Symptoms and conditions of Craniocervical Instability

Ross Hauser, MD.

In this article, I have put together a summary of some of the symptoms and conditions that we have seen in our patients either previously diagnosed or recently diagnosed with Craniocervical Instability, upper cervical spine instability, cervical spine instability, or simply problems related to neck pain.

For many of these people, symptoms, and conditions extended far beyond the neck pain, radiating pain of cervical radiculopathy, headaches, TMJ, and possibly dizziness usually associated with problems in the neck. These people’s symptoms and conditions extend into neurologic-type problems that may include digestion, irregular cardiovascular problems, hallucinogenic sensations, vision problems, hearing problems, swallowing problems, excessive sweating, and a myriad of others.

I want to point out that the symptoms and conditions you will see described below can be caused by many problems. This article demonstrates that craniocervical instability and cervical neck instability can be one of them.

Symptoms and conditions of Craniocervical Instability

When your neck feels like it cannot keep your head up

Craniocervical Instability is a structural problem of the craniocervical junction.  If you have been diagnosed with  Craniocervical Instability, your doctors have concluded that you have a structural disorder at the back of your head where the base of your skull (the occipital bone) and C0 (the atlas) – C1 vertebrae (the axis) function together. You may have been relieved to get this diagnosis as your medical journey took you on a long meandering course from specialist to specialist with no answers. Let’s start exploring the symptoms and conditions. In many people this instability is not limited to only this region of the cervical spine, it extends through the neck from C0 – C7 and leads to issues of atlantoaxial instability (c1-c2), Upper cervical instability, and compression of the brainstem and cervical neck instability.

“I can’t keep my head up”

There are obvious signs that a patient suffers from craniocervical instability or upper cervical instability. One sign is their inability to keep their head upright. As some of you reading this article are probably aware through your own first-hand experience, and through an eventual diagnosis of Dropped Head Syndrome or Isolated neck extensor myopathy, there are many things that can cause this problem. In your own experience, you may have already been through a barrage of tests to rule out Lou Gehrig’s disease, Parkinson’s disease, head and neck cancer, myasthenia gravis among other neurological or hereditary disorders. Once all these things are ruled out, your Dropped Head Syndrome may become a diagnosis of isolated neck extensor myopathy. Sometimes you will carry both diagnoses. But simply stated, you cannot keep your head upright.

Your treatment history may have included medications, physical therapy, chiropractic adjustments, and cervical collars.  You may be wearing a cervical collar right now as you are reading. You may have a strong recommendation from a neurosurgeon to consider cervical spine fusion surgery.

What are we seeing in this image?

Craniocervical instability or upper cervical instability can be caused by the stretched rear or posterior neck ligaments. Stretched ligaments can occur over time in the CREEP phenomena which is a degenerative condition brought on by wear and tear from the head down work (computer) or chronic cell phone use. Stretched ligaments can also occur as a result of whiplash or other injury and a diagnosis of hEDS or Ehlers-Danlos Syndrome.

Ligament Creep can cause a chronic cycle of neck pain, headaches, and the many symptoms and conditions that I will outline below. As the cervical spine ligaments become weaker, the head-forward position increases. The weakened ligaments can no longer keep the cervical vertebrae in proper alignment.

This can cause the neck muscles to start to tighten and chronically spasm. This will limit the range of head motion and decrease the load on the ligaments. The muscles are trying to prevent you from turning your head so you do not damage yourself further. Muscle spasms are a defense mechanism.

However, the muscles were not intended to be a defense mechanism. This extra demand cervical spine instability is putting on them can quickly cause the cervical spine muscles to atrophy. Injured ligaments, unfortunately, heal very slowly, this has to do with the poor blood circulation they get (this is why ligaments are white and muscles are red – muscles get blood, ligaments don’t.)

Damaged ligaments and atrophied muscles cause hypermobility of the cervical spine vertebrae. Floating vertebrae leads to pinched nerves, pinched arteries, pinched veins. All leading to possible situations of pain, blood flow problems to the brain, and the neurologic-type symptoms and conditions I will describe throughout this article.

Dropped Head Syndrome – Isolated neck extensor myopathy, research on treatments

You have probably tried all these treatments mentioned above. You may have a strong recommendation from a neurosurgeon to consider cervical spine fusion surgery. In my article on Dropped Head Syndrome, I outline our non-surgical treatment methods for restoring cervical ligament strength with Prolotherapy injections (explained below) and correction of the natural cervical spine curve that is lost in the forward head – Dropped head syndrome phenomena.

What are we seeing in this image? Craniocervical instability – upper cervical instability

The Horrific Progression of Neck Degeneration with Unresolved Cervical Instability

The first of the four images is the Lordotic curve, the natural curve. Over the course of your medical history, this natural neck curve has deteriorated into a condition and symptom causing structural problems. The progression demonstrated in this image passes through the phases of the Lordotic (normal) to the straight spine (Military curve) to the Kyphotic curve where the cervical spine is now curved in the wrong direction. Finally, the degenerative condition continues to the “S” curve configuration. The cervical spine is twisted out of shape. With this twisting comes the stretching and tearing of the cervical spine support ligaments.

What are we seeing in this image?

In this image from a digital motion x-ray, we can see how a reverse curve or “S” curve can lead to problems of the vertebrae banging against the back of the head (the occiput), nerve impingement, or pinching, and reducing blood flow into the brain. With these problems comes the long list of “unexplained” neurological symptoms the patient may suffer from.

In this image from a digital motion x-ray we can see how a reverse curve or "S" curve can lead to problems of the vertebrae banging against the back of the head, nerve impingement or pinching, and reducing blood flow into the brain. With these problems comes the long list of "unexplained" neurological symptoms the patient may suffer from.

My head is tilted, I have terrible spasms, I was diagnosed with Cervical dystonia – spasmodic torticollis

Among your symptoms, one day you started having painful, involuntary muscle spasms in the neck. These were much worse than the muscle spasms you were use to. Coinciding with this was your head started rotating and tilting to one side as these spasms got worse and it became difficult to get your head back in line. Some describe this as a feeling of a clenched fist in their neck.

Your pain sometimes starts suddenly, sometimes it goes away, sometimes the pain stays for a while and becomes continuous. When the pain spasms become more frequent you notice that is when your head tilts the most, you get a feeling of near incapacitating tightness in your head, neck, shoulder, and upper back.

