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  • Dr. Mark Freund

How to Fix Atlas Pain in the Neck (Upper Cervical Spine instability)

Updated: Jun 23, 2022

how to fix atlas pain in the neck

If you're tormented by neck pain, lack of mobility in your neck, headaches, dizziness, or weakness in your limbs, you may have upper cervical spine instability. Any movement in the cervical vertebra can affect your body and lead to plenty of uncomfortable and nagging symptoms.

Fortunately, there are many natural and non-invasive treatment options to relieve your atlas pain. We'll cover everything you need to know, such as the causes and how to fix cervical instability.

What is Cervical Instability?

Atlas pain or upper cervical instability occurs when the skull and spinal cord ligaments are loose. This orthopedic condition can be categorized by hypermobility of the cervical vertebrae. This means that the neck vertebrae can move beyond their normal range of motion caused by the loose or overly stretched-out ligaments. Consequently, the Atlas (upper cervical bone) will have difficulty supporting the head, leading to twisting or turning the neck and the head tilted in an off-balanced position.

Typically, a doctor will evaluate the patient's symptoms and history. They may suggest some testing methods to diagnose whether the patient has upper cervical spine disorder properly:

  • Digital x-ray

  • Supine MRI

  • CT scan

  • Upright MRI

Upper Cervical Instability Symptoms

Symptoms of cervical instability are generally similar to the symptoms of other musculoskeletal, neurologic and orthopedic conditions. Here are signs that may indicate that you have upper cervical spine instability:

upper cervical instability

  • Tight or stiff neck

  • Feeling heaviness in the head

  • Pain in the upper neck or the shoulder

  • Frequent and recurring headaches

  • Difficulty holding up your head for long periods

  • Dizziness

  • Balancing problems

  • Tenderness in the base of the head or neck

  • Vertigo

  • Fainting, nausea, or fatigue

  • Shortness of breath

  • Weakness in your limbs

  • Cognitive decline

  • Memory loss

Cervical Spine Instability Causes

There are many potential risk factors and causes for cervical instability. The most common ones are:

Trauma: Any traumatic event to the cervical spine where the ligaments become loose may cause cervical spine instability. Common traumatic events include car crashes or sports-related injuries.

Micro-injuries: Repeated overuse of the area can cause micro-injuries in the neck ligaments, injuring the cervical spine leading to chronic instability.

Genetic disorder: Individuals with particular syndromes such as Ehlers-danlos or down syndrome frequently experience cervical spine instability.

Rheumatoid arthritis: This chronic inflammatory disease leads to stiffness, swelling, and pain in joints. Progressive deterioration in the neck and joint vertebrae can lead to cervical instability.

Besides the root cause of the issue, some risk factors can increase a person's chances of experiencing the condition. These include:

upper cervical spine x-ray

Age: The chances of getting cervical spine instability will increase as you age. Generally, people above 40 or 50 years are more likely to incur this condition.

By the age of 40, people's spinal discs begin to shrink or dry up. These discs provide a cushion between the spine bones. Disc deterioration can produce extra bone, resulting in the nerve roots and spinal cord being pinched. Also, as you age, your spinal ligaments can become stiff, thus making your neck less stiff.

Repetitive neck motions: Repetitive motions that would disrupt the ligament can lead to cervical spine instability—for example, people who repeatedly dive headfirst into a pool or drive a truck with vibrating equipment.

Strenuous activities: Certain strenuous activities can place a lot of stress on the cervical spine, such as weight-lifting or wrestling.

Upper Cervical Instability Treatment

There are many treatment options for cervical neck instability, all of which can improve your symtpoms.

Some are non-surgical, while others may require surgical procedures.Before you start any treatment plan, make sure to consult with a medical practitioner ahead of time to see whether the treatment option is right for you.

One of the safest ways to treat the symptoms of cervical instability such as spinal misalignment, headache, and poor posture is chiropractic treatment. One 2020 study found that spinal chiropractic manipulative therapy can be an effective and safe way to correct cervical instability, especially when the patient has dislocations or joint disorders in the cervical area.

Spinal manipulation usually combines moving and jolting the joints and massaging the connective tissue around them. The technique is designed to improve nerve function, reduce inflammation, and relieve pressure on the joints.

atlas neck pain relief

It's done by an experienced chiropractor practitioner who has been trained in spinal adjustments. This process involves using their hands to apply a sudden force to a specific joint. However, spinal mobilization may also be incorporated, where the practitioner uses less forceful thrusts and implements more stretching. Often the treatment can increase mobility and reduce some of the symptoms like frequent headaches.

Typically, surgery isn't necessary for treating upper cervical instability, especially if the condition is mild. Important to remember that surgical procedures can be expensive and invasive. Therefore, it's always recommended to try more conservative treatments like chiropractic care and physical therapy first.

Physical Therapy

Physical therapy is another very effective treatment option for cervical spine instability. Many patients will do chiropractic care along with physical therapy for best recovery outcomes. What does physical therapy typically involve?

treatments for upper cervical spine instability

  • Proprioception exercises

  • Soft tissue mobilization

  • Joint mobilization

  • Strengthening exercises

  • Posture education

  • Spinal manipulation

One study found that manual physical therapy and exercise demonstrated better short and long-term improvements in pain and disability in patients with neck pain compared to a program without it.


