Neck & Cervical Instability
Atlantoaxial Instability
Excessive movement between the first two neck bones — a medical finding requiring caution.
Also called: AAI.
Atlantoaxial instability refers to excess movement between the top two vertebrae in the neck. It can be associated with certain medical conditions, congenital differences, or significant trauma, and it requires medical evaluation and imaging before any hands-on neck care is considered.
Because this level of the spine sits so close to the spinal cord, confirming stability here is not something that can be judged by symptoms or a physical exam alone.
Why this matters
Knowing a person's relevant medical history changes what is safe well before any care begins, which is why a thorough health history is taken seriously at the outset rather than treated as a formality.
Where there is any reasonable suspicion of atlantoaxial instability, referral for medical evaluation takes priority over any chiropractic care.
The brain & nervous-system connection
Where the nervous system fits in
Movement at this level directly affects the space available for the spinal cord, so caution here protects a structure that is central to the entire nervous system.
Where instability is not present and has been appropriately ruled out, general neck function and coordination can be evaluated using gentler, more conservative approaches.
What we look at
We look for patterns, not a single test
- Detailed health history and consultation
- NeuroInfiniti Stress Response Evaluation
- Posture and movement
- Balance and coordination testing
- Eye movement or neurological screening when appropriate
- Grip or motor-function testing when appropriate
- Palpation and spinal function
- Other examination procedures based on the individual
Not every person receives every test. What we perform depends on your history, your age and what the examination shows as we go.
Scope of care
What this does — and doesn't — mean
What we do
- • We evaluate chiropractic and musculoskeletal function.
- • We look at nervous-system-related functional findings that fall within our scope.
- • We assess movement, balance and coordination findings.
- • We measure stress-response patterns with the NeuroInfiniti evaluation.
- • We make individualized chiropractic care recommendations and re-measure over time.
What we don't claim
- • We do not diagnose, treat or cure diseases.
- • Chiropractic care is not a treatment for dementia, Alzheimer's disease or other neurological diseases.
- • Chiropractic care is not a replacement for medical care, testing or medication.
- • No outcome is promised. Results vary from person to person.
This is a concern where medical evaluation, imaging or co-management may be the right first step. Dr. Mike Geran will say so plainly if that is what the history and examination suggest.
Common questions
- Will I be adjusted on the first visit?
- Generally no. The first visit is an evaluation visit. Dr. Geran reviews the findings and makes recommendations at the follow-up visit.
- Do I need imaging before I come in?
- Not usually. If your history or examination suggests imaging is needed, we will say so and help arrange the right next step.
When medical evaluation may be needed
Suspected atlantoaxial instability needs medical evaluation. We do not adjust the upper neck in this situation.
- Sudden severe neck pain after trauma
- Weakness, numbness, or clumsiness in the arms or legs
- A sense that the head needs support
Related at Foothills Chiropractic
- Balance & Coordination — Balance is a whole-nervous-system task. It is also one of the easier things to measure and re-measure.
- Ankle Instability — A repeatedly rolling or unreliable ankle, usually following earlier sprains.
- Auto Accident Injury — Musculoskeletal injuries following a motor vehicle collision.
- Balance Problems & Disequilibrium — Feeling unsteady on your feet, particularly in the dark or on uneven ground.
Think Foothills Chiropractic might be right for you?
Start Here walks you through what the process looks like, so you can decide whether taking the next step makes sense for you.