Neck pain? Stabilising the atlantoaxial joint
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. Conventional medical treatment involves a steroid injection or in extreme cases surgery. In this article I discuss how craniosacral therapy can help.
What causes instability to occur in the atlanto axial joint?
Severe injury such as whiplash or a boxing injury, decades of misuse of the body, postural impairment, a difficult birth where compressive or twist vector forces were not resolved, or autoimmune conditions can all lead to degeneration in the transverse ligament.
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.
What are the symptoms of atlantoaxial joint instability?
- stiffness in neck esp when flexing - dull ache in neck or sharp pain
- constant neck tension - headaches/ migraines - itchy scalp - numbness sometimes on side of face - shallow breathing - chronic tension in shoulders - difficulty resting or feeling settled
- oversensitivity to light - emotions: frustration, feeling always on edge -racing thoughts, self deprecation
What treatment is available?
Currently, there is a lack of consensus among surgeons on the best approach to diagnose, characterize, and treat this condition as the mechanism of injury to this area is not understood or agreed upon. Neutral and dynamic cervical radiographs are often used to diagnose atlantoaxial instability but the diagnostic sensitivity is low. Surgery and steroid injections are often resorted to.
What are the psychosomatic influences?
Persistent internal tension between the need to hold oneself up in order to interact with the world vs wanting to be held up by the world in order to interact with it is a key component i've observed in cases of AA. It is closely related to thought patterns about “doing enough” and there is an element of constantly watching the world for a response in order to validate internally, the sense of being upheld.
Persistent internal tension between the need to hold oneself up in order to interact with the world vs wanting to be held up by the world
Being upheld by our environment is our right as humans but if our life experiences have taught us that this isn't reliable or forthcoming, we go about creating it ourselves. We uphold ourselves. Creating a mindset of doing, achieving, proving, protecting. This striving to keep the head above water actually requires a lot of energy. Over many years, it creates an internal fatigue, a fragility, a constant 'whizzing' mind. Energetically the head spins round with the eyes wide open, or rocks incessantly back and forward. There is a feeling of not knowing what more to do, in order to feel upheld. Addressing these factors is part of the treatment of craniosacral therapy.
This striving to keep the head above water actually requires a lot of energy. Over many years, it creates an internal fatigue, a fragility, a constant 'whizzing' mind. Energetically the head spins round with the eyes wide open, or rocks incessantly back and forward.
How can craniosacral therapy help?
The first aspect of craniosacral treatment of AA is probably to create a sense of safety in the field that allows the forces especially circular forces around the head to settle. There is usually a deep need for slowing down and coming into stillness.
Allowing the neck muscles and shoulders to relax will also help. Sometimes as a result of holding this in the body the back muscles will have become contracted and tight so gradually allowing them to release and connecting with the whole spine ensuring the cervical vertebrae are reintegrated to the whole.
Key to this though, is to understand specifically, how the body needs to be upheld - everyone will respond differently. By offering upholding and recognition, there can be a softening and settling in the ligaments.
If you or anyone you know has neck issues or spinal integrity is being affected by stress, illness or pain they can’t seem to shake off, contact me firstname.lastname@example.org
You can watch a video of the C1C2 joint in action: