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If you experience a clicking noise when you turn your head, it's possible that you have a misalignment between the C1 and C2 vertebrae in your neck. If so, neck clicking can be an early sign of a most significant problem. We've got a lot of stuff to unpack in this article in order to explain what causes neck clicking. Fortunately, it is a pretty straightforward explanation that we will be able to describe in plain English. And most of the time, neck clicking can be resolved without drugs or surgery.
So, what causes neck clicking when you turn your head? When you turn your neck, the two bones in your neck that are responsible for the majority of that movement are your atlas (C1) and your axis (C2) located just below the base of your skull. Usually, the clicking noise is what happens when there is abnormal movement occurring between the joints, which either causes a ligament to “flick” across another surface or causes the cartilage to rub unevenly making a “gristle”-like noise.
Even though neck clicking when you turn your head isn’t necessarily painful, it can be a sign of a more significant problem. If you have spoken to your GP, they probably said that it was just a bit of arthritis and perhaps recommend some basic exercises and to stop sticking your head far forwards at work. On the other hand, if you have done a bit of research on Google, you probably diagnosed yourself with a condition known as atlanto-axial instability or maybe even Ehlers-Danos Syndrome.
It is my experience that these conditions are commonly over-diagnosed. Just because you have a clicking neck and major some other symptoms that are associated with atlanto-axial instability or Ehlers Danos Syndrome does not mean that you have either of these conditions. So let us explain what each one is, how they are related, but then also how there may be a natural approach to healthcare that may be able to help with your neck clicking when you turn your head.
Neck Clicking, Atlanto-Axial Instability, and Ehlers Danos Syndrome
Let’s start with Ehlers Danos Syndrome. Ehlers Danos is a genetic disorder, which means that the protein-matrices that make up the ligaments in your body are not quite as strong as normal. Think of it as the difference between a thick elastic strap versus a stretchy rubber band. When ligaments by their architecture are overly stretchy, it means that there is likely going to be excessive movement between the joints in your body.
Note: As a child, we sometimes use the expression of being “double-jointed.” There actually is no such thing, but it does refer to the idea that some people are more excessively flexible through their hands, shoulders, and other joints than others. As a quick litmus test, unless you are able to a) touch your thumb against the back of your wrist or b) hyperextend your fingers, shoulders, or knees, then the odds are that you do not actually have Ehlers Danos Syndrome. With Ehlers Danos Syndrome, the joints in the upper neck which support your head and neck movements are no exception. As a result, people with Ehlers Danos are more likely to experience what is known as a craniocervical syndrome, which is a combination of symptoms associated with disruption to the nerves of the brainstem:
- Migraines
- Vertigo
- Seizures
- Drop Attacks
It is also possible to experience these symptoms even without Ehlers Danos syndrome if there is a problem with the alignment or motion through the joints in your upper neck. This brings us next to atlanto-axial instability. Atlanto-axial instability is a consequence of either a genetic disorder (including rheumatic arthritis), but most likely a physical injury that tears at least 30% of the fibres that normally support the movement between your atlas (C1) and axis (C2) vertebrae. When such injuries known as Type II Sprains occur, the consequence is that there is excessive movement between the two joints. As a result, the ligaments are likely to click when you turn your neck, and you will also likely experience the same array of symptoms that we just mentioned with Ehlers Danos Syndrome. The difference as you see is in the cause of the condition.
With both Ehlers Danos Syndrome and also Atlanto-Axial Instability, depending on the degree of ligament laxity, treatments such as Prolotherapy to strengthen the ligaments or even surgery to fuse and stabilise the region are commonly cited. While these approaches can often help people, oftentimes there may be a more natural, conservative option to trial first. Here then brings us to a third possibility, which we find is actually most common: i.e., the cause of your neck clicking is not actually because the area is unstable per se, but just isn’t moving correctly.
Neck Clicking, Atlanto-Axial Instability, and Compound Interest
We just described that true atlanto-axial instability or atlanto-axial subluxation occurs when there is a 30% tear of the ligament's fibres. However, we should like to point out that it is possible that even if the fibres are not torn that if they stretch less than 30% that it is still very likely that your neck will click when you turn your head. What this suggests is that one part of your neck is clicking because it is moving too much as compensation for something else that isn’t quite moving enough.
So what happens is that the term “atlanto-axial instability” is still used even though it is not at all appropriate in our opinion. In other words, you don’t need to have atlanto-axial instability for your neck to click or to have the other symptoms associated with it. So what else could it be?
