Upper Cervical CareAdelaide
The top two vertebrae in your neck allow most of your head movement and sit directly beneath the brainstem. When these joints are not moving well, the effects can include headaches, neck stiffness, and cervicogenic dizziness. Research suggests that targeted, low-force upper cervical care may help manage these presentations. $69 initial consultation with Dr Sam Johnson (Chiropractor). No referral needed.
Does this sound familiar?
Common upper cervical patterns we hear. Tap a card for a plain-English explanation.
"I get headaches that start at the base of my skull and wrap around to behind my eye."
"My neck is stiff and tight right at the top, near where it meets my skull."
"I feel dizzy when I turn my head, and my neck has been stiff for months."
"I sit at a desk all day and the top of my neck and base of my skull get worse through the afternoon."
Understanding the Upper Cervical Spine
The atlas (C1) and axis (C2) are unlike any other vertebrae in your spine. They are shaped to prioritise movement over stability, which is what allows you to nod, rotate, and tilt your head freely.
The atlas has no vertebral body and no disc above it. It sits like a ring around the top of the axis, which has a bony peg (the dens) that acts as the pivot for head rotation. Together, these two joints account for approximately 40% of cervical flexion and extension and 60% of head rotation.
Because the upper cervical spine sits directly beneath the brainstem and shares nerve pathways with the trigeminal nerve (the main pain nerve of the head and face), dysfunction at C1-C3 may contribute to:
- Cervicogenic headache — headache referred from the upper cervical joints, often felt at the base of the skull, behind the eye, or across the forehead
- Neck stiffness and reduced range of motion — particularly rotation and extension
- Cervicogenic dizziness — a sense of unsteadiness or light-headedness originating from cervical spine dysfunction
- Suboccipital tension and pain — tightness at the base of the skull, often associated with desk work and sustained postures
How Chiropractic Care May Help
At Stapleton Chiropractic, Dr Sam Johnson (Chiropractor) uses low-force, targeted techniques to assess and manage upper cervical presentations.
Upper cervical care at Stapleton Chiropractic typically involves:
- Activator Method — a handheld instrument that delivers a precise, low-force impulse to specific joints. No broad manipulation or twisting of the neck.
- Toggle recoil — a quick, shallow manual contact directed at the atlas or axis. The practitioner's hands recoil immediately after the thrust, with no sustained pressure and no rotation.
- Soft tissue work — targeted release of the suboccipital muscles, upper trapezius, and associated cervical musculature where clinically appropriate.
- Exercise and ergonomic advice — simple home-based strategies to support cervical range of motion and postural awareness between visits.
Research suggests that cervical manual therapy, particularly when combined with exercise, may help manage cervicogenic headache, mechanical neck pain, and cervicogenic dizziness. A Cochrane review of 27 RCTs found moderate-quality evidence supporting cervical manipulation and mobilisation for mechanical neck disorders. Individual responses vary.
Warning Signs That Warrant Urgent Medical Review
Most upper cervical presentations are mechanical and not an emergency. A small number of symptoms involving the upper cervical spine do need urgent medical review, because they can occasionally indicate something more serious.
Seek urgent medical review (GP, healthdirect 1800 022 222, or emergency department) if your neck pain or upper cervical symptoms are accompanied by any of the following:
- Loss of hand dexterity, clumsiness with buttons or writing, or difficulty with fine motor tasks. May suggest cervical myelopathy, a condition where the spinal cord is compressed. This is a medical emergency that warrants urgent specialist review.
- Gait changes, unsteadiness, or a feeling that your legs are not obeying you, especially with neck stiffness. May suggest cervical myelopathy or upper motor neuron involvement.
- Bowel or bladder dysfunction (new incontinence or retention) alongside neck pain or upper limb symptoms. This is a red flag for spinal cord compression and warrants immediate emergency review.
- Sudden onset of dizziness with nausea, vomiting, double vision, slurred speech, difficulty swallowing, or a drop attack (sudden fall without loss of consciousness). May suggest vertebrobasilar insufficiency or a vascular event. Call 000 immediately.
- Severe, sudden headache unlike any you have experienced before (thunderclap headache), especially with neck stiffness and sensitivity to light. May suggest subarachnoid haemorrhage or meningitis. This is a medical emergency.
- Progressive weakness, numbness, or pins and needles in both arms or legs that does not settle. May suggest a progressive neurological deficit that warrants urgent medical review.
- Unexplained weight loss, night sweats, or persistent bony night pain in the neck. May suggest a systemic or oncological cause that warrants GP review.
If any of these apply, please do not wait for a chiropractic appointment. Contact your GP, call healthdirect on 1800 022 222, or attend your nearest emergency department. These features may indicate a condition that warrants urgent medical review, not chiropractic care.
What the Research Suggests
Conservative manual therapy and targeted exercise feature in clinical guidelines for cervicogenic headache, mechanical neck pain, and cervicogenic dizziness. The studies below summarise what the research suggests, not what any individual person will experience. Individual responses vary.
Jull et al. 2002 · Spine
200 participants: manipulation and exercise may help manage cervicogenic headache
Landmark multicentre RCT. Both manipulative therapy and a specific exercise program significantly reduced cervicogenic headache frequency and intensity, with effects sustained at 12-month follow-up. The combination of manual therapy and exercise may offer particular benefit for cervicogenic presentations. Individual responses vary.
Read the study →Dunning et al. 2016 · BMC Musculoskelet Disord
110 participants: upper cervical and upper thoracic manipulation for cervicogenic headache
Multi-centre RCT comparing upper cervical and upper thoracic thrust manipulation to mobilisation and exercise. Research suggests the manipulation group may have experienced greater improvements in headache intensity, frequency, duration, and disability at follow-up. Individual responses vary.
Read the study →Gross et al. 2010 · Cochrane
27 RCTs: cervical manipulation and mobilisation for neck disorders
Comprehensive Cochrane review found moderate-quality evidence that cervical manipulation and mobilisation, including techniques directed at the upper cervical spine, may produce improvements in pain, function, and patient satisfaction. Multimodal care combining manual therapy with exercise showed the strongest evidence. Individual responses vary.
Read the study →Reid et al. 2015 · Manual Therapy
86 participants: manual therapy for cervicogenic dizziness
RCT investigating cervical manual therapy compared with placebo for cervicogenic dizziness. Research suggests that manual therapy approaches may have long-term beneficial effects on dizziness symptoms, with some improvements maintained at 12-month follow-up. Individual responses vary.
Read the study →Eriksen et al. 2011 · BMC Musculoskelet Disord
Prospective multicentre study: upper cervical chiropractic outcomes
Prospective multicentre cohort study of patients receiving upper cervical chiropractic care. The majority of participants reported clinically significant improvements in neck pain and disability scores. Symptomatic reactions were generally mild and transient. Individual responses vary.
Read the study →Haas et al. 2018 · Spine Journal
256 adults: dose-response for cervicogenic headache
Dual-centre RCT found a dose-response relationship between spinal manipulation sessions and cervicogenic headache improvement. Cervicogenic headache, arising from dysfunction of the upper cervical segments, responded to manipulation with approximately one fewer headache day per month for every six additional sessions. Individual responses vary.
Read the study →Chiropractic vs Physiotherapy vs GP vs Neurologist
Upper cervical care is almost always a team sport. Here is where each role typically sits.
| What you get | Chiropractic (Stapleton) | Physiotherapy | GP | Neurologist |
|---|---|---|---|---|
| Primary focus | Upper cervical joint assessment, low-force manual therapy (Activator, toggle recoil), cervicogenic headache and dizziness management | Exercise-first rehab, vestibular rehabilitation, progressive loading and strengthening | Medical diagnosis, medication, imaging referral, overall care coordination | Complex headache diagnosis, neurological assessment, medication management for migraine and other headache disorders |
| Manual therapy | Low-force options (Activator, toggle recoil), gentle mobilisation, soft tissue work. No broad twisting. | Soft tissue work, gentle mobilisation, varies by practitioner | Minimal; focus is on medical management | Not typically; focus is on neurological diagnosis and pharmacological management |
| Exercise prescription | Yes, short home-based routines for cervical range of motion and posture | Yes, often more volume and structured progressive rehab | Typically referred out | Typically referred out |
| Imaging and medication | We coordinate; we do not prescribe or order imaging | Usually coordinate; do not prescribe | Full scope, including imaging referral and medication | Full scope, specialist imaging (MRI, CT angiography), specialist medication |
| Vestibular assessment | We screen for cervicogenic vs vestibular dizziness and refer when needed | Vestibular physiotherapists may provide specialist assessment (Epley, VRT) | Initial screening, referral to ENT or neurologist | Specialist assessment for complex or persistent dizziness |
| Lock-in plans | No. Visit by visit; the decision is always yours | Varies by clinic | Not applicable | Not applicable |
| Referral pathway | No referral needed; we happily coordinate with your GP | No referral needed | Your referral hub for imaging, neurology, and ENT opinions | Usually via GP referral |
All professions have their place. At Stapleton Chiropractic, if we assess your presentation and feel you would benefit from a different approach, we will always let you know and help coordinate your care.
Why Stapleton Chiropractic
Est. 1972
Over 50 years of family chiropractic practice at the same Plympton Park location.
Low-Force Techniques
Activator and toggle recoil. No broad rotation or twisting of the neck. Gentle and precise.
Evidence-Informed
Clinical decisions guided by published research, systematic reviews, and clinical practice guidelines.
No Lock-In Plans
No pressure, no packages. Visit by visit. The decision about ongoing care is always yours.
What Your First Visit Looks Like
Your first visit takes up to 30 minutes. No referral needed. No surprises.
History
We ask about your symptoms, how long they have been present, what aggravates them, and what you have tried.
Assessment
Cervical range of motion, upper cervical joint palpation, neurological screening, and dizziness screening where relevant.
Explanation
We explain what we find in plain English, what we think is contributing, and what options are available.
Care (Same Day)
Where clinically appropriate, we begin hands-on care at the same visit. No waiting weeks for a follow-up.
Transparent, Affordable Fees
No surprises. No hidden fees. Pricing well below the South Australian average.
Over 40% below the SA average for an initial consultation. All major health funds accepted. No lock-in plans. If you have prepaid for sessions you do not end up using, we refund them in full.
Upper Cervical Assessment — $69
Thorough assessment plus same-day care where appropriate. No referral needed.
Book a ConsultationFrequently Asked Questions About Upper Cervical Chiropractic Care
What is upper cervical chiropractic care?
Upper cervical chiropractic focuses on the alignment and movement of the top two vertebrae in the spine, the atlas (C1) and axis (C2). These vertebrae support the head, protect the brainstem, and influence the mechanics of the entire spinal column. At Stapleton Chiropractic, Dr Sam uses gentle, low-force techniques including Activator and toggle recoil to assess and address dysfunction in this region.
Individual responses vary. This is general information only and does not replace a proper clinical assessment.
Upper cervical techniques are among the gentlest forms of chiropractic care. The Activator instrument delivers a precise, low-force impulse without the twisting or "cracking" associated with traditional manipulation. Dr Sam will conduct a thorough assessment before any care begins and will discuss the approach, risks, and alternatives with you. Individual responses vary.
Upper cervical assessment may be relevant for cervicogenic headaches, persistent neck stiffness, cervicogenic dizziness, and post-concussion neck symptoms. The key question is whether dysfunction at C1 or C2 is contributing to your presentation. A careful assessment helps determine whether this approach is suitable for your situation.
The focus is narrower: the atlas and axis region, where the skull meets the spine. The techniques used are typically lower-force and more specific than a general spinal adjustment. Not every presentation requires upper cervical care; Dr Sam will assess and recommend the most appropriate approach for your situation.
Most patients describe the Activator technique as a light tap or click. There is typically no discomfort during the adjustment. Some patients notice mild post-adjustment soreness that settles within a day. Dr Sam will explain what to expect before proceeding.
This depends entirely on your individual presentation. Some patients notice changes within a few visits, while others with longer-standing issues may take longer. Your progress is reviewed at each visit, and the plan is adjusted based on your response. There are no lock-in contracts.
Not necessarily. Dr Sam will determine whether imaging is clinically indicated based on your history and examination findings. Where imaging is recommended, it is discussed with you, and X-rays may be bulk-billed where eligibility criteria are met.
Initial consultation is $69 (the SA average is $122). Standard visits are $60 (SA average $71). Most major health funds cover chiropractic care, and we process claims on-site.
Cervicogenic dizziness, where dysfunction in the upper cervical spine contributes to balance and spatial orientation symptoms, may respond to upper cervical assessment and care. However, dizziness has many potential causes. Dr Sam will assess whether a cervical contribution is likely and refer on if another cause is suspected.
No referral is needed. You can book directly online or call (08) 8297 5277. We are open Monday to Friday 7am to 7pm and Saturday 8am to 12pm.
Upper cervical chiropractic care focuses on the atlas (C1) and axis (C2) vertebrae at the top of the spine. These two vertebrae allow approximately 40% of all cervical flexion and extension and 60% of head rotation. Because they sit directly beneath the brainstem and share nerve pathways with the trigeminal nerve, dysfunction at C1-C2 may contribute to cervicogenic headache, neck stiffness, and cervicogenic dizziness. At Stapleton Chiropractic, Dr Sam Johnson (Chiropractor) uses low