Contraindications for Upper Cervical Treatment

by Son PMR(Physical medicine & Rehabilitation ) & Chiropractic Clinic in Seoul

The upper cervical spine (C1 and C2) plays a critical role in connecting the head and body. Due to its delicate and complex nature, treatment of this area can offer significant benefits but must be performed with great caution. Certain conditions may require delaying or avoiding upper cervical treatment to ensure patient safety.

1. Suspected Cerebrovascular Disorders

  • Conditions such as vertebral artery anomalies, stenosis, or dissection require thorough evaluation before considering upper cervical treatment.

  • Manipulation of the upper cervical region may affect blood flow; therefore, it is important to confirm vascular integrity through appropriate imaging and medical consultation beforehand.

2. Bone Disorders and Structural Abnormalities

  • Patients with severe osteoporosis, pathologic fractures, or congenital anomalies (e.g., Down syndrome, Arnold-Chiari malformation, severe spinal deformities) must be carefully assessed.

  • In cases of weakened or structurally compromised bone, improper mechanical force may increase the risk of injury.

3. Instability or Dislocation

  • Atlantoaxial instability or upper cervical ligament injuries are absolute contraindications.

  • Imaging studies such as dynamic X-rays, CT, or MRI are essential to evaluate spinal stability before initiating any manual intervention.

4. Infectious Diseases

  • Active infections involving the cervical spine (e.g., osteomyelitis, discitis) necessitate avoiding mechanical stimulation to prevent worsening or systemic spread of the infection.

5. Malignant Tumors

  • If a primary bone tumor or metastatic lesion is present in the cervical spine, upper cervical treatment is strictly contraindicated.

6. Acute Trauma

  • In cases of recent trauma (e.g., motor vehicle accidents, falls), immediate upper cervical treatment should be withheld until thorough orthopedic or neurosurgical evaluation confirms safety.

7. Severe Neurological Symptoms

  • Symptoms such as acute paralysis, bladder or bowel dysfunction, or profound sensory loss require emergency neurological assessment. Manual therapy should be avoided until the underlying cause is clearly diagnosed.

Conclusion

Upper cervical treatment must always prioritize patient safety through careful evaluation.
When any of the above contraindications are suspected, appropriate diagnostic imaging and specialist consultations are essential before proceeding.

At Son Cheolho Rehabilitation Medicine & Chiropractic Clinic, we are committed to providing safe and individualized care, carefully evaluating each patient to ensure that treatment is both effective and appropriate. 

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

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