An upper cervical subluxation is a misalignment of the atlas (C1) or axis (C2) vertebrae at the top of your spine that disrupts nervous system function. This condition can cause headaches, neck pain, dizziness, and numerous other health issues because the upper cervical spine protects the brainstem, the master control center connecting your brain to your body.
Blair upper cervical chiropractic care uses precise, gentle adjustments to correct these misalignments and restore proper function.
Main Insights
- Prevalence: Research suggests 79% of the population experiences upper cervical subluxation at some point
- Symptom Onset: Average time from injury to symptoms is 10-15 years
- Location: Affects C1 (atlas) and C2 (axis) vertebrae at the skull-neck junction
- Importance: Upper cervical spine surrounds the brainstem, controlling vital body functions
- Treatment: Blair upper cervical chiropractic provides gentle, precise correction without twisting or cracking
- Specialist: Upper cervical chiropractor certified in Blair
Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating health problems or diseases. Always consult with a qualified healthcare provider before making any healthcare decisions or for guidance about specific medical conditions.
What Is an Upper Cervical Subluxation?
An upper cervical subluxation (also called Atlas Subluxation Complex or ASC) occurs when the top vertebrae of your spine, the atlas (C1) and axis (C2), shift out of their proper position and become locked in a stressed, abnormal configuration. Unlike a complete dislocation where bones fully separate, a subluxation involves a partial misalignment that disrupts normal joint function and nerve communication.
The upper cervical spine is uniquely vulnerable to misalignment because it's the most mobile section of the entire spine. Your atlas weighs only about 2 ounces yet supports your head, which weighs 9-17 pounds. This junction allows approximately 50% of your neck's rotation, but that same flexibility makes it susceptible to shifting out of place from injuries, poor posture, or stress.
What makes upper cervical subluxation particularly significant is its proximity to the brainstem, the portion of your central nervous system that controls virtually all vital body functions including heart rate, breathing, digestion, blood pressure, and sleep. When the atlas or axis misaligns, it can exert pressure on the brainstem, interfere with nerve signals, disrupt blood flow to the brain, and affect cerebrospinal fluid circulation.
The term "subluxation" comes from Latin: "sub" meaning less than, and "luxation" meaning dislocation. In chiropractic terminology, it refers to a vertebral misalignment that affects nerve function. Upper cervical subluxation specifically affects the craniocervical junction, where your skull meets your spine, and can have far-reaching effects throughout your entire body.
What Causes Upper Cervical Subluxation?
The upper cervical spine can become misaligned through various mechanisms, often categorized as the "3 T's": trauma, toxins, and thoughts (stress). Understanding these causes helps explain why so many people develop subluxation without realizing it.
Physical Trauma
- Motor Vehicle Accidents: Whiplash injuries are among the most common causes, even from low-speed collisions. The sudden acceleration-deceleration forces can damage ligaments and shift vertebrae
- Falls: Childhood falls, slips on ice, sports injuries, or any impact to the head or neck can misalign the upper cervical spine
- Sports Injuries: Contact sports, cycling accidents, and activities with head/neck impact risk
- Birth Trauma: The birthing process, especially with forceps, vacuum extraction, or difficult deliveries, can misalign an infant's atlas
- Concussions: Head injuries often involve simultaneous neck trauma that goes undetected
Postural and Lifestyle Factors
- Poor Posture: Years of forward head position from computer work, phone use, or slouching gradually shifts vertebral alignment
- Repetitive Strain: Occupations requiring repetitive neck movements or sustained awkward positions
- Sleeping Position: Sleeping on your stomach or with improper pillow support can stress the upper cervical spine
Other Contributing Factors
- Chronic Stress: Emotional and mental stress causes muscle tension that can pull vertebrae out of alignment
- Inflammatory Conditions: Rheumatoid arthritis and other inflammatory diseases can affect cervical joint stability
- Congenital Abnormalities: Some people are born with structural variations that predispose them to subluxation
Critically, once an upper cervical subluxation occurs, it typically does not self-correct. The vertebrae become locked in their abnormal position, and without proper intervention, the misalignment persists and often worsens over time. Research indicates the average time from initial injury to symptom onset is 10-15 years, meaning many people suffer for decades without understanding the root cause.
