C7-T1 Mobilization

Apart from chronic low back pain, one of the other common complaints our patients have is chronic neck pain. When the t-spine no longer moves well, the c-spine will compensate by working even harder to produce the same movements necessary to bring the head up so we can look forward. Most of this translates to excessive hinging at the C7-T1 junction, where the cervical spine (neck vertebrae) meets the thoracic spine (upper back). Over prolonged periods of time this gets overworked and eventually, the strained C7-T1 junction will get stiff as well, since it isn’t meant to undergo that about of stress.

As the desk life becomes more prominent and people spend more time in front of a computer screen or on their phones, chronic neck pain becomes more common as well. Our positions during screen-time can exacerbate the symptoms, as more strain is put on the neck to support the weight of the head when it juts out beyond the shoulders—this strain increases as the head tilts further forward. Therefore, it’s important to understand that the position we spend our time in for prolonged periods will certainly affect our symptoms. However, that’s not to say neck pain is caused solely by “bad posture.” It has more to do with the inherent anatomy and structure of one’s bones, but more on that later.

The key to relieving most cases of chronic neck pain starts with the mobilization of the C7-T1 junction, so the head can be positioned back over the shoulders. This removes a lot of the additional strain put on the neck, as the compensations for stiff joints is removed and the head is able to rest properly on the spine for support. Here we can see the active mobilization of the C7-T1 junction, where the patient is participating in the mobilization. As Dr. Letgolts pushes with his thumbs on the stiff segments in a posterior –> anterior direction, the patient lifts her head and chest up to help facilitate extension of the thoracic spine.

C7-T1 Mobilization_ lateral view

C7-T1 Mobilization_posterior view