From short term stiffness to chronic numbness neck issues have far reaching and knock on effects in the body, especially if left untreated. Atlantoaxial joints are the most mobile and complex in the whole body, and are also most vulnerable. It is the joint that provides stability and mobility to the head.
Clients with atlantoaxial joint instability (AA) instability often report persistent headaches, a dull ache or sharp pain in the neck on rotation, constant tension held in the shoulders and sometimes a numbness down the side of their face.
AA occurs when there is excessive movement at C1,2 and is common in patients with acute trauma or rheumatoid arthritis.
Anatomy of the Cervical Spine
The neck is formed by spinal vertebrae C1-7 and 8 pairs of nerves. C1 and C2 are also called the 'atlantoaxial joint' (see image below) and allows the head to flex up and down and rotate.
Uniquely, there is no disc between the vertebrae, but the joint is secured by thick ligament - the transverse ligament. This prevents the spine from becoming compressed during flexion.
Symptoms of Atlantoaxial Joint Instability
Stiffness in the neck, especially when flexing the neck
Dull ache in the neck or sharp, stabbing pain
Constant tension or tightness in the neck
Frequent headaches or migraines
Itchiness or irritation on the scalp
Numbness or tingling sensation on one side of the face
Shallow, restricted breathing
Chronic tension or tightness in the shoulders
Difficulty relaxing or feeling settled
Persistent fatigue or exhaustion
Oversensitivity to light
Feelings of frustration, restlessness, or being "on edge"
Racing or intrusive thoughts, and self-critical tendencies
What Causes Instability in the Atlanto Axial Joint?
Instability in the atlanto-axial joint, which is the joint between the first and second cervical vertebrae (atlas and axis), can be caused by several factors:
Congenital abnormalities: Some people are born with structural abnormalities or deficiencies in the ligaments and joints that support the atlanto-axial region, leading to inherent instability.
Traumatic injury: Sudden, severe trauma to the neck, such as whiplash injuries from car accidents or sports-related impacts, can damage the ligaments and structures that stabilize the atlanto-axial joint.
Rheumatoid arthritis: This autoimmune condition can cause inflammation and destruction of the joints, including the atlanto-axial joint, resulting in instability.
Down syndrome: Individuals with Down syndrome have an increased risk of atlanto-axial instability due to ligamentous laxity and joint abnormalities.
Connective tissue disorders: Conditions that affect the integrity of connective tissues, such as Ehlers-Danlos syndrome, can contribute to atlanto-axial instability.
Inflammatory conditions: Diseases that cause inflammation in the cervical spine, like ankylosing spondylitis, can lead to atlanto-axial instability over time.
Transverse ligament rupture: The transverse ligament, which helps hold the atlas (C1) in place, can be torn or ruptured, leading to instability.
What are The Psychosomatic Influences?
Emotional trauma, whether from a single devastating event or a prolonged, tumultuous upbringing, can have a profound and lasting impact on the body's structural integrity. The atlanto-axial joint, being a delicate and critical juncture in the cervical spine, is particularly vulnerable to the effects of emotional distress.
When we experience trauma, our nervous system goes into a heightened state of alert, triggering the fight-or-flight response. This physiological reaction causes the muscles surrounding the AA joint to tense up, constricting the joint's natural range of motion and stability. Over time, this persistent muscle tension can lead to structural changes, weakening the ligaments and other supporting tissues.
But the impacts of emotional trauma extend far beyond the physical realm. The psychological and emotional scars left by traumatic experiences can shape our very beliefs about the world and our place in it. Individuals who have endured trauma often develop a deep-seated sense of insecurity, a belief that the world is an unsafe and unreliable place.
This worldview can manifest in the way we carry ourselves, both literally and figuratively. The need to constantly "hold ourselves up," to be vigilant and self-reliant, places an immense strain on the musculoskeletal system, including the delicate atlanto-axial joint. The body, in a sense, becomes a physical embodiment of the psyche's attempt to protect itself from further harm.
Furthermore, the emotional turmoil associated with trauma can lead to habits and coping mechanisms that further exacerbate the problem. Stress, anxiety, and depression can all contribute to altered breathing patterns, poor posture, and a general state of muscular tension – all of which place additional demands on the AA joint.
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