What is upper cervical manual therapy?

Upper cervical manual therapy is a general term to describe the different ways of using the upper neck area (upper cervical) to treat various health problems.

There are different types of upper cervical manual therapies and they are typically performed by trained health professionals or doctors. Massage therapists, physical therapists, osteopaths, and most notably chiropractors have the most training in this form of manual therapy.


The connections between the upper cervical area, the central nervous system, and overall body function are both numerous and complex.

If the upper cervical area is contributing to a person’s chronic health problem the effects can be dramatic when it finally gets fixed. Before any treatment begins, however, some objective testing should be performed to determine if the upper cervical area is playing a role in the person’s health problem. Doing any sort of upper cervical manual therapy when it’s not needed can actually cause other health problems and isn’t worth the risk.


The central nervous system (brain, brain stem, and spinal cord) are the source of all the neurological messages that control all parts of the body and all other systems of the body. The connection between the upper cervical area and the central nervous system begins with something called mechanoreception and proprioception – neurological messages that are constantly being sent from the muscles, tendons, ligaments, and joints up to the brain stem and various parts of the brain.


In fact, the muscles, tendons, ligaments, and joints from all over the body are constantly sending these mechanoreceptor and proprioceptor neurological messages up to the brain stem and brain, but the upper cervical area contributes the vast majority of messages compared to any other part of the body.


You can think of it like this –

if all the muscles, tendons, ligaments, and joints around the body were shouting messages to the brain the upper cervical area shouts the loudest by far and therefore it’s messages get listened to the most by the brain.


When there is an imbalance of muscle tension in the upper cervical area, or if one of the joints between the skull and the first two bones of the neck (C1 and C2, or atlas and axis) get stuck the mechanoreception and proprioception messages being sent up to the brain begin to change. Since those messages influence the decisions being made in the brain about how to control other functions of the body it can cause other body parts or systems to dysfunction.


Some of the most common chronic health problems that can result from problems in the upper cervical area include (but are not limited to): frequent headaches, recurring migraines, balance problems, poor posture, heartburn, GERD, chronic indigestion, thyroid problems, blood pressure problems, asthma, TMJ, chronic neck and back pain, and a few more.


The doctors that have the most training and experience with upper cervical manual therapy are a certain type of chiropractor called upper cervical chiropractor. These doctors use objective diagnostic testing to determine if the upper cervical area is contributing to the person’s chronic health issues. They use x-rays and functional posture tests to figure out exactly how to perform the upper cervical manual therapy and follow up tests to make sure the therapy is helping and not causing more problems. If other forms of upper cervical manual therapy are needed, such as massage, the chiropractor will make that decision and refer the patient to a trained massage therapist.

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