It is our experience that when you experience micro or receptive trauma that causes the vertebrae of your spine - especially of your upper neck - to become locked within their normal range of motion that your body will attempt to compensate but recruiting your muscles and ligaments in other parts of your body. What this means is that your body Innately is trying to adapt for insufficient movement in one spot by causing other areas to move too much.
And the thing about the atlanto-axial joint is that it is the only joint in your entire spine that produces pure rotation. Therefore, it is really the only place that can absorb the stress like a series of chainlinks kinking against each other. It is our experience that the two most likely areas that are actually responsible for a C1-C2 neck clicking problem are actually located just above or just below between the base of your skull or with your C3 vertebra.
Again, just because these joints aren’t dislocated or unstable does not mean that they cannot cause significant problems. Consider the potential effects of exponential growth and compound interest at just 2%. If the joints in your neck only move 98% of what they should per year, and if these types of problems accumulate over a period of time after only 10 years the overall function, flexibility of your neck has decreased by nearly 20%! And after 20 years, that overall amount is decreased by 33%! This is how problems such as neck clicking, arthritis, pain, vertigo, dizziness, and other symptoms associated with aging creep into your life. It is not necessary because you are getting older. It is because you have an old injury that you never realised was there!
Fortunately, even if you do have neck arthritis - and really, even if you have a certain degree of genuine atlanto-axial instability or Ehlers Danos Syndrome - there may still be a conservative option without drugs, needles, or surgery that may be able to help you known as Upper Cervical Care.
Neck Clicking and Upper Cervical - A Different Type of Chiropractor
Upper cervical care is a special division of chiropractic that uses a precision-based approach to treating conditions of the upper neck, specifically the alignment of the atlas (C1) and axis (C2) vertebrae. The particular method that we use in our practice is known as the Blair Technique, which was developed in the USA alongside other specific atlas techniques including the Atlas Orthogonal and NUCCA procedures.
Unlike general spinal manipulation, the Blair Technique does not use any twisting, stretching, or cracking. The Blair Technique is a precise, personalised, and gentle approach that uses a series of detailed diagnostic tests to determine first the exact location, direction, and degree of misalignment that may be present in your upper neck in order to know what exact combination you may need. Note: There are over a half-million combinations that the top four vertebrae in your neck may misalign based on your unique bone structure and individual circumstances, and so it is important to narrow it down in order to help give you the best possible chance of success!
The Blair procedures begin with a detailed health history, focused physical and neurological assessments, and then specialised diagnostic imaging that is not typically performed in a GP, specialist, physiotherapist, or even other chiropractors. In other words, even if you have already had X-rays, CTs, or MRIs and things come back as “normal,” with the types of images that we take we are often able to discover the underlying problems that aren’t showing up elsewhere. With this information, we are then able to make a customised recommendation and do something different to help with your condition including neck clicking.
When we know the exact direction that is needed to correct the alignment in your neck, we need only use a gentle impulse (approximately what you would use to click a pen) in order to restore the normal movement. Thereafter, the purpose of care is to give your body the best opportunity to do what it does naturally: heal and stabilise itself. And really, that is the point. It is not our aim to keep adjusting your neck over and over, only to have the vertebrae misalign over and over again. Our goal is to help maintain your correction for as long as possible so that your body may be able to stabilise so that the neck clicking and other symptoms may be able to resolve themselves over a period of time on their own!
In other words, the less treatment you need, the better! We hope that this article has been able to provide you with a lot of valuable information not just about what causes neck clicking, but even if you do have atlanto-axial instability or Ehlers Danos Syndrome, that there may still be other natural options available to help you. If you would like to schedule a 15-minute complimentary over-the-phone consultation to find out if the Blair Technique and Upper Cervical care may be right for you, call our office at 07 3188 9329 or click the Contact Us link on this page.
Atlas Health Australia is a leader for the Blair Technique and Upper Cervical Care in Australia. Located in North Lakes (north Brisbane), we provide services for people with a variety of health conditions associated with the upper cervical spine (including neck clicking) so that they can find long-term solutions and enjoy the things in life that matter most to them.
References
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Rosa S, Baird JW. The craniocervical junction: observations regarding the relationship between misalignment, obstruction of cerebrospinal fluid flow, cerebellar tonsillar ectopia, and image-guided correction. Smith FW, Dworkin JS (eds): The Craniocervical Syndrome and MRI. Basel, Karger, 2015, pp 48-66 (DOI:10.1159/000365470).
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