Upper Cervical Instability Treatment in Indianapolis

Symptoms of upper cervical instability (UCI)

UCI presents with a variety of symptoms, depending on the severity of instability and the structures affected. Because the upper cervical spine is in close proximity to the brainstem, spinal cord, and vertebral arteries, even slight instability can have widespread effects on both physical and neurological functions. Common symptoms include:

• Neck Pain: Persistent or recurrent pain in the neck, often described as deep and throbbing, is common in people with UCI. Pain may worsen with certain head movements or prolonged periods in a single position.

• Headaches: Cervicogenic headaches, which originate from the cervical spine, are frequent in UCI. Occipital neuralgia, a stabbing or shooting pain in the back of the head, is another headache type often associated with upper cervical issues.

• Neurological Symptoms: Symptoms such as dizziness, vertigo, and balance problems can arise due to instability affecting the brainstem or the vertebral arteries, which supply blood to the brain. These symptoms may be aggravated by sudden movements, causing a sensation of light-headedness or “brain fog.”

• Visual and Auditory Disturbances: Some individuals with UCI report visual disturbances like blurred vision, double vision, or difficulty focusing. Others may experience ringing in the ears (tinnitus), hearing loss, or even a sense of fullness in the ears.

• Upper Limb Weakness or Numbness: If UCI compresses the spinal cord or nerve roots, it may lead to weakness, numbness, tingling, or a “pins and needles” sensation in the arms and hands.

• Swallowing and Speech Difficulties: Compression of the brainstem or nearby nerves may interfere with swallowing and speech, causing dysphagia (difficulty swallowing) or dysphonia (hoarseness).

Diagnosis of Upper Cervical Instability

• Diagnosing UCI can be challenging, as its symptoms often overlap with other conditions. However, a thorough evaluation using the following methods can help confirm the diagnosis:

  1. Physical Examination: A physician may examine the neck for range of motion, tenderness, muscle strength, and signs of nerve involvement. Certain physical tests, such as the sharp-purser test, may be used to assess ligament stability.

  2. Imaging Studies: Imaging is critical in diagnosing UCI. Common imaging techniques include:

  • X-rays: Special cervical spine X-rays, including flexion and extension views, can reveal abnormal movement or alignment between the vertebrae.

  • Magnetic Resonance Imaging (MRI): MRI is useful for assessing the soft tissues, including the ligaments, and identifying any spinal cord compression.

  • Computed Tomography (CT) Scans: CT scans provide detailed images of the bony structures and can reveal fractures or abnormalities in the vertebrae.

  3. Dynamic Imaging: In some cases, dynamic imaging (imaging taken while the neck is in motion) may be used to observe the movement of the cervical spine in real-time, which can reveal instability that is not evident in static images.

  • Neurological Testing: In cases with neurological symptoms, additional testing such as electromyography (EMG) or nerve conduction studies may be performed to evaluate nerve function.

How Do You Treat Upper Cervical Instability?

Treatment of UCI varies depending on the severity of the condition, underlying causes, and specific symptoms. Our goal is to help your body heal itself and to avoid surgery whenever possible. Below are the main approaches we use to treat UCI.

• Injection Therapy: We perform injections, such as prolotherapy or platelet-rich plasma (PRP) injections, to promote ligament healing and provide temporary pain relief.

• Physical Therapy: A specialized physical therapy regimen can strengthen the muscles around the neck to provide added stability and alleviate pain. Therapists may teach patients exercises that enhance postural alignment, which reduces stress on the cervical spine.

• Bracing: Cervical collars or braces may provide temporary stability and help to prevent excessive movement. Bracing is typically a short-term solution and is used to support the neck during periods of increased instability or to aid in recovery from an injury.

Surgical Treatment

In cases where conservative treatments are ineffective or the instability is severe, surgery may be necessary. Surgical options aim to stabilize the upper cervical spine and protect the spinal cord and brainstem. Surgical treatment is a worst-case scenario option. Many patients with upper cervical instability can find relief through less invasive treatment, such as platelet-rich plasma (PRP).

On the Day of My Appointment

You and Dr. Dan will begin by going over your medical history. You will then be given a comprehensive medical exam to determine your overall state of health. At this point, special tests including lab studies or imaging studies may be requested. You will then undergo an osteopathic structural exam to examine your range of motion and gait. Once Dr. Dan identifies a problem area, he will perform a more specific evaluation. Following your structural exam, you and Dr. Dan will explore your treatment options which may include OMT treatments, injections, and other options.

Conclusion

Upper cervical instability is a complex condition with potentially serious implications for neurological function and quality of life. While some cases are mild and manageable through conservative measures, others require surgical intervention to ensure stability and prevent complications. Early diagnosis and individualized treatment are essential to address the symptoms and underlying causes effectively.

Treatment Info:

How much does it cost?
Upper cervical instability treatments are included as part of your comprehensive treatment plan.
 

Will I experience any pain?
Most of our patients experience no pain during treatment. Some experience soreness and tightness in the days following treatment. This is perfectly normal.
 

Where are you located?
We are located in Carmel. If you're traveling from out of town to see us, we'd be more than happy to assist with travel and accommodations.