The health of the cervical spine is important. The neck has to support the weight of the head, facilitate a wide range of motion, and acts as the bridge between the brain, the spine, and the rest of the body. If there is muscle and ligament laxity surrounding the spine, the vertebrae can experience excessive movement due to a lack of support, potentially causing pain and increasing instability.
The cervical spine refers to the neck and has its own roles to play in maintaining overall spinal health and function. Cervical spine instability occurs when the muscles and ligaments surrounding the neck become weak, depriving the cervical spine of support and stability.
Before getting to the signs and symptoms of cervical spine instability, let's explore the importance of cervical spine health and function.
The main spinal sections include the cervical spine (neck), the thoracic spine (middle/upper back), and the lumbar spine (lower back), and the health of each spinal section is affected by the others.
The spinal sections work together to maintain its strength, flexibility, and ability to absorb and distribute mechanical stress evenly, and if a single section loses its healthy curve or support, the spine's natural position can be disrupted.
The sections consist of vertebrae (bones) stacked on top of one another in a straight and neutral alignment; this is optimal for the spine's health and biomechanics, as well as the body's range of motion and movement patterns.
The cervical spine has to support the weight of the head and facilitate the neck's range of motion to turn the head from side to side and look up and down.
Good posture depends on a healthy neck curve facilitating the head's alignment with the torso.
So in addition to supporting the head's weight and movement, what else does the cervical spine do?
The spinal cord consists of 31 pairs of spinal nerves that exit the spine through openings between adjacent vertebral bodies (foramen) and branch off throughout the body; these nerves work with the brain to form the body's central nervous system.
The spinal cord is protected by the vertebrae that surround it, allowing the nerves room to function optimally: sending and receiving input to and from the brain and the rest of the body.
The cervical spine contains the spine's first eight vertebrae (C1 - C8), and these nerves control neck and head movement, facial and shoulder sensation, sending input to the arms/hands, and muscles involved in breathing.
The cervical spine also contains vertebral arteries that deliver blood to the brain, and blood flow in and around the brain is key for brain health and function.
The brain's blood supply has two main sources: the carotid arteries and the cervical spine's vertebral arteries; the arteries meet at the base of the brain, forming a loop of blood vessels that maintain consistent blood flow by allowing the two circulation paths to converge.
So as you can see, cervical spine health is important in a number of ways.
Cervical spine instability can affect the neck and head, neurological function, balance, coordination, vision, and a number of breathing and digestive functions.
In most cases of spinal instability, the section with the initial instability will feel the majority of its direct effects, but it can disrupt the biomechanics and stability of the entire spine, especially if left untreated.
Common symptoms of cervical spine instability include neck pain, headaches, tingling, numbness, and/or weakness in the extremities, disruptions to balance and coordination, brain fog, and these symptoms can worsen with movement.
When there is too much movement in the neck due to ligamentous laxity, there is too much movement of the vertebrae, and can cause spinal cord, nerve root, and/or blood vessel compression.
The ligaments and muscles that surround the cervical spine can become weak for a number of reasons, from a traumatic brain injury to degenerative conditions like spondylosis and arthritis, chronic poor posture, and genetic connective tissue disorders such as Ehlers Danlos syndrome.
Regardless of the cause, if connective tissues surrounding the spine are stretched and/or damaged, the vertebrae can experience a loss of support and excessive movement, and if one or more vertebrae bodies shift their position, they can compress surrounding nerves, causing widespread effects.
In order for the head to be supported and the neck to have a healthy range of motion, the cervical spine's healthy curve and alignment has to be in place. 
While the design of the spine is movement-based, there can also be excessive movement that compromises the spine's stability, and in order to improve the cervical spine's stability, the underlying cause of the instability has to be addressed.
The first step to addressing any type of spinal instability is determining its underlying cause, otherwise only symptoms are being addressed.
Treatment options include chiropractic care, physical therapy, strengthening exercises, pain medications, and in severe cases, surgical intervention may be recommended.
In most cases, initial treatment will include non-invasive conservative options such as chiropractic care and physical therapy.
Gentle and precise chiropractic adjustments work towards improving the position of the spine's vertebrae, improving its alignment, and taking pressure off affected nerves.
Physical therapy works towards restoring the neck's range of motion, strengthening the cervical spine's surrounding muscles, postural restoration, and integrates specific exercises for stabilizing the neck flexor muscles.
Specific exercises applied to strengthen the neck's flexor muscles include chin tucks, the neck flexor endurance test, and isometric holds.
The goal of conservative treatment is to restore the cervical spine's alignment, support, and stability.
A diagnosis of cervical instability means the muscles and ligaments that support the neck have become weak and don't properly support the cervical spine; when there is a lack of support, the vertebrae (bones of the spine) can experience abnormal movement and may become increasingly unstable.
When the vertebrae are moving too much and/or change their position, it can irritate the spinal nerves; cervical instability symptoms can range from chronic neck pain to dizziness/balance issues, headaches, muscle spasms and fatigue.
While most of the direct effects of instability in the cervical spine will be felt by the neck and its surroundings, instability in a single spinal section can disrupt the entire spine's alignment and biomechanics. If the spine is misaligned, considering the many key roles of the spine in maintaining healthy posture, the body is also off-balance.
Common causes of cervical spine instability can include trauma, degenerative disc disease, connective tissue disorders such as Ehlers-Danlos, and/or chronic inflammation.
Cervical instability patients have a number of treatment options available including conservative treatment (physical therapy, strengthening exercises, and chiropractic care) and surgical intervention.
The best way to manage chronic pain caused by upper cervical instability is to determine its underlying cause and apportion treatment disciplines accordingly.
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