At this point, your medical journey began to accelerate. Your doctor may have made a recommendation that your issue is best served by a physical and occupational therapist who specializes in neurological disorders. Possibly this is the first time you heard you had a neurological disorder and this may have frightened you very much.

Your doctor tells you that he/she suspects Cervical dystonia also called Spastic Torticollis or Cervical Torticollis. It is not curable, but it is treatable. Your doctor may suggest a specialist who can prescribe and recommend various muscle relaxants. You probably received the first of your muscle relaxant prescriptions at this consultation.

Then your story may have taken a turn like this:

After I starting receiving treatments, specifically botox injections, I started to feel better. I was advised that if my condition worsened, we could continue on with the botox. My condition worsened. At this point, I was being tested for everything including looking for a brain tumor. When nothing came back, my doctors began to explore that my problems were phycological. I hear them talking that they think this is “all in my head.” All the treatment I am getting at this point is Klonopin for panic disorders and anxiety.

Let me point out that some people do very well with Botox injections. The above represents one story.

In my article Cervical dystonia and spasmodic torticollis treatment I describe that when a patient who is suffering from dystonia comes into our clinics looking for help and some answers it is because their condition has worsened and they have become “difficult to treat.” The reason that some suffer from worsening and developing symptoms is from craniocervical instability – cervical spine instability.

In this article, I also discuss the problems of a diagnosis, symptoms of cervical disc disease, essential tremor, anxiety, and depression. I also discuss why prescription medications may have not helped you, Why relaxation techniques did not help and why doctors often turn to psychotherapy. I also look at C1-C2 Surgery.

Finally, I outline treatments as demonstrated through the story of a patient. The patient struggled with spastic torticollis for several years prior to coming to our office. Because spastic torticollis is a condition in which the head will twitch or turn uncontrollably and tilt to one side, our patient needed to turn her body to the side in order to see straight ahead.

What are we seeing in this image?

In this image, we see a depiction of a muscle spasm in the back of the neck. Why the muscle spasms, or why it gets thicker is a response to cervical spine ligament injury. The muscle is trying to hold things together to prevent the nerve or cervical arteries from being impinged.

In this image we see a depiction of muscle spasm in the back of the neck. Why the muscle spasms, or why it gets thicker is a response to cervical spine ligament injury. The muscle is trying to hold things together to prevent the nerve or cervical arteries from being impinged.

In this video, Ross Hauser, MD gives a brief outline of  Cervical dystonia – spasmodic torticollis treatment

Intracranial hypertension – pressure headaches and other conditions

We see many patients who have a serious health challenge in having intracranial hypertension. In many of these people, intracranial hypertension was not initially thought of as a problem, the symptoms manifest from this problem were. So their doctors instead tackled the symptoms that these people were facing not the cause.

Symptoms that included dizzinessheadachevision problems such as sensitivity to light were exaggerated. Pupillary hippus dilating is a common condition we see in patients. This is where constricting of arteries and veins in the cervical spine can cause problems with light sensitivity and the pupil’s failure to respond correctly to light sources. These people also faced symptoms and diagnosis of Tinnitus or ringing in the ears, neck pain, and tremors.

Once a problem of intracranial hypertension or a  build-up of pressure around the brain was discovered, a myriad of tests and treatments were tried. Once obvious causes such as head injury or stroke were ruled out, initial testing may have looked for causes in blood clots, infection, and tumors. Once tests ruled those out as causes your diagnosis of intracranial hypertension, you then got an updated diagnosis of idiopathic intracranial hypertension, which means no one knows why you have intracranial hypertension.

Once these tests are performed you may be given a treatment plan that includes weight loss, a review or reduction or repurposing of the medications you are on, you may be given medications to reduce the production of cerebrospinal fluid, steroids, routine spinal taps to remove excess fluid buildup.

For many people, these treatments may have worked wonderfully. These are not the people that are contacting our office. We see the people that continue to have these symptoms and challenges despite years of treatment. So what is it that we can offer them? The possibility of a missing diagnosis. For some of these patients, not all, there is a problem of cervical spine instability causing a problem of cerebral spinal fluid drainage and buildup.

Ross Hauser, MD, and Brian Hutcheson, DC explain the problems of blurry vision, brain fog, and other symptoms seen in patients with intracranial hypertension and treatments to alter the cervical spine dynamics to relieve these symptoms.

What are we seeing in this image?

A cause of the problems of intracranial pressure and blood flow into the brain may be found in the relationship of the internal carotid artery to the upper cervical vertebrae. The internal carotid artery sits just in front of the transverse process of the atlas (C1) and the axis (C2). Even its blood flow can be constricted or blocked by atlantoaxial (upper) cervical instability.

Relationship of the internal carotid artery to the upper cervical vertebrae. The internal cartoid artery sits just in front of the transverse process of the atlas (C1) and the axis (C2). Even its blood flow can be constricted or blocked by atlanto-axial (upper) cervical instability.

In my article Cervical Spine Instability, Vein blockage, fluid build up and intracranial hypertension, I discuss problems of venous obstruction in the cervical spine, “sludge” buildup in the brain caused by malrotation at the C1, loss of blood flow to the brain, Vertebrobasilar insufficiency – Drop Attacks, Bow Hunter Syndrome, and vision problems and we develop non-surgical treatment programs surrounding Prolotherapy injections into the neck along with a program to correct the natural curve of the neck.

Dysautonomia: brainstem compression

We get a lot of emails from people suffering from symptoms of tachycardia (rapid heartbeat), dizziness, fainting, headaches, vertigo, excessive fatigue, digestive problems including nausea, weight loss. Because of the fainting symptoms, especially the “blackouts,” people would find themselves in the emergency room because of injuries they sustained in the fall to the ground. They would also tell us of their need for a companion to accompany them when they ventured out.

Some people reported that every time they got to their feet or stood up, their heart would race. Their heart may race wildly after eating. Eventually, some would be diagnosed with panic disorders and be sent on a different path of treatment, one towards physiatrists and mental health professionals and months, possibly years of testing various anxiety and panic disorder medications that seemingly did not help, and worse accelerated “bad thoughts.”