Prolotherapy is a regenerative injection technique designed to stimulate the body's natural healing process to repair and strengthen the injured ligaments and joints. These injections contain natural substances that help stimulate a healing response. This treatment encourages the growth of new tendon fibers and ligaments, which will tighten the weakened cervical structure.

Cervical Spine Instability Exercises

A proper exercise routine for cervical spine instability will consist of strengthening and stretching exercises. Follow these exercises to help you relieve some of the pain and improve your range of motion. Consulting with a chiropractor or physical therapist can help you develop the proper exercise regimen for your neck pain.

Chin tucks are one of the best postural exercises for combating neck pain. It helps to strengthen the upper thoracic extensors, which are the muscles responsible for pulling the back into alignment over the shoulders. It also stretches the suboccipital and scalene muscles.

  • Keep your spine against a door jamb.

  • Then pull your head and upper back until the head makes contact with the door jamb.

  • Hold your head up against the door jamb for five seconds.

  • Repeat this exercise ten times.

The back burn is an exercise done by standing with the back flat on the wall and your feet four inches apart.

  • Position your forearms, elbows, and back of the hands-on wall with your wrists at shoulder level.

  • Slowly slide the hands above your head and back down while keeping all parts touching the wall.

  • Repeat this exercise ten times and between three to five times per day.

The prone cobra is an exercise that specifically strengthens the shoulder girdle muscles along with the upper back and neck. This exercise uses gravity as resistance since you rotate the shoulders and neck and you lie down.

prone cobra exercise for upper cervical spine instability

  • Lie face down and place your forehead on a rolled-up hand towel.

  • Place the palms down on the floor and arms at the side.

  • Pinch the shoulder blades together and lift your hands off the ground.

  • Roll your elbows inward and palms facing out.

  • Gently lift your forehead about one inch off the towel, keeping your head facing towards the floor.

  • Hold the positions for about ten seconds.

Pull-aparts require the use of an exercise band. It's typically made of rubber tubing that can be purchased at any sporting goods store.

  • Start with your arms at shoulder level and shoulder-width apart.

  • Palms will face each other, pointing their thumbs at the ceiling.

  • Slowly stretch and pull apart the exercise band. Your elbows ideally should be in line with your shoulders and your hands spread apart. Your arms must be parallel to the ground at all times.

  • Then slowly squeeze your shoulder blades together. Move your arms slowly back to the starting position.

Cervical Instability Prevention

People who have connective tissue disorders may commonly experience cervical instability. Individuals with Ehlers-danlos or down syndrome will need to actively prevent cervical instability.

Here are ways to prevent cervical instability:

  • Practice good posture daily.

  • Do chin tucks daily for one minute.

  • Regularly visit your chiropractor.

  • Avoid situations that can cause trauma or whiplash.

Atlas Neck Pain Relief

The cervical Atlas is the first bone in the vertebra at the top of the spine, also known as the C1. It has a doughnut shape and allows millions of nerve fibers to pass through. It also allows blood to travel to and from the brain. Since the opening is very narrow, even a slight misalignment can lead to uncomfortable complications.

If you're experiencing some pain and need some relief before your visit, there are some ways to cope and relieve some of the atlas neck pain. Follow these at-home tips for atlas neck pain relief. It's important not to manually try to adjust your neck as that can further complicate the condition and intensify the symptoms.

  • Apply ice for the first few days when the symptoms appear. After that, you can apply heat using a hot compress, heating pad, or taking a hot shower.

  • Avoid strenuous activities that could aggravate the symptoms, such as heavy lifting, sports, or vigorous exercise activities.

  • Perform some of the neck stretches and exercises mentioned above.

  • Practice good posture.

  • Neck a special neck pillow when sleeping.

  • Receive a gentle neck massage.

  • Move around during the day and don't sit in one position for long.

  • Avoid using a neck collar or brace unless your doctor recommends them since they can worsen your symptoms.

How Atlas Orthogonal Chiropractic Can Help

Atlas orthogonal chiropractors use a high-tech instrument to very gently align your Atlas into a straight and orthogonal position. This helps to ensure that the nerve signals from the brain to the rest of your body and vice versa can operate normally again. Atlas orthogonal treatment is different from normal chiropractic care because they don't twist or turn the neck to adjust it. There's no popping or cracking in the adjustment either.

cervical spine instability symptoms

In short, the atlas orthogonal treatment is much more gentle and specific. We use a state-of-the-art adjusting instrument along with highly detailed x-rays to help realign the Atlas with precision. Due to the accuracy of the procedure, there's very little force that is needed to be applied, and the treatment is comfortable for the patient.

At Natural Care Chiropractic, our special atlas orthogonal chiropractic care can help with many of the nagging cervical instability symptoms such as vertigo, headaches, whiplash syndrome, and sciatica. As a result, our atlas realignment treatment can have powerful and transformative results.

Dr. Mark Freund is a practitioner that specializes in Atlas Orthogonal procedures and has also experienced cranial manipulation procedures. If you suspect that you have cervical instability, don't wait for the symptoms to get worse. Book an appointment with us immediately and see if atlas orthogonal chiropractic treatment is right for you.


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