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C1 and C2 Vertebrae Misalignment Symptoms

by Dr Brent Wells DC(more info)

listed in back pain, originally published in issue 281 - September 2022


Originally Published on


The C1 and C2 vertebrae are the first two vertebrae located directly under the skull. They allow us to move our heads as we do hundreds of times a day. A misalignment of those vertebrae can cause a range of problems throughout the body if the spinal cord is affected. Luckily, most misalignments only require non-surgical and non-invasive treatments.


Cervical Vertebrae


Common C1 and C2 vertebrae misalignment symptoms include pain in the upper back, the neck, and the top of the head. It can also cause pain behind the eyes, at the temples, and behind the ears. Dizziness, fatigue, nausea, and numbness of one side of the tongue can occur. 

Symptoms of C1 and C2 Vertebrae Misalignment

Since the C1 (atlas) and C2 (axis) vertebrae serve to protect the spinal cord as well as to facilitate head movement, there are a number of symptoms that can be caused by their misalignment. Mainly these symptoms consist of the following:

  • Neck pain;
  • Headaches;
  • Back pain;
  • Numbness or pain in one or both arms and legs;
  • Fainting;
  • Loss of hearing;
  • Difficulty turning the head;
  • Trouble sleeping.

However, since much of the central nervous system and blood vessels pass through the C1-C2 joint, some research suggests that a misalignment can cause a host of other problems, such as:

The fact is that what makes the C1 vertebra so beneficial for head movement also makes it susceptible to misalignment. It allows for head movement but it’s also very resilient to injury. However, misalignments can happen without injury and can be corrected with non-invasive treatment options.

What Nerves Are Affected by C1 and C2 Misalignment?

The spinal cord serves as a protective highway for the central nervous system. The nerve branches in the body all send signals through the spinal cord up to the brain. As such, nearly all the nerves of the body pass through the C1-C2 joint.

This is why a serious injury to that cervical joint is considered the worst spinal injury. It can cause paralysis from the neck down if the communication is severed. However, since the human body is designed to protect itself, serious injuries to the C1 or C2 vertebrae are the rarest of spinal injuries.

So, although a misalignment won’t cause paralysis, it can affect many of the functions of the body. The nerves that are most likely to be affected by a C1 and C2 misalignment are named for the vertebrae from which they exit. The C1 nerve mainly controls motor function, whereas the C2 nerve allows for sensation on the upper part of the head.

How To Fix Misalignment

Fixing an upper cervical misalignment depends mostly on what’s causing the misalignment in the first place. Unfortunately, this is hard to determine without seeing a chiropractor. There can be many different causes, including:

  • Spinal Osteoarthritis – Degenerative joint disease in the cervical spine.
  • Crowned dens syndrome – Calcium deposits on the C2 vertebrae.
  • Basilar invagination – When the C2 vertebrae move into an unnatural position.
  • Synovial cysts – When fluid-filled sacs occur due to joint degeneration.

What’s causing the misalignment will inform the treatment options available. Most often, non-surgical techniques will be prescribed unless the spinal cord is severely inhibited or the symptoms are serious or life-threatening. For most people, chiropractic treatment for this type of neck pain is the best option.


How Chiropractors Adjust C1 and C2


How Chiropractors Adjust C1 and C2?

When visiting a chiropractor for the first time, no matter the presumed issue, patients will undergo a thorough initial exam. This includes family and personal medical history, a physical exam, lifestyle habits, and work habits. This is essential for the chiropractor to get an overall picture of the patient’s health and perhaps even what’s causing the pain.

Sometimes chiropractors may order X-rays, CT, or MRI scans. If a chiropractor decides that the patient will best benefit from a specialist, he or she will recommend one for treatment. If the doctor of chiropractic decides that the patient would benefit from chiropractic care, the following are options for treatment:

Chiropractic Neck Adjustments for Misalignment

The most common treatment for a misalignment of the C1 and C2 vertebrae is a neck adjustment. While some chiropractic care for the lower spine involves high-velocity low-amplitude adjustments, this is not usually the case for neck adjustments. While every patient’s needs are a little different, most chiropractors use gentle, hands-on adjustments for the upper neck area. These adjustments are very precise and aimed at relieving pain, increasing range of motion, and getting the vertebrae back into their proper place.

Are Neck Adjustments Risky?

Some people are concerned about the risk of neck adjustments. However, studies have shown that the risk of serious adverse events due to a chiropractic neck adjustment is very low. One study puts the number at approximately one serious adverse event in 5 million adjustments. This is much less than even the adverse effects of taking over-the-counter pain relievers.

Efficacy of Chiropractic Care and Neck Adjustments

Chiropractic care is not only safe, but it is effective in treating patients with upper cervical misalignment. One study showed that patients saw improvements in under 3 visits on average. Some patients see improvements after one adjustment.

If you or someone you know may have C1 and C2 vertebrae misalignment, consider visiting a chiropractor for initial diagnosis and care. Most insurance plans cover chiropractic care and you don’t need a physician’s recommendation to visit. You can schedule a visit today to get rid of your neck pain.

Sleeping With Neck Pain

Unfortunately, a misalignment of the C1 and C2 vertebrae can often become more apparent when lying down. As such, many people have great difficulty sleeping with this cervical misalignment. Luckily, there are a few things you can do to get to sleep when you have neck pain. A few of these include:

  • Sleep on a memory foam pillow for proper support;
  • Sleep on your back or your side, not your stomach;
  • Maintain proper posture throughout the day to avoid neck pain at night;
  • See a chiropractor for tips and treatment to alleviate neck pain.


Acknowledgement Citation

Originally Published on



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About Dr Brent Wells DC

Dr Brent Wells DC has been a chiropractor for over 20 years. His practice has treated thousands of patients from different health problems using various services designed to help give you long-lasting relief. He founded Better Health Chiropractic & Physical Rehab in Alaska in 1998.

Dr Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe and Lifehack. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more. For further information and to schedule an appointment please visit Brent Wells DC at  Better Health Alaska


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