The autonomic nervous system (ANS) is made up of nerves that control the automatic functions throughout the body. It is the master regulator, controlling heart rate, blood pressure, temperature, respiration, sweating, digestion, and other vital functions. These systems operate without consciously thinking about them because the ANS provides the connection between them and the brain.

The ANS is made up of two subsystems: the sympathetic autonomic nervous system (SANS) and the parasympathetic autonomic nervous system (PANS). Most organs are directed by both the sympathetic and parasympathetic systems. The SANS is usually more of a stimulatory system, increasing heart rate and blood pressure when necessary.

Dysautonomia refers to problems of or dysfunction of the autonomic nervous system. Since the ANS regulates automatic or involuntary bodily functions, such as controlling the activities of organs, glands, smooth muscles, and cardiac muscles, when the ANS malfunctions, the organs it regulates malfunction. For this reason, when individuals suffer from dysautonomia, they often exhibit numerous maladies and symptoms.

For a further discussion on Dysautonomia and POTS (Postural Orthostatic Tachycardia Syndrome) please see my article: Dysautonomia and POTS.

Arterial and Venous Compression related symptoms

What are we seeing in this image?

The brain needs to drain out or flush out toxins and refill itself with fresh fluids. In the image to the left, I point out that obstruction of the veins and arteries will cause a “clogged toilet.” What happens when the toilet clogs?

Ultimately this will result in an accumulation of cerebrospinal fluid in various parts of the brain including the frontal lobe. This will destroy neurons and brain tissue. This can be one explanation for the problems of memory, cognitive function, and brain fog described by some patients with cervical spine instability.

To the right we see a brain without obstruction and the flow of blood in and blood out is not impeded.

While most people understand vertebral and carotid arteries supply the brain with blood, oxygen, and nutrients, few are aware that an intricate network of lymphatic cells and veins drain the brain. Obstruction of venous brain output is called Chronic Cerebrospinal Venous Insufficiency (CCSVI).

For good brain health, the blood supply and drainage must meet the demand of its metabolic activity. Brain intelligence and problem-solving areas, such as the anterior cingulate cortex and front lobe cortex, experience the highest metabolic demands and are very susceptible to injury from Chronic Cerebrospinal Venous Insufficiency. When these vital areas of the brain become injured, the first noticeable symptom will often be brain fatigue or brain fog, and if the brain toilet is not unclogged, will progress to extreme lethargy, emotional numbing, dissociation, severe depression, and hopelessness. Even if the brain toilet obstruction is low-level, if it continues, the slow but progressive destruction of brain tissue and brain neurons will result.

As more brain tissue is lost (front lobe atrophy, for example) mental capacity and emotional well-being continue to decline. We have personally seen many young people in their 20s who appear to have Alzheimer’s dementia. With the resolution of their neck instability and injury, which caused their clogged brain toilet, their intellect, emotional stability, and mental capacities return.

Digestive problems 

Perhaps somewhere on your journey a chiropractor, acupuncturist, or neck specialist connected your nausea to dizziness caused by neck instability. You knew there was a connection but you also knew there was much more to this than dizziness-induced nausea.

We see many people who in their own research started putting together the pieces as to why they had the many symptoms and conditions they do. They may have discovered that their digestive problems may be linked to their neck problems. This was something they had not thought of initially as is attested to by the tone of some of the emails we get from them. It is a tone of discovery. Their emails go something like this:

People like this, people perhaps like you, have been sent to the Gastroenterologist, and then sent on to a more specialized Gastroenterologist. Over the course of their visits, they were given new diet rules, new medications, new eating suggestions. From many, there was little symptom relief, seemingly no answers for their digestive problems such as bloating, sensitive stomach, constipation, diarrhea, and a sense that their stomach was not emptying. This led to recommendations for surgeries.

Digestive problems are conditions and symptoms we see regularly in our patients with neck pain and instability. Our treatment programs for addressing the possible craniocervical instability and cervical neck instability are described in these articles: Neck instability and digestive disorders, Neck instability nausea, gastroparesis, and other digestive problems, Pyloric stenosis, and SIBO: Small intestinal bacterial overgrowth.

What are we seeing in this image?

In our example stories we hear from patients, they talk about making a connection of some type of disruption to their vagus nerve function and their digestive problems. Here we show that:

In the illustration below, the many things the vagus nerve is responsible for are outlined. Highlighting digestive disorders, we see that the vagus nerve:

In this illustration, the many things the vagus nerve is responsible for is outlined. Highlighting digestive disorders, we see that the vagus nerve: Controls throat muscles to assist in swallowing. Regulates insulin secretion and glucose balance (homeostasis) in the liver. Regulates and controls digestion. Provides your brain with the felling of satiation or "I'm full." Helps regulate gastric juices, gut motility (the ability to move food through the digestive tract), and production and regulation of stomach acids.

Gastrointestinal symptoms and vagus nerve compression

In this video Ross Hauser, MD. discusses a myriad of gastrointestinal symptoms that may be caused by vagus nerve compression typically found in cervical spine instability.


Swallowing difficulties

Nor could you make sense of the fact that you may have had swallowing difficulties, a choking sensation, and a disrupting gag reflex. You may have had chronic hiccups and coughing when you tried to swallow,  These were symptoms that you could not attribute to dizziness insured nausea nor could specialists pinpoint some type of hernia.

Some patients experience a weird clicking sensation in the neck and/or tongue. Others feel like they cannot push the food back for a complete swallow because they sense their tongues are not working.

I have a very extensive article: Cervical disc disease and difficulty swallowing – cervicogenic dysphagia that I invite you to refer to: Below is a summary.

Treating Cervical Spine Instability is treating swallowing difficulties

I also discuss:

C2 malrotation can cause swallowing difficulties

In this x-ray from one of our patients, we can display C2 malrotation. The dotted center line represents where the center of the C2 should be. We see that the C2 is shifter far over. Restoring the C2 to its natural position can alleviate swallowing difficulties as well as many symptoms attributed to cervical spine instability.

In this x-ray from one of our patients we can display a C2 malrotation. The dotted center line represents where the center of the C2 should be. We see that the C2 is shifter far over. Restoring the C2 to its natural position can alleviate swallowing difficulties as well as many symptoms attributed to cervical spine instability.

In this video Ross Hauser, MD explains the functional dynamics and possible solutions to swallowing difficulties.

