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Craniocervical Instability Symptoms: How To Identify and Treat Them

Medically Reviewed by Cellaxys

By Published: November 24, 2022Updated: December 4, 2023No Comments

Cervical instability or craniocervical instability (CCI) is a medical condition in which the ligaments holding your head to the upper neck become loose or relaxed. This results in excruciating pain close to your neck, skull, and shoulders

CCI occurs due to the excessive movement of the patient’s vertebrae at the atlantoaxial joint (upper part of the neck) and the atlanto occipital joint (articulation between the atlas bone and the occipital bone). These joints are between the first two vertebrae (C1 and C2) and the skull. This instability can cause compression in the brain stem, vagus nerve, or spinal cord, along with several other symptoms. 

CCI can even lead to rheumatoid arthritis if not treated on time. Luckily, many treatment options, including orthobiologic methods, are giving excellent results in relieving CCI symptoms. 

7 Craniocervical Instability Symptoms To Look for

Are you feeling pulsating pain from the back of your head to your shoulders? If so, it could be a sign of craniocervical instability. Here are some other common symptoms that can help you identify craniocervical instability:

Heavy Head

One of the most common symptoms of craniocervical instability is having a heavy head with constant cervicogenic pain. It feels like your head might fall off your body or your neck can no longer support your head. 

The condition occurs when the loosened ligaments fail to tighten the skull at one position. The head weight increases due to forward movement from the neutral alignment of the spine. As a result, many patients experience severe dizziness and posture problems

Some patients have also reported a continuous urge to turn their heads down because of the uneasiness. This situation is somewhat similar to having a “bobblehead.” 


A migraine is a severe headache resulting in excruciating pain in a particular part of your head. It can be a specific vein or a brain chamber that’s been affected due to craniocervical instability. 

Migraines usually observed due to cranial instability start from the base of your skull and radiate upward following the ram’s horn pattern. You may suddenly experience a shocking wave of migraines out of the blue or develop a constant chronic headache that lasts for hours or days.

Blurred Vision

Several patients complain about experiencing various visual problems with cervical instability. Visual impairment, like blurred vision, results from your throbbing forehead. 

Cervical muscle instability can disturb your cognitive abilities and cause visual disturbances. Such disturbances may range from mild to severely affected eyes. 

Brain Fog

Brain fog is a significant symptom of craniocervical instability. It refers to the unintentional scattered thoughts, usual forgetfulness, inability to concentrate, haziness, and lack of mental sensing are all signs of brain fog.

People suffering from CCI struggle to remember everyday things. They’re always full of different thoughts. Extreme brain fogging may lead to cognitive impairment.

Elevated Heart Rate

An elevated heart rate may indicate various bodily abnormalities, including craniocervical instability. In CCI, the vagus nerve that manages heartbeats gets stimulated by uncontrolled head movements. 

The condition increases your heartbeats per minute, leading to postural orthostatic tachycardia syndrome (POTS). It is an autonomic movement disorder.

Neck and Shoulder Pain

The localized neck and shoulder pain is another common cranial instability symptom. First, the pain radiates outward from the base of your skull. Then, it starts to spread throughout the neck to the shoulders. The pain increases further with continuous muscle movement. 

For example, whenever you flex your arm muscles or move your shoulders laterally, you’ll feel a sharp, stinging pain run down your spine. The throbbing pain in the trapezius and scapular region of the neck pain is known as Cervicalgia

Chronic Muscle Fatigue

Craniocervical instability usually occurs due to constant strain on your muscle fibers. First, the ultimate nonstop pressure exhausts your muscles, resulting in swollen mass. Then, the inflated muscle mass starts throbbing with pain due to inflammation, giving you chronic fatigue for days, maybe weeks. 

Usual fatigue may fade away with time, but if your condition is severe, you may experience complete immobility. Even getting up from your bed will feel like climbing mountains.

Other Symptoms of Cervical Instability

You might experience a few other symptoms depending upon your condition, such as: 

  • Occipital headaches
  • Muscle spasms
  • Jaw pain
  • Difficulty in swallowing
  • Light sensitivity
  • Ringing in ears (Tinnitus)
  • Orthostatic intolerance
  • GI disturbances (diarrhea, constipation, flatulence, etc.)

Treatment for Craniocervical Instability Symptoms

Treatment for Craniocervical Instability Symptoms

Patients with mild craniocervical instability symptoms can eliminate the excruciating pain in their neck and shoulder with conservative treatments. However, if the pain becomes unbearable, you may need extensive care or orthobiologic methods.

Conservative Care

Some effective conservative methods include:

  • Upper cervical chiropractic care
  • Physical therapy
  • Neck bracing or collars
  • Anti-inflammatory medications

Orthobiologic Methods

With advancements in regenerative medicine, orthobiologic methods are giving exceptional results in treating multiple neck, shoulder, and spine-related conditions. Over the years, cell-based therapies (also known as stem cell therapies) and platelet-rich plasma therapy (PRP) have become increasingly popular among patients as they are less invasive and less painful with a very short recovery period. 

At CELLAXYS, we perform orthobiologic treatments with an excellent recovery and healing rate. We harvest healthy cells from different body parts, process them, and reinject them into your injury site. Depending on your condition, we opt for any of the two types of methods:

  • Cell-Based Therapies: The process includes taking your healthy autologous or own tissues from the adipose (fat) tissue or bone marrow and reinjecting them into your craniocervical area. In the case of fatty tissues, the process is called Minimally Manipulated Adipose Tissue Transplant (MMAT). When the cells are taken from bone marrow, the process is called Bone Marrow Concentrate (BMAC). 
  • PRP Therapy: The process isolates platelets from the patient’s blood plasma, processes them, and reinjects them into the injury site. Platelets are the first line of defense in our body. They perform three main functions. First, they release 10 Growth Factors to promote new tissue development. Then, they attract healing cells from the blood. Finally, they produce a web-like scaffolding called fibrin to support the growth of new cells. Many platelets in the injury site promote quick healing and healthy recovery. 

Cell-based therapies and PRP are outpatient procedures, meaning you can go home right after the procedure. MMAT and BMAC take 1.5 to 2 hours, while PRP takes 45 minutes.

Dr. Pouya Mohajer

Director of Regenerative Interventional Spine Medicine
Board certification in Anesthesiology and Interventional Pain Medicine
Fellowship-trained from Harvard University
UCLA Alumni


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