Cervical Instability

Cervical instability is one of the most underdiagnosed conditions (1). It can lead to endless symptoms ranging from severe headaches and neck pain to random spells of vertigo. The right diagnosis is key to resolving these symptoms, especially when nothing else seems to work.

The Cervical Spine

The cervical spine consists of top seven vertebrae, known as C1 through C7 (“C” for cervical). These vertebrae make up the neck and connect the head to the rest of the body. The neck makes a passage for blood vessels (veins and arteries) to and from the head as well as nerve plexuses and the spinal cord.

Due to the many important structures that run through it, injury to the neck muscles or cervical spine can be reflected in a variety of symptoms. Pain may present itself on the arms and shoulders, for example, because the brachial plexus consists of ventral rami that extend from C-5 to T1 (the 1st thoracic vertebra).

C1-C2 (Atlantoaxial) Instability

C1 (the atlas) and C2 (the axis) are the two uppermost vertebrae of the spine. These two vertebrae work closely together to support the weight of the head and its movement. Unlike other vertebrae, C1 and C2 vertebrae don’t have an intervertebral disc between them which is a major source of stability. C1 and C2’s main support comes from intervertebral ligaments and other soft tissue structures.

When supporting ligaments (like the facet capsular ligament) of the atlas and axis are damaged and weak it leads to hypermobility of vertebra during neck motion. This, in turn, will cause severe pain and may pinch nearby blood vessels and nerves leading to many of the unexplained symptoms (like the ringing of the ear).

Symptoms of Cervical Instability

While some symptoms of cervical instability, like neck pain and headaches, are expected there are many others that are unusual. Here are a few less obvious symptoms-

• Vertigo/ Sudden loss of balance
• Face Pain
• Unusual headaches
• The ringing of the ear
• Dizziness/blurred vision
• Arm/Shoulder/Neck pain

Treating with Prolotherapy

Conventional treatments for neck pain and injuries include local analgesics, manual therapies, anti-inflammatories, and in severe cases surgery (1). Yet, the majority of these treatment modalities lead to only temporary and partial relief of symptoms. Pain may linger and sometimes comes back stronger than before. This is because most of these treatments are superficial fixes (like a band-aid), they don’t treat the real problem- the ligament injury.

Dextrose prolotherapy, on the other hand, aims to repair the injured ligament thus fixing the cervical instability and its associated symptoms. It works by recruiting healing mechanisms to the injury and stimulating fibroblasts to produce more collagen. The result is a tighter and stronger ligament that properly supports the weight of the head and neck movements.

References-

1. Hauser, R. A., & Hauser, M. A. (n.d.). Dextrose Prolotherapy for Unresolved Neck Pain. Retrieved from https://www.practicalpainmanagement.com/pain/spine/dextrose-prolotherapy-unresolved-neck-pain