Hiccups

It may have been when these added symptoms came into play with your digestive problems, or that they came on separately, that a specialist may have suspected some type of neurological disorders. For more on these symptoms as they may be connected to Craniocervical Instability see my article:  Hiccups and neck instability, difficulty swallowing – cervicogenic dysphagia.

Chewing and TMJ

Some people will come in with a history of a TMJ diagnosis and neck pain as part of their list of conditions and symptoms. In other of our articles, we discuss symptoms of unresolved TMJ, face, ear, and throat pain as well as problems of TMJ and tinnitus as problems that may be caused by Craniocervical Instability and cervical spine and neck instability.

In these articles we discuss treatment options for people who tell us a medical history that sounds like this:

Burning Mouth Syndrome

If we took the combined emails we received about problems of Burning Mouth Syndrome, a common thread would create a cumulative person’s that would go something like this:

My mouth and tongue feel like they have been burnt, like from a hot spoon or scolding coffee. I went to the dentist to see if this was a problem with my gums or an infection in my teeth. None of the x-rays showed anything. He told me that he thought it was burning mouth syndrome. Nothing could be done for it except anti-depressants. When I went to my doctor, I was referred to a specialist, a Psychiatrist.

Many people with face and/or mouth pain have been chasing the cause of their symptoms for years. The upper cervical area of C1, C2, C3 is where the important nerves that control the motion of the tongue, as well as sensations of the mouth, are located. When the movement of the upper spine becomes unstable, the bones can pinch on nerves, veins, and other vital structures that run through the neck.

A Patient’s Case History – Burning Mouth Syndrome

Dr. Hauser at 1:00 of the video:

Why I believe burning mouth syndrome is from cervical instability, specifically upper cervical instability

Neck-Tongue Syndrome is considered a rare disorder. It is considered so rare that when learning institutes or universities get a patient that is confirmed with Neck-Tongue Syndrome they write up a case history to share with their colleagues because of the rareness of the diagnosis. But how rare is this problem or is it simply misdiagnosed or misunderstood and more apparent than initially thought.

In our office, we see many patients with numbness or other unusual sensations in the tongue. While this may be their most troubling symptoms it is rarely a symptom that the patients have by themselves. Accompanying this tongue numbness can problems of neck pain. This has been described by other doctors as well. For the research please see my article: Neck-Tongue Syndrome treatments

Strange sensations in the skin

What are we seeing in this image?

In other articles on this website, I explore problems that many of the people we see have. Symptoms including tactile allodynia or painful to the touch skin, skin sensations where one-half of their body will feel hot and one-half of their body will feel cold, rashes, and problems of sweating. The sensation is felt as the nerve impulses go up the posterior columns of the spinal cord to the parts of the brain that sense stuff that is the somatosensory centers of the brain. But what happens if this messenger – information highway has a roadblock or traffic is being diverted from and many of the highway lanes are closed? The messages move more slowly, priority messages may be delayed.

In this image, we see that this patient has cervical spine instability. This is allowing the rear or posterior spinal canal to hit against the walls of the spinal canal. The pressure being created by hypermobile, unstable cervical vertebrae was causing this patient’s whole body to be in a state of distress. They had the sensation that their body was buzzing or vibrating, their skin had different temperatures from one side to the other, and itching sensations consistent with the sensation that something was crawling on them. Our treatments to alleviate this patient’s problems focused on removing the pressure on the spinal cord by stabilizing the cervical vertebrae and restoring the natural curve of the cervical and thoracic spine with Prolotherapy injections. This is explained below.

 

You are hot on one side of your body, cold on the other, you sweat all the time, but only in patches

Patients who suffer from craniocervical instability and cervical spine degenerative disease and instability may have a condition where they have an inability to regulate their body temperature. For some, this may have occurred after a cervical spine fusion. In our world of cervical spine instability, we have been helping patients for decades who may have been dealing with chronic and years ongoing neurologic-type symptoms that may reveal themselves as temperature instability. In these patients we may explore a chronic hypothalamic mis-messaging (compressed nerves sending confusing messages to the hypothalamus, the gland that regulates body temperature), and, a neurogenic inflammatory response (nerve inflammation – something, like a disc or vertebrae is pinching the nerve). We look for pathologic changes in cerebral blood flow (the patient does not get enough blood to the brain). There are science and research behind these observations and treatment guidelines, please see our article on Thermoregulatory instability and a patient’s inability to temperature regulate.

Hot and cold, sweaty hands

A patient will tell us on their first visit:

The symptoms that confuse my doctors the most is my ability, depending on how I stand, is to make my hands feel hot or cold, sweaty or dry, pale or red in color. They tell me that this is a neurology problem. I do not like having sweaty palms.

In the video below with Ross Hauser, MD, and Brian Hutcheson DC, a discussion of chronic skin sensations that can be common symptoms and findings in cases of cervical instability. These include symptoms like abnormal temperature regulation over half of their body or certain areas that are hot or cold compared to the rest of the body as well as specific areas that are hypersensitive or numb compared to the rest of the body, and other odd skin sensations, including localized swelling, vibration, and severe itching that have not been resolved by other traditional treatments by a dermatologist, rheumatologist, neurologist, etc.

Itching skin

When people have itching of unknown origins they will be recommended over to dermatologist care. If you suffer from itching skin and rashes, this probably happened to you. The initial treatments offered were probably more potent or heavy-duty prescription ointments and creams to those you had already bought over the counter or on the internet. When these treatments are not working or have been eliminated from being useful for you, the next step is of course to dig deeper and look for other things.

Patients who suffer from craniocervical instability and cervical spine degenerative disease and instability may have problems of skin rashes and itching. The problems of itching can in itself be challenging. Is it a problem of the skin and skin rashes or is it a problem of neurology and a symptom more on its own? We have seen patients with uncontrolled itching from an unknown source. In some of these people, it was coming from the patient’s neck and cervical spine instability.

We have a detailed article on this one condition on our website that features research, clinical observations, and patients describing treatments and challenges of Brachioradial Pruritis and Neuropathic itch.

Bugs crawling on my skin

People will contact us with a diagnosis of difficult-to-treat formication, that is the sensation of creepy crawlies or bugs crawling on your skin. The medical term formication comes from the Latin for ants and can be translated as a condition of “ants crawling on the skin.” These people may have a diagnosis of tactile hallucinations, a strange sensation where the skin feels things that are not there, such as a touch, or heat, or any sensation that one would “feel.”

