2 Types of Cervical Instability That Physical Therapists Treat

2 Types of Cervical Instability That Physical Therapists Treat

Cervical instability can be a complex and often debilitating condition that affects the neck and upper spine. While it can stem from various causes, two common types that physical therapists treat are ligamentous-capsular hypermobility and functional postural disorders (proprioceptive dysfunction of the craniocervical junction, or CCJ).

These forms of instability may not always show clear structural damage on imaging, but they significantly affect a patient’s quality of life and function.

Let’s explore these two types of cervical instability and how physical therapy can help.

1. Ligamentous-Capsular Hypermobility

Ligamentous-capsular hypermobility occurs when there is excessive movement in the cervical spine due to looseness or laxity in the ligaments and capsular structures that support the neck. This increased range of motion can lead to mild instability in the cervical spine, often resulting in non-specific neck pain or occasional discomfort.

Symptoms:

• Mild neck pain or discomfort
• Occasional feelings of instability in the neck
• Lack of significant neurological symptoms (e.g., numbness, tingling, or weakness)
• Imaging findings that show no significant structural damage

While ligamentous-capsular hypermobility may cause discomfort, it does not typically present with the severe symptoms seen in structural instability, such as neurological deficits or significant tissue damage. This condition is often identified by a physical therapist during a clinical examination, as imaging studies may not reveal the full extent of the problem. Physical therapy focuses on strengthening the stabilizing muscles of the cervical spine to improve support and reduce the excess range of motion.

Treatment Options:

• Postural retraining to improve alignment and reduce strain on the neck
• Strengthening exercises to target deep cervical stabilizers, such as the deep neck flexors
• Manual therapy techniques to improve joint mobility and decrease discomfort

By addressing the muscular imbalances and promoting better spinal alignment, physical therapy can help patients manage symptoms and prevent further strain on the cervical spine.

2. Functional Postural Disorders (Proprioceptive Dysfunction of the Craniocervical Junction)

The second type of cervical instability that physical therapists treat is functional postural disorders, which are often caused by a disruption in the proprioceptive system. This dysfunction affects the body’s ability to sense and control cervical spine movements, leading to functional instability.

Despite the absence of visible damage to the bones, ligaments, or discs of the cervical spine, patients with this form of instability can experience a range of symptoms that mimic neurological or musculoskeletal dysfunctions. These can include dizziness, balance issues, and even muscle hyperactivity in the neck and upper body. The condition is often associated with proprioceptive dysfunction in the craniocervical junction (CCJ), where the cervical spine meets the skull.

Symptoms:

• Dizziness or vertigo
• Balance disturbances
• Muscle tightness or hyperactivity in the neck and shoulders
• Occasional headaches or tension in the neck
• Lack of structural abnormalities on imaging

While the symptoms may seem similar to those caused by more severe conditions, such as herniated discs or nerve impingements, functional postural disorders are typically not visible on imaging. This makes it challenging to diagnose, as imaging often appears normal despite the presence of symptoms.

However, a detailed physical therapy evaluation that looks at movement patterns, muscle coordination, and proprioceptive feedback can help uncover the root of the problem.  At PhysioFit of North Carolina, we utilize NeckCare Technology to examine your proprioceptive abilities.

Treatment Options:

• Proprioceptive retraining to enhance awareness and control of neck movements
• Strengthening exercises for deep neck stabilizers to support the cervical spine
• Balance exercises to address dizziness and improve coordination
• Stretching and relaxation techniques to relieve muscle tension and hyperactivity

For individuals with functional postural disorders, physical therapy is key in helping the body re-establish proper movement patterns and improve its ability to maintain stability.

How Physical Therapy Can Help

Physical therapists play a crucial role in the treatment of cervical instability, whether it’s ligamentous-capsular hypermobility or functional postural disorders. Through comprehensive assessments, including manual muscle testing, range of motion evaluation, and proprioceptive testing, physical therapists can determine the specific cause of the instability. From there, they develop individualized treatment plans focused on restoring stability, reducing pain, and improving overall function.

Both types of cervical instability can benefit from a gradual rehabilitation approach, starting with gentle exercises to restore range of motion and progressively building strength and stability. By incorporating postural training, muscle strengthening, and proprioceptive exercises, physical therapy aims to help patients regain control over their neck and spine, leading to better posture, less pain, and improved quality of life.

Conclusion

Cervical instability can significantly impact daily life, but with the right treatment, patients can find relief and regain stability. Whether you’re dealing with ligamentous-capsular hypermobility or functional postural disorders, a physical therapist can help guide you toward a path of healing and recovery. If you’re experiencing neck pain, dizziness, or balance issues, it’s important to seek a proper evaluation to determine the underlying cause and begin the appropriate treatment plan.

Learn more at our Cervical Stability Program to see if we are a right fit for you!