Cervical Spine Instability Glastonbury

What Is Cervical Spine Instability?

The human spine has five different sections. The top section, in your neck, is known as the cervical region. Cervical instability is the condition that occurs when this area lacks the necessary stability to maintain proper alignment and function. It is characterized by too much movement between the vertebrae. Cervical spine instability may be the result of an injury, surgical complications, or a connective tissue disorder.

Symptoms of Cervical Spine Instability

You might have cervical spine instability if you suffer from any of the following:

• Chronic neck pain
• Migraines and/or headaches
• Dizziness and/or vertigo
• Ringing and/or rushing in the ears
• Chronically tight or spasmed neck and upper back muscles
• Blurry vision
• Difficulty focusing
• Sinus congestion or fullness
• Hoarseness or difficulty swallowing
• TMJ disorder symptoms

Why Do These Symptoms Occur?

Ligaments are connective tissue structures that connect bone to bone. They help stabilize the joints and limit the amount of movement at the joints. But if the ligaments get stretched out, either because of an injury or because of chronic strain over time, this can result in looseness and excess motion. This is called instability. 

Instability in the neck can lead to any of the above symptoms. If several of the symptoms occur together, it is known as the Barre-Lièou Syndrome. This is because instability causes the body to react. One response to the instability is that your neck muscles tighten up. This is the body's way of trying to protect against excess motion. Being somewhat of a wise guy, Dr. Tortland sometimes tells patients that the reason they are so tight is because they are so loose! Physical therapy and massage therapy can help loosen the muscles. But this is only temporary because the body wants to continue to protect against instability. In rare cases, massage therapy can even make the symptoms worse because the muscle tightness serves a protective function.

A second response to instability is symptoms that affect the eyes, ears, nose, and/or throat. Patients oftentimes will see an ear, nose, and throat (ENT) specialist (or several specialists!) and they are told that there is nothing wrong with them. In one sense, the specialists are correct — there is nothing wrong with the eyes, ears, nose, or throat themselves. The problem is that the nerves that supply these organs are chronically irritated and activated because of spinal instability. (Technically, this is caused by increased activation of what is known as the superior cervical sympathetic ganglion.)

If cervical instability goes untreated for a long enough period of time, gradually it can cause degenerative disc disease and spinal arthritis, both of which themselves can start to cause pain.

Diagnosing Cervical Instability

Cervical instability can be challenging to diagnose. MRI and standard X-rays do not show the instability and oftentimes are normal. In some cases, X-rays that include flexion and extension views of the neck can help. But the most sensitive test for diagnosing cervical instability is called a digital motion X-ray (DMX). This is a special video X-ray where the spine is filmed throughout the entire range of motion, and subtle instability is much easier to detect.

Treating Cervical Instability & Neck Pain

Can we treat the cervical spine in our office? Yes. Understandably, we always recommend any patient to start conservatively, usually with physical therapy, and, only when appropriate, osteopathic or chiropractic treatment. However, if those measures fail to provide lasting relief, then more aggressive treatment may be needed. Surgery is rarely needed — except in extreme and especially severe cases.

The ideal treatment for treating cervical segmental instability that has failed to respond to conventional approaches is regenerative medicine treatments, including prolotherapy and PRP. Our office has been doing prolotherapy treatments since 1995, and PRP treatments since 2007. Whether we use prolotherapy or PRP is a discussion best had with each patient’s physician. However, note that in all the years that our office has been doing treatments for cervical instability, we have never needed to use stem cell treatments for cervical instability. In our opinion, this is overkill and there is no compelling reason to incur the significantly increased expense and invasive nature of stem cell treatments when less expensive and less invasive treatments, such as prolotherapy and PRP, work so well.