As these people got deeper and deeper into their testing and diagnosis because a cause of these symptoms could not be found, some of their doctors believed these people to be delusional and psychiatric examinations were recommended.

We have a detailed article on Tactile hallucinations and Formication where we explain that while formication and tactile hallucinations can be seen as symptoms of dementia or advancing mental illness, vitamin deficiency, or a hormonal problem in post-menopausal women, we present the case that in some people, these symptoms are part of a myriad of “neurological-type” disorders caused by Craniocervical Instability and cervical spine and neck instability.

That is, in some people, these conditions can be caused by pressure or compression of the posterior spinal cord caused by increasing spinal tension created by a poor cervical curve or neck instability.

The problems of Excessive Sweating

If you have a problem with sweating, it can be caused by many factors including those mentioned above. But if you suffer from excessive sweating as one of many other symptoms, the causes have to be looked at in neurology. For many people we see, especially those with moderate to severe neck problems, we start looking for clues that the sweating is coming from cervical spine instability.

We do realize for some of these people, sweating becomes a primary concern and they become very self-conscious of people looking at their excessively wet clothes. Of the many of their symptoms that the people want to be treated, is the problem of excess sweating.

The extreme sweating is very difficult to manage, I have to change my clothes many times a day.

This is an example of what we hear from people at our center:

I have a diagnosis of Occipital neuralgia. My doctors tell me I have compression at C2. I have headaches, syncope (fainting), nausea and vomitingblurred and double visionswallowing difficultiesmigraines, heat intolerance, and extreme sweating. The extreme sweating is very difficult to manage, I have to change my clothes many times a day.

Sweating caused by cervical disc herniation is something we see in patients. Yet for many, this is a controversial issue. Controversial means that there is not enough published research to make an opinion one way or the other. For people who have Hyperhidrosis, there is no real controversy. They have it, and if you are like many, are reading this article because you suffer from many symptoms that your doctors cannot help, the controversy rests in the inability to be treated. Please see my article The problems of Excessive Sweating – Hyperhidrosis. Is upper cervical instability the missing treatment?

Cardiovascular type disorders

What are we seeing in this image?

This image describes the impact of compression of the vagus nerve and the glossopharyngeal nerve on heart rate and blood pressure

 

  • There are a lot of people who have unexplained dizziness, balance problems, blood pressure swings, arrhythmia, palpitations, OR their heart rate can go really low.
  • They go to a cardiologist or several cardiologists and other doctors and no one seems to know the cause of their heart problems are.
  • We find that in a lot of these cases, the person is suffering from cervical instability especially upper cervical instability.
  • The sensory nerves that tell the brain what’s going on, moment to moment, in regard to heart rate and blood pressure are carried by the vagus nerve and the glossopharyngeal nerve. If the messages that these sensory nerves need to deliver to the brain are blocked or impaired, the heart symptoms described can develop.

Many people are aware that the issues they are having in their cervical spine and neck are being caused by cervical nerve root compression leading to chest pains that mimic a cardiovascular event.  It is important to realize that this may only be one possible explanation as to why seemingly healthy individuals, having been checked out by their cardiologist, have cardiovascular-type symptoms with seemingly no explanation.

Cervical Angina and a long list of other symptoms you also suffer from. Do they all come from the neck?

Like many problems that come from cervical spine and neck instability, cervical angina or chest pain can be considered controversial or a mystery ailment. It is also not a symptom that develops in isolation. Cervical angina is typically accompanied by many coexisting problems related to the neck.

“All of a sudden I had chest pain, chest heaviness, shortness of breath, and my heart was pounding.”

Someone will be in our office. They will tell us a story about a sudden, without cause, onset of panic attacks. Such as this one:

I had an uncontrolled panic attack while driving to work. There was no new stress in my life, I was not even thinking “bad thoughts,” in fact I was not particularly thinking about anything. All of a sudden I had chest pain, chest heaviness, shortness of breath and my heart was pounding, I thought I was going to pass out. After I calmed down enough to drive again, I went home, laid down, and waited for this to subside. 

When searching for a possible cause of this event, this person revealed to us that she worked for a chiropractor and had a lot of cervical manipulation recently. Upon examination in our office with a digital motion x-ray (see below) it showed an incredible amount of upper cervical instability.  This, we suggested, maybe the cause of these and other symptoms she was suffering from including head pressure, history of migrainessensitivity to soundintermittent blurry vision, off-balance, as well as brain fog.

Please read my articles Can cervical spine instability cause heart palpitations and blood pressure problems? and Cervical Angina, where I discuss how chest pain, a racing heartbeat, panic attacks, and anxiety may be coming from a cervical spine and neck instability pressing on the vagus nerve.

Vision Problems

This image is self-explanatory: Craniocervical instability and cervical neck instability can be considered as possible causes of vision problems. Here we show that the negative effect from vagus nerve degeneration can:

  • Diminish ocular blood flow. When a condition of diminished ocular blood flow occurs, this can prevent the regular “flushing,” of fluids in and out of the eyes. If the fluids in the eyes cannot drain they cause increased intraocular pressure.
  • Exaggerated pupillary hippus or pupillary athetosis is a spasming of the iris sphincter and dilator muscles which causes pupil dilating and constricting dysfunction. It can occur as a result of sensitivity to light but it can also occur without a light stimulus.
  • Hampered accommodation – the muscular coordination that allows your eye lens to focus on distant objects.

In this image, vision problems caused by cervical spine instability is connected to Diminished ocular blood flow, Exaggerated pupillary hippus dilating, Hampered accommodation or human ocular accommodation mechanism or accommodation reflex, Increased intra-ocular pressure or elevated intraocular pressure, Limited pupillary constriction, Optic nerve damage

Chronic Neck Pain and Blurred or Double Vision Problems

In my article on Chronic Neck Pain and Blurred or Double Vision Problems, I cover the following points:

  • Chronic Neck Pain and Blurred or Double Vision Problems – Is the answer in the neck ligaments?
  • Cervical spine instability possible causes of a swollen optic nerve
  • Problems of neck stability and movement caused by muscle atrophy. Can muscle atrophy cause double, blurry vision?