Signs and Symptoms of Upper Cervical Subluxation
Because the brainstem controls so many body functions, upper cervical subluxation can produce an remarkably diverse range of symptoms. Many patients are surprised to learn that seemingly unrelated health issues may all trace back to their upper neck.
Head and Neurological Symptoms
- Headaches and Migraines: Especially those originating at the base of the skull and radiating to one side of the head
- Vertigo and Dizziness: Including sensations of spinning, floating, or imbalance
- Brain Fog: Difficulty concentrating, mental cloudiness, and memory issues
- Tinnitus: Ringing, buzzing, or humming sounds in the ears
- Visual Disturbances: Blurred vision, difficulty focusing, or eye strain
- Trigeminal Neuralgia: Facial pain or numbness
Neck and Musculoskeletal Symptoms
- Chronic Neck Pain and Stiffness: Especially at the base of the skull
- Limited Range of Motion: Difficulty turning head fully to one or both sides
- Shoulder and Upper Back Pain: Often between shoulder blades
- Muscle Tension: Chronic tightness in neck, shoulders, and jaw
- Postural Imbalance: Uneven shoulders, head tilt, or hip imbalance
- Crepitus: Grating or crackling sounds when moving the neck
Systemic and Autonomic Symptoms
- Chronic Fatigue: Persistent tiredness despite adequate sleep
- Sleep Disturbances: Insomnia, poor sleep quality, or teeth grinding (bruxism)
- Anxiety and Mood Changes: The neck influences brain centers that regulate stress response
- Digestive Issues: Vagus nerve disruption can affect stomach and bowel function
- Blood Pressure Irregularities: Some patients experience hypertension related to cervical issues
- Arm and Hand Symptoms: Numbness, tingling, or weakness radiating from the neck
Most patients with upper cervical subluxation present with 3 or more of these symptoms. The pattern and combination of symptoms varies based on which specific nerves and blood vessels are affected by the misalignment.
SEEK IMMEDIATE MEDICAL ATTENTION IF YOU EXPERIENCE:
- Sudden severe neck pain or headache after trauma
- Numbness or weakness in arms or legs
- Loss of bladder or bowel control
- Difficulty walking or loss of coordination
- Difficulty breathing or swallowing
These symptoms may indicate spinal cord compression or other serious conditions requiring emergency evaluation.
Conditions Linked to Upper Cervical Subluxation
Research and clinical experience have linked upper cervical subluxation to numerous health conditions. While subluxation may not be the sole cause of these conditions, correcting upper cervical misalignment has helped many patients find relief.
- Cervicogenic headaches and migraines
- Vertigo and Meniere's disease
- Trigeminal neuralgia and Bell's palsy
- TMJ disorders (temporomandibular joint dysfunction)
- Post-concussion syndrome
- Fibromyalgia and chronic fatigue syndrome
- Multiple sclerosis symptoms
- High blood pressure (hypertension)
- Dysautonomia (autonomic nervous system dysfunction)
- Chronic neck and back pain
- Scoliosis (especially when postural)
How Is Upper Cervical Subluxation Diagnosed?
Upper cervical subluxation often goes undiagnosed because standard medical imaging and examinations may not detect subtle misalignments. Specialized evaluation by an upper cervical chiropractor is typically required for accurate diagnosis.
Comprehensive Evaluation Process
1. Detailed Health History: Your provider will review your complete medical history, including past injuries (even those from childhood), symptom patterns, and previous treatments. This helps identify potential causes of subluxation.
2. Postural Analysis: A thorough assessment of your posture identifies visible signs of spinal imbalance, such as head tilt, uneven shoulders, or hip displacement. Many upper cervical practices use computerized posture analysis for precise measurements.
