Upper Cervical Spine Range of Motion

C01 and C23 play an intricate role in cervicogenic headache and although a loss of range of motion is not definitively linked to headaches, it is a good indicator that it is involved.  A simple screening test you can do in your clinic is differentiating how much movement C1-2 is contributing to rotation vs the rest of the cervical spine. Approximately 50% of neck rotation comes from C1-2, so if we gently block the neck at c3 and don’t allow any lower cervical spine movement, the patient should still be able to turn their head 45 degrees or so.

If the patient has a restriction in their upper cervical spine but can still turn their head over their shoulder, we know that they are using dysfunction compensatory movements to achieve this and unless addressed, will more than likely end up with degenerative joint disease, normally around the C5-6 segment.