What are we seeing in this image?

In this photograph, an optic nerve measurement is taken via ultrasound.  We are looking for swelling of the optic nerve that may explain vision problems by way of demyelinating optic neuritis (swelling of the nerve sheath and optic nerve) or non-arteritic anterior ischaemic optic neuropathy (loss of blood flow to the optic nerve). Characteristic symptoms of compression or entrapment of the nerves and arteries in the cervical spine.

In this photograph, an optic nerve measurement is taken via ultrasound.  We are looking for swelling of the optic nerve that may explain vision problems by way of demyelinating optic neuritis (swelling of the nerve sheath and optic nerve) or non-arteritic anterior ischaemic optic neuropathy (loss of blood flow to the optic nerve). Characteristic symptoms of compression or entrapment of the nerves and arteries in the cervical spine.

Transient monocular blindness

Many people who contact our office will report to us a slow fading out to gray in the vision of one of their eyes. This is a problem that currently, they and their doctors are at a loss for. For some people, this vision loss or alteration has become so frequent, that they simply live with it once their tests ruled out cardiovascular, vascular, and neurological disease. But there has to be a cause and possibly an unexplained treatment. One possibility is that cervical spine or neck instability and a diagnosis of craniocervical instability may be the missing diagnosis for the temporary loss of vision or vision disturbances in one eye.

The people who contact our center are people who usually do not begin the conversation with their temporary loss of vision in one eye. They have many different symptoms and conditions and temporary vision loss is only one of them, and even then, vision loss may not be at the top of the symptom list. That shows us nearly immediately the complexity of their medical history. These people, maybe like yourself, have been on a long medical journey of test after test. For most, the tests did not tell them why this is happening, but, at least the tests have the benefit of telling these people what is not causing their vision problems. The usual outcomes in situations like this are the person receiving more medications, this time for blood thinners, and a recommendation to avoid a high-fat diet. This of course, on top of other medications that they are already taking for their other symptoms. Or as some people say of their medications, “more on the pile.”

For more on this condition and symptom please see my article on Transient monocular blindness and craniocervical and cervical spine instability

Nystagmus – Oscillopsia

If you have been diagnosed or suspected of having Nystagmus – Oscillopsia, it may have taken a long time to get this diagnosis and an understanding of these disorders. For many, Oscillopsia can be one of many diagnoses or comorbidities that you suffer from and a contributing factor for the myriad of symptoms that are causing your health challenges. Oscillopsia is a problem of a “world in motion,” and jumping vision. For more information on the cause of this problem being craniocervical instability please see my article: Nystagmus – Oscillopsia caused by cervical spine instability and neck pain


Ear pain, ear fullness, sound sensitivity, and hearing problems

Many patients we see have ear pain, ear fullness, or sensitivity to sound. Some of these people have a long medical history that may include visits to the ENT and other specialists and doctors. Some may get a diagnosis of Meniere’s disease. In many of these patients, their problems of tinnitus, Meniere’s disease, dizziness, ear fullness, decreased hearing, or sensitivity to sound may be traced to problems of cervical spine/neck instability.

People we see rarely suffer from one problem or condition by itself. We see people who have chronic sinusitis as one condition among many. We see people who have Eustachian tube dysfunction is one condition among many. These symptoms can include tinnitusear fullnessvertigovision problems, facial pain, and numbness feeling. What many people have in common and the one constant condition they suffer from is neck pain.

What are we seeing in this image?

Problems of ear discomfort, ear fullness, pressure, pain, dizziness, and even partial or complete hearing loss can be caused by dysfunction of the Eustachian Tube. The normal function of the Eustachian Tube requires the action of the tensor veli palatini and the levator veli palatini muscles innervated by the vagus and trigeminal nerves. When these muscles do not operate normally, fluid builds up in the middle ear.

Proper Eustachian Tube function vs. dysfunction. In this illustration the proper opening of the Eustachian Tube is shown to require the action of the tensor veli palatini and the levator veli palatini muscles innervated by the vagus and trigeminal nerves. When these muscles do not operate normally, fluid builds up in the middle ear potentially causing the problems of ear discomfort, ear fullness, pressure, pain, dizziness and even partial or complete hearing loss.

In our article: Neck pain Chronic Sinusitis and Eustachian Tube Dysfunction, we discuss the many reasons you have clicking in your ears and chronic sinusitis and the many many reasons you have both. This article presents one possible answer to why you may have not responded to treatment. That answer is a connection to cervical spine instability and neck pain.

Meniere’s Disease and Chronic cerebrospinal venous insufficiency

We will often be contacted by people with a diagnosis of Meniere’s Disease with symptoms and conditions of hearing loss, dizziness, vertigo, sensitivity to high-pitched sounds, lightheadedness, loss of balance, fatigue, swallowing difficulties, vision problems, and some people suggesting that they have an altered sense of reality or dissociation with reality. Some of these people have been suffering from Meniere’s Disease for years and even decades. Many also have tinnitus, inner ear pressure, and a lot of neck and shoulder pain.

Some will tell us that their Meniere’s Disease gets better when they have upper cervical spine chiropractic adjustments. They will also tell us that their chiropractors have noted a reverse curve in their cervical spine and vertebrae misalignment, especially C1-C2 Atlantoaxial instability. Others will tell us about their Idiopathic (no one knows where it is coming from) Intracranial Hypertension. In our article Meniere’s Disease and Chronic cerebrospinal venous insufficiency, we concentrate on the aspects of Meniere’s Disease caused by upper cervical instability and the connection to Intracranial Hypertension and Chronic Cerebrospinal Venous Insufficiency.

Tinnitus, cervical spine instability, and neck pain

If you have a diagnosis of Tinnitus you have probably been subjected to multiple testings, have researched the condition extensively, have had more people look into your ears than you can count. You have had all sorts of treatments, sound therapies, behavioral therapies, drug therapies, and coping therapies to help you manage your day. There are many treatments to help manage tinnitus, but there are no validated treatments that will cure tinnitus.

Many people that reach out to our offices say they are confused and scared because there does not seem to be a direction that they can go to have this problem taken care of. This is why they are reaching out, we are presenting a different option.