3. Neurological Testing: Assessment of reflexes, muscle strength, balance, and coordination helps evaluate nervous system function and identify areas affected by subluxation.
4. Range of Motion Assessment: Evaluating how well you can move your neck in all directions helps identify restrictions and areas of dysfunction.
5. Precision Imaging: Blair upper cervical chiropractors use specialized 3D X-rays or cone beam CT scans to visualize the exact position and alignment of your atlas and axis. These precise images reveal misalignments that standard X-rays miss and allow for customized correction based on your unique anatomy.
6. Palpation: Hands-on examination of the neck identifies areas of muscle tension, joint restriction, and vertebral position.
The diagnostic process is essential because every person's anatomy is unique. The Blair technique, in particular, emphasizes that each individual's atlas has a different shape and relationship to the skull—there is no "one-size-fits-all" adjustment. Precise imaging ensures corrections are tailored specifically to your anatomy.
Treatment Options for Upper Cervical Subluxation
Upper cervical subluxation requires specialized care that addresses the unique anatomy and function of the C1-C2 region. The Blair Chiropractic Technique is specifically designed for precise, gentle correction of upper cervical misalignments.
Blair Upper Cervical Chiropractic Care
The Blair technique differs significantly from general chiropractic approaches:
- Precision 3D Imaging: Detailed X-rays map your unique upper cervical anatomy to identify exact misalignment patterns
- No Twisting or Cracking: Adjustments are delivered with gentle, specific pressure—no rotational manipulation of the neck
- Individualized Corrections: Each adjustment is calculated specifically for your anatomy and misalignment pattern
- Toggle-Torque Technique: A precise, controlled adjustment delivered with the patient lying on their side
- Objective Monitoring: Post-adjustment testing confirms correction; you're only adjusted when needed
What to Expect from Treatment
Initial Phase (Weeks 1-8): More frequent visits (typically 1-2 per week) to establish and stabilize the correction. Your spine has been in the wrong position for a long time and needs consistent care to hold the new alignment.
Stabilization Phase: As your spine begins holding the correction longer, visits decrease. Many patients notice progressive improvement during this phase.
Maintenance Phase: Once stable, most patients require only periodic check-ups (every 4-6 weeks or less). One key advantage of upper cervical care is that properly performed corrections often hold for weeks, months, or even years.
Important: Unlike traditional chiropractic where you may be adjusted at every visit, Blair practitioners only adjust when testing indicates it's necessary. Some visits may involve only checking your alignment without adjustment—this is a sign your spine is holding well.
Living With Upper Cervical Subluxation
While professional care is essential for correcting subluxation, daily habits significantly impact how well your corrections hold and your overall recovery progress.
Supporting Your Recovery
- Protect Your Adjustment: Avoid activities that stress your neck for 24-48 hours after each correction. This includes heavy lifting, high-impact exercise, or prolonged poor posture
- Optimize Sleep Position: Sleep on your back or side with a supportive pillow that maintains neutral neck alignment. Avoid sleeping on your stomach
- Improve Workstation Ergonomics: Position your computer monitor at eye level and take regular breaks from sitting
- Limit Screen Time: Reduce phone and tablet use, and when you do use devices, bring them to eye level
- Manage Stress: Practice relaxation techniques to reduce muscle tension that can pull vertebrae out of alignment
- Stay Hydrated: Proper hydration supports disc health and overall tissue function
Recognize Your Patterns: Learn to identify signs that you may need an adjustment, such as returning symptoms, postural changes, or muscle tightness
Prevention Strategies
While some causes of subluxation (like accidents) aren't preventable, you can reduce your risk and help prevent recurrence through proactive measures.
