally causing joint hypermobility syndrome. In this condition, the ligaments that connect finger bones loosen, allowing an increased range of motion. At the same time, the abnormal range of motion in the neck area triggers cervical instability. 

Genetic connective tissue disorders like Marfan syndrome or Ehlers-Danlos cause ligament laxity. The joints at which ligaments loss may lead to cervical instability are  

  • Atlanto-occipital joint  
  • Atlanto-axial joint 

Cervical instability is also called as  

  • Craniocervical instability 
  • Craniovertebral instability  
  • Clinical cervical spine instability 
  • Cervical neck instability  
  • Cervical spine instability  
  • Atlantoaxial instability. 

Cervical instability symptoms  

The major symptoms of cervical instability include 

  • A feeling of falling off the skull from the spine  
  • Occipital headaches  
  • Migraines  
  • Muscle spasms 
  • Neck, jaw or shoulder pain. 
  • Difficulty in swallowing  
  • Tenderness at the skull base  
  • Light sensitivity  
  • Blurred vision  
  • Ringing in ears (tinnitus)  
  • Orthostatic intolerance  
  • Tremors 
  • Vertigo 
  • Clumsiness  
  • Dizziness  
  • Fainting  
  • Limb weakness  
  • Breath shortening  
  • Nausea  
  • Fatigue  
  • Lhermitte’s sign  
  • Cognitive decline 
  • Memory loss 

How to diagnose cervical instability  

There are four different testing methods  

  • Upright MRI (AKA magnetic resonance imaging) 
  • Supine MRI (MRI while lying on back)  
  • CT Scan (AKA computerized tomography)  
  • Digital X-rays 

Although healthcare providers use MRIs as a common diagnostic method for cervical instability, scientific investigation shows that MRIs have limited diagnostic values in patients with cervical instability. Below are the measures your healthcare providers can take for diagnosing cervical instability. 

  • Clivo-Axial Angle that is equal to or less than 135 degrees. 
  • Grabb-Oakes measurement equal to or greater than 9 mm. 
  • Harris measurement that is 12 mm greater. 
  • Spinal subluxation. 

Causes of cervical instability 

The causes of ligament laxity that results in cervical instability include 

  • Whiplash or other injuries. 
  • Disorders of connective tissues like Rheumatoid arthritis or Ehlers-Danlos syndrome. 
  • Tethered cord syndrome 
  • Chiari malformation. 
  • Genetics. 

Treatments for cervical instability  

There are five standard techniques for cervical instability 

  • Chiropractic treatment  
  • Surgery  
  • Physical therapy  
  • Strengthening exercises  
  • Prolotherapy 

Chiropractic care 

Chiropractic care is an effective and common treatment for poor posture, headaches and spinal misalignment. These symptoms are interrelated with cervical instability. Healthcare providers may use upper cervical chiropractic care techniques to correct cervical instability by improving the symptoms.  

Research shows that healthcare providers use spinal chiropractic manipulative therapy to correct joint disorders, cervical vertebrae dislocation and much more. 

Spine manipulation is an effective and safe therapy that a qualified chiropractor performs on patients that need specific care. 

The chiropractors at Complete Medical Wellness have treated countless patients with cervical instability. Gentle adjustments of the upper spine are significant to recover from cervical instability.  


The major question raises here is why cervical instability requires surgery. You require surgery only if your cervical instability worsens and no treatment affects it. In severe cases, surgery is necessary to manage the advanced symptoms of the condition.  

Most surgical treatments aim to rectify the dysfunctions of the craniocervical junction, the point where the upper spine joins the skill.  

The surgical treatment for cervical instability includes 

  • Cervical fusion spine surgery. 
  • Halifax clamp 
  • Screw-rod constructs along with atlas vertebra lateral mass and axis vertebra pedicle.  
  • Transarticular screws  
  • Posterior sublaminar wiring 
  • Cervical spinal fusion is performed when the healthcare provider detects subluxation before the odontoid migration process to prevent cervical instability progression. You can obtain optimal results in a patient with mild myelopathy and severe pain.  

However, conservative methods to treat cervical instability, like chiropractic treatment or physical, are also effective. Since surgery is expensive and invasive, it is wise to try conservative treatments on a priority basis. 

Physical therapy  

Physical therapy is an effective and efficient treatment method for cervical instability. The healthcare providers from Complete Medical Wellness recommend patient physical therapy and chiropractic care. Physical therapy for cervical instability involves 

Strengthening exercises  

  • Posture education  
  • Joint mobilization  
  • Soft tissue mobilization 
  • Spinal Manipulation  
  • Proprioception exercises  

You may have to wear a cervical collar or brace, depending on the severity of your condition or if you had surgery before this one,  

According to a study, surgery can improve patient outcomes after one year of the procedure. However, physical therapy may take more time.  

Surgery is a short-term technique to provide immediate pain relief, whereas physical therapy is a long-term procedure.  

Strengthening exercises  

You must consult your healthcare provider before doing strengthening exercises. There are five major strengthening exercises to prevent cervical instability, including  

Chin tucks  

Stretching and strengthening posture along with the neck joints. Chin tucks are a common strengthening exercise that a healthcare provider uses to improve cervical instability. 

Isometric exercises.  

Your healthcare provider can combine isometric exercises with a wide range of motion to strengthen the neck area.  

Neck rotating: 

Methodologically and slowly, neck rotation strengthens joints and muscles of the cervical spine area. 

Yes, and no motion exercises. 

These exercises help stretch muscles and joints around the neck. A yes motion depicts nodding the head up and down gradually. At the same time, a no motion is shaking head right and left slowly. 

Practice better postures  

Practicing better postures reduces pressure from the spine. You must practice good posture every day. It is not only good exercise and helps you in the long run. 

You must discontinue the exercise or movement if it triggers pain. Pain is a symptom that you must take rest before pushing further. 


Prolotherapy is a unique new treatment option for cervical instability with no major side effects. It is a regenerative injection treatment that aims to stimulate the body’s natural healing process to strengthen and repair ligament and joint injury.  

Healthcare providers use prolotherapy for chronic and acute musculoskeletal injuries, especially those causing chronic neck pain caused by ligament laxity. 


Cervical stability is an underdiagnosed but a rare disease. For example, connective tissue disorders triggering cervical instability is affecting nearly 5,000 people globally. If you experience symptoms of cervical instability, contact your healthcare provider and chiropractor immediately.