In our article Tinnitus, cervical spine instability, and neck pain we suggest treatment surrounding the connection of tinnitus symptoms to cervical neck instability and treatments that strengthen the cervical spine neck ligaments.

Sinus problems – can’t breathe through the nose

In our article on Empty Nose Syndrome, we describe a person’s story here at the Hauser Neck Center at Caring Medical. The person suffered from many different “neurologic-type” symptoms, had received many different diagnoses, had many treatments, procedures, and tests, and was finally diagnosed with Empty nose syndrome amongst his other problems. He contacted us because he felt his symptoms were related to atlantoaxial instabilityvagus nerve compression, and cerebrospinal venous insufficiency.

The patient suffered from shortness of breath (dyspnea) and an inability to feel the air going through his nose. He cannot breathe at times and constantly feels like he is drowning in nasal and sinus fluids. Then he begins to hyperventilate.

Chronic fatigue syndrome

Many people will describe to us their challenges with Myalgic encephalomyelitis (muscle pain from nerve inflammation) or Chronic Fatigue Syndrome. These are very complex disorders. It is difficult to determine their true causes as the true cause can be extremely multifactorial. Many of these people will tell us about yeast, molds, environmental illness, diet, hormones, thyroids and adrenals, and a runaway immune system that causes muscle pain. Sometimes this is diagnosed as Fibromyalgia.

They have been to many doctors, nutritionists, allergists, immunologists, endocrinologists, and other specialists. They will also describe a lot of neck pain, back of the head headaches, trips to chiropractors, an orthopedist, and neurologists. Mostly they will describe a feeling of being sick and tired all the time and a recommendation from their doctors that stress and exhaustion of being in pain all the time are “wearing me out.”

The person who comes to us for problems related to the cervical spine or craniocervical instability does not come in presenting one problem. They come in presenting many problems. We rarely get a patient who comes in with Myalgic encephalomyelitis or chronic fatigue syndrome as the primary concern. But fatigue is a dominating secondary concern. In our article Can Chronic fatigue syndrome and Myalgic encephalomyelitis be caused by cervical stenosis and cervical spine instability? We show research that makes the case for the cervical spine or craniocervical instability for symptoms related to patients with Myalgic encephalomyelitis or chronic fatigue syndrome.

Cervical Vertigo and Cervicogenic Dizziness

In my article on Cervical Vertigo and Cervicogenic Dizziness, I discuss:

  • The diagnosis and treatment of cervical vertigo and chronic dizziness associated with neck movement. Or more commonly for some, a diagnosis of Benign Paroxysmal Positional Vertigo and worsening of its symptoms.
  • Neck pain and dizzy spells – “When I turn my head I get dizzy.”
  • Referral for an ENT specialist, a neurologist, and a cardiovascular specialist. Let’s “rule out what is not wrong with you.”
  • “After all the lab tests, I was still dizzy”
  • “Cervical Vertigo–Reality or Fiction?”
  • Dizziness, blood pressure, and fainting
  • Neck osteoarthritis and dizziness
  • Anterior cervical decompression and fusion plus posterior longitudinal ligament (PLL) resection. The removal of the ligament in the neck region.
  • Cervical Realignment Therapy

Postural-perceptual dizziness (PPPD)

This is also a disorder of persistent sensations of rocking or swaying. It can be vertigo, a sensation of movement without dizziness. It is suspected in people who have had or history of concussion or whiplash, some of the disorders listed here: Benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, or Dysautonomia (problems or disease of the autonomic nervous system). Symptoms may worsen by standing or sitting upright. If you have been diagnosed with Persistent Postural Perceptual Dizziness, it may have been explained to you by your doctors that this is a mystery ailment with an unknown cause.

Even though you were told that you have Persistent Postural Perceptual Dizziness, and you may have some of the diagnoses and conditions mentioned above at the same time, you may still not have understood exactly what Persistent Postural Perceptual Dizziness (PPPD) is or what it describes and how it is different than these other problems you are facing. PPPD remains a mystery to you. In patients we see with a diagnosis of PPPD, some do not understand what this diagnosis is although they know they have it. For more information see my article: Postural-perceptual dizziness (PPPD).

Dissociation, anxiety, and depression

We see many people at our center who suffer from a vast myriad of symptoms related to neurologic-type and vascular-type symptoms and conditions. These health challenges can be traced to their problems with their neck, cervical spine, and craniocervical instability.  These challenges can be termed psychiatric-like because, in some people, these problems are manifest of the cervical spine and craniocervical instability and are symptoms of nerve, vein, and arterial compression caused by the unstable bones of the neck pressing and compressing these vital structures. For a more detailed discussion, please see my article: dissociation, anxiety, and depression.

Emotional stress: A neurologic and psychiatric like condition caused by cervical spine instability

If you have been battling chronic illness, you probably do not need a scientific article to convince you that your challenges come with an emotional price. However, it may be helpful to have some science that says your emotional stress is something more than “illness fatigue.” In the case of emotional stress, this problem is usually listed at the end of a long line of symptoms and conditions. At the end of this list of neck pain, digestion problems, ear tubes, hearing problems, vision problems and other neurologic-like, vascular-like symptoms and psychiatric-like conditions to name just a few, people tell us about their inability to stop taking opioids and antidepressants, and their inability to regulate or control their stress, anxiety and emotions.

For many of these people, reassuring talk centered around their conditions and symptoms causing their emotional challenges would be helpful in explaining the benefits of cognitive behavior management, stress reduction, the benefit of meditation and the benefit of spirituality and prayer. However, there is also a physical manifestation in emotional stress that can come from cervical spine instability killing nerve cells. It would, for many, be equally beneficial to help them understand the possible mechanisms of the physical manifestation of their challenges. Please see my article: Emotional stress: A neurologic and psychiatric like condition caused by cervical spine instability.

What are we seeing in this image?

A Digital Motion X-Ray or DMX is a tool we use to help understand a patient’s neck instability and how we may be able to help the patients with our treatments. In the illustration below a patient who suffered from upper cervical instability demonstrated hypermobility of the C1-C2. This hypermobility can result in common symptoms of neck pain, headaches, dizziness, vertigo, tinnitus, concentration difficulties, anxiety, and other symptoms common in TMJ/TMD patients.