- Maintain Good Posture: Keep your ears aligned over your shoulders, avoiding forward head position
- Use Seatbelts Properly: Correct seatbelt positioning and properly adjusted headrests reduce whiplash risk
- Exercise Safely: Use proper form and protective equipment during sports and physical activities
- Address Injuries Early: Even minor accidents should be evaluated; early intervention prevents chronic problems
- Schedule Regular Check-ups: Periodic upper cervical evaluations can identify and correct subluxations before symptoms develop
When to See a Doctor
Consider an upper cervical evaluation if you experience:
- Chronic headaches or migraines that haven't responded to other treatments
- Neck pain or stiffness lasting more than a few weeks
- Dizziness, vertigo, or balance problems
- Symptoms that began after an accident, fall, or head injury
- Multiple unexplained symptoms affecting different body systems
- Symptoms that worsen with neck movement or certain positions
- Chronic fatigue or sleep problems without clear cause
Because subluxation often develops gradually and symptoms may take years to appear, many people benefit from preventive evaluation, especially if they've experienced any head or neck trauma in their past.
Frequently Asked Questions
1. How do I know if I have an upper cervical subluxation?
Common signs include chronic headaches originating at the skull base, neck pain or stiffness, dizziness, uneven posture (head tilt, uneven shoulders or hips), and multiple symptoms affecting different body systems. However, subluxation can exist without obvious symptoms for years.
The only definitive way to know is through a comprehensive upper cervical examination including specialized imaging. If you've experienced any head or neck trauma, even years ago, an evaluation is worthwhile.
2. Is upper cervical chiropractic adjustment safe?
Upper cervical techniques is considered very safe because they use gentle, precise corrections without the twisting, cracking, or forceful manipulation associated with some other approaches. The adjustments are delivered with minimal force in a controlled manner.
Research indicates adverse events are rare and typically limited to mild, temporary soreness. These techniques are suitable for patients of all ages, including those who may not tolerate more aggressive treatments.
3. How long does it take to see results from upper cervical care?
Response times vary significantly based on how long you've had the subluxation, your overall health, and how well your body holds corrections. Some patients notice improvement within the first few visits, while others require several weeks of care before significant changes occur. Chronic conditions that developed over years typically take longer to resolve. Your chiropractor will monitor your progress and adjust your care plan accordingly.
4. Why haven't other doctors found this problem?
Upper cervical subluxation often goes undetected because standard medical imaging and examinations aren't designed to identify subtle vertebral misalignments. Regular X-rays may appear normal because they don't capture the specific angles needed to see upper cervical problems.
Additionally, many healthcare providers aren't trained to look for these specific misalignments. Upper cervical chiropractors use specialized imaging protocols and examination techniques specifically designed to detect these issues.
5. Will I need ongoing treatment forever?
Not necessarily. The goal of upper cervical care is to achieve stable correction where your spine holds alignment for extended periods. Many patients eventually require only periodic check-ups (monthly or less frequently) once their spine stabilizes.
Unlike approaches that adjust you at every visit, Blair practitioners only adjust when testing indicates it's necessary. Some patients maintain excellent alignment with minimal ongoing care, while others, particularly those with severe structural damage or lifestyle factors that stress the neck, may benefit from more regular monitoring.
6. Can children have upper cervical subluxation?
Yes, children can develop subluxation from birth trauma, falls, sports injuries, or poor posture. In fact, many adult subluxations originated in childhood.
Children are particularly vulnerable because their spines are still developing. Early detection and correction can prevent chronic problems from developing. Upper cervical techniques are gentle enough for patients of all ages, including infants and children.
7. What's the difference between a subluxation and a pinched nerve?
A subluxation refers to the vertebral misalignment itself, while a pinched nerve is one possible consequence of subluxation. When vertebrae shift out of position, they can compress or irritate nerves, but subluxation can also affect blood flow, cerebrospinal fluid circulation, and muscle function without directly pinching a nerve.
Correcting the subluxation often resolves pinched nerve symptoms along with other issues caused by the misalignment.
