What are 2 types of Cervical Instability?

Cervical instability refers to the excessive movement or abnormal alignment between the bones at the base of the skull and the cervical spine (neck). While structural instability is caused by damage to ligaments or bones, functional craniocervical instability is more complex. It doesn’t always show visible signs of injury on imaging, but instead, it manifests through symptoms like dizziness, balance issues, muscle tension, headaches, and pain, often caused by the nervous system’s inability to properly regulate movement.

Therefore, cervical instability can be categorized into two primary types

1. True (Structural) Instability:
   This occurs when there is significant elongation, damage, or weakening of the ligamentous structures, or deformation of the bony anatomy within the CCJ. These changes lead to abnormal motion patterns, which are often detectable through provocative mobility tests and radiological imaging. Structural instability is characterized by measurable physical changes in the anatomy, resulting in clear mechanical dysfunction.
2. False (Functional) Instability:
   Unlike structural cases, functional instability presents without clear abnormalities on imaging or clinical mobility tests. Instead, it is associated with symptoms such as muscle hypertonia, pain, dizziness, balance difficulties, pseudo-radicular or pseudo-meningeal symptoms, dysautonomia, and mood or concentration disturbances. These symptoms arise from dysregulation in the nervous system, often described as “informational noise.” Functional instability does not stem from mechanical failure but rather from impaired neuromuscular control and heightened nervous system sensitivity.

Understanding these distinctions is critical for tailoring treatment approaches, as true instability often requires stabilization techniques, while functional instability benefits from strategies addressing nervous system regulation, muscular balance, and proprioceptive retraining.

A targeted cervical stability program can play a crucial role in addressing functional craniocervical instability. This type of program typically involves a combination of strength training, posture correction, proprioceptive exercises, and manual therapy techniques to improve the overall function and stability of the cervical spine.

Physical therapy is often a key component in treating functional craniocervical instability. By working with a skilled physical therapist, patients receive a personalized program that addresses their specific symptoms and needs. The therapist can tailor exercises based on the severity of instability and guide the patient through safe and effective techniques that gradually rebuild strength and mobility.

You can learn more about our personalized approach at our Cervical Stability Program page.