A Digital Motion X-Ray or DMX is a tool we use to help understand a patient' neck instability and how we may be able to help the patients with our treatments. In the illustration below a patient who suffered from upper cervical instability demonstrated hypermobility of the C1-C2. This hypermobility can result in common symptoms of neck pain, headaches, dizziness, vertigo, tinnitus, concentration difficulties, anxiety and other symptoms common in TMJ/TMD patients.

Prolotherapy Treatments

Throughout this article, I suggested that you visit the companion articles on this website for each symptom and condition. In those articles, I hope you will find more specific information on the conditions and symptoms that have plagued you.

In each article is a description and explanation of Prolotherapy treatments, cervical spine curve correction, and the various methods and tests we use to help find and treat

Prolotherapy is a regenerative injection technique that utilizes substances as simple as dextrose to repair and regenerate damaged ligaments.

In 2015, Caring Medical published findings in the European Journal of Preventive Medicine (1) investigating the role of Prolotherapy in the reduction of pain and symptoms associated with increased cervical intervertebral motion, structural deformity, and irritation of nerve roots.

Twenty-one study participants were selected from patients seen for the primary complaint of neck pain. Following a series of Prolotherapy injections, patient-reported assessments were measured using questionnaire data, including the range of motion (ROM), crunching, stiffness, pain level, numbness, and exercise ability, between 1 and 39 months post-treatment (average = 24 months).

  • Ninety-five percent of patients reported that Prolotherapy met their expectations with regard to pain relief and functionality. Significant reductions in pain at rest, during normal activity, and during exercise were reported.
  • Eighty-six percent of patients reported overall sustained improvement, while 33 percent reported complete functional recovery.
  • Thirty-one percent of patients reported complete relief of all recorded symptoms. No adverse events were reported.

We concluded that statistically significant reductions in pain and functionality, indicating the safety and viability of Prolotherapy for cervical spine instability.

In our clinical and research observations, we have documented that Prolotherapy can offer answers for sufferers of cervical instability, as it treats the problem at its source. Prolotherapy to the various structures of the neck eliminates the instability and the sympathetic symptoms without many of the short-term and long-term risks of cervical fusion. We concluded that in many cases of chronic neck pain, the cause may be underlying joint instability and capsular ligament laxity.

A Patient case with many symptoms

This is a case history. The case history presented here may not be typical of results achieved. Medical procedures have successes and failures. In situations of cervical spine instability and the many symptoms and conditions neck instability can cause a thorough examination including testing needs to be discussed.

The patient’s story is this:

  • A bad whiplash injury in 2013.
  • The patient had received osteopathic treatments, physiotherapy treatments, chiropractic manipulation, and various pain medications.
  • She continued to have a self-described horrible pain in the neck especially on the left side
  • Symptoms included:
    • Electric shock type or “zingy” pain” disabling pains down the left side,
    • pins and needles sensation,
    • jaw pain,
    • headache,
    • earache and ear pain,
    • fatigue, enough that throughout the day she would have to lay down.
    • chronic “sickness”,
    • toothache.
    • A self-described feeling of constantly “being punched in the face” or “feeling that somebody was stabbing me with the knife in the upper back.”
    • Walking would increase the symptoms.
    • Turning her heard would create cracking sounds in the neck.
    • Feeling that her neck is not supporting her head. A self-described feeling that “nothing inside in my neck is supporting my neck and head.”
    • Whole body aching.
    • A sensation that “someone was twisting the nerves in my neck.”

The patient was from England, she had come to the United States to get a Digital Motion X-Ray. She was then referred to a clinician in London who started treating her with shockwave treatment and laser treatment. The treatments were helping, the clinician was also offer spinal manipulations that would help for a few weeks at a time. But then her cervical spine would go out again. After researching further a decision was made to seek Prolotherapy injections to help keep the cervical spine in place. One doctor would treat me from C3-C7 but now one in England would treat C1-C3 because they considered it dangerous.

“There was nothing wrong with me”

“I’ve been to that many practitioners, clinics, hospital appointments nobody’s helped me. They said there was nothing wrong with me. I looked up on the internet where I could get help and that is how I wound up here. . . . No one was listening, no one knew what I was talking about. That did not help.”

“My whole life had been taken away for the past five years”

“It got to a point where I was so depressed because I couldn’t do what I wanted to do and everybody else’s life with going on around me. I felt worthless.”

The headache and scalp sensitivity problem.

“I had bad headaches. They were clustered at the back of my head near the top. The headaches would creep across the back of my neck. My head was sore all the time, like a sensation that it had been burnt, I would run my fingers through my hair and it be so sensitive because the main area at the back of my neck hair was so sore and tender all the time from the weight of my head.”

The Digital Motion X-Ray Showed:

We did another digital motion x-ray which showed significant C1 C2 instability. But the instability extended from beyond an upper cervical instability at C1-C2 to an instability from C1-C5. We were not sure we could help this patient initially. It was suggested to her and her husband that a cervical spine fusion may be needed. But as we started the Prolotherapy injections improvement was seen over the first few sessions.

“Getting the treatments were scary. I am in a foreign country, so far away from home. But I was noticing improvements and I continued with the treatments. After I returned home I started having the ability to do more things. I started doing more around the house I got more mobile. But I also noticed that I started feeling guilty because I did feel poorly anymore, the good feeling does not feel right, this is not me. Day to day things were getting better. We moved from one house to another and I found myself lifting boxes. I would still get very tired, but the next day I could do a little more. I painted ceilings in the new house. I ride my bicycle now. I have a new job. I still have some symptoms and concerns about the back of my neck, but they are more rare. I do not get the headaches or the sharp stabbing pains, I am a totally different person, like all those problems never even happened.”

Treating and repairing cervical instability with Prolotherapy: research papers

Summary and contact us. Can we help you? How do I know if I’m a good candidate?

We hope you found this article informative and it helped answer many of the questions you may have surrounding Craniocervical Instability, upper cervical spine instability, cervical spine instability, or simply problems related to neck pain… Just like you, we want to make sure you are a good fit for our clinic prior to accepting your case. While our mission is to help as many people with chronic pain as we can, sadly, we cannot accept all cases. We have a multi-step process so our team can really get to know you and your case to ensure that it sounds like you are a good fit for the unique testing and treatments that we offer here.

Please visit the Hauser Neck Center Patient Candidate Form

This article was updated April 7, 2021

 

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