Do I Need to See a Doctor? Quick Assessment
Check all that apply to your current situation:
- I have chronic headaches, especially at the base of my skull
- I experience neck pain, stiffness, or limited range of motion
- I have dizziness, vertigo, or balance problems
- I've had a car accident, fall, or head/neck injury (even years ago)
- My symptoms haven't responded to other treatments
- I notice postural imbalances (head tilt, uneven shoulders, hip shift)
- I have multiple unexplained symptoms affecting different body areas
- I experience chronic fatigue or sleep problems
- My symptoms worsen with certain neck positions or movements
- I have ringing in my ears, brain fog, or vision problems
Your Results:
0-2 items checked: Low likelihood of significant subluxation, but consider evaluation if symptoms persist or you have history of neck trauma
3-5 items checked: Moderate likelihood. Schedule an upper cervical evaluation within the next few weeks
6-8 items checked: High likelihood. Schedule an evaluation as soon as possible—your symptoms strongly suggest upper cervical involvement
9-10 items checked: Very high likelihood. Contact an upper cervical specialist promptly. Your combination of symptoms indicates urgent need for evaluation
Ready to Get Evaluated?
Contact Dennis Campbell, DC at our Wasco, California office to schedule your comprehensive Blair upper cervical evaluation.
Practical Conclusion
Upper cervical subluxation is a common but often overlooked condition that can cause widespread health problems because of the critical relationship between your upper neck and nervous system.
When the atlas or axis vertebrae shift out of alignment, they can interfere with brainstem function, nerve communication, blood flow, and cerebrospinal fluid circulation, affecting virtually every system in your body.
The good news is that upper cervical subluxation responds well to specialized chiropractic care. The Blair technique offers a precise, gentle approach to correcting these misalignments without the twisting or cracking associated with traditional manipulation. Many patients who have suffered for years with unexplained symptoms find significant relief once the underlying subluxation is addressed.
If you've been struggling with chronic headaches, neck pain, dizziness, or multiple unexplained symptoms, especially if you have a history of head or neck trauma, upper cervical subluxation may be the missing piece in your health puzzle. A comprehensive evaluation can determine if your symptoms originate from your upper cervical spine and guide you toward appropriate care.
Principal Insights
- Upper cervical subluxation affects the atlas and axis vertebrae, which protect the brainstem and control vital body functions
- Symptoms can affect the entire body because of the upper cervical spine's connection to the nervous system
- Subluxation often goes undetected by standard medical examinations—specialized evaluation is required
- Blair upper cervical care provides gentle, precise correction without twisting or cracking the neck
- Corrections can hold for extended periods, reducing the need for frequent adjustments
References
Blair Chiropractic Society. (2024). The Blair Technique. https://www.blairtechnique.com/the-blair-technique/
Eriksen K. (2004). Upper Cervical Subluxation Complex: A Review of the Chiropractic and Medical Literature. Lippincott Williams & Wilkins.
Haavik H, Murphy B. (2012). The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22(5):768-76.
Kessinger RC, Boneva DV. (2000). Vertigo, tinnitus, and hearing loss in the geriatric patient. Journal of Manipulative and Physiological Therapeutics, 23(5):352-362.
Matsunaga S, et al. (1999). Atlantoaxial subluxation: Review of 904 patients. Journal of Neurosurgery: Spine.
Merck Manual Professional Version. (2024). Atlantoaxial Subluxation. https://www.merckmanuals.com/professional/
National Upper Cervical Chiropractic Association. (2024). Atlas Subluxation Complex and Dizziness: A Narrative Review. PMC11927947.
Rosa S, et al. (2017). Post-traumatic upper cervical subluxation visualized by MRI: a case report. Chiropractic & Manual Therapies.
StatPearls. (2024). Cervical Subluxation. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK559144/
Thomas MD. (2002). NUCCA Protocols and Perspectives: A Textbook for the National Upper Cervical Chiropractic Association. First Edition.
Woodfield HC, et al. (2015). Effect of Atlas Vertebrae Realignment in Subjects with Migraine. BioMed Research International.
Hartz R, Sauer S, Dickholtz M. (2019). Undiagnosed Atlas Subluxation in Patient with Pain and Poor Myofascial Function. Practical Pain Management, 16(1).
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Last medically reviewed: December 2025
Dennis Campbell, DC | Blair Upper Cervical Chiropractic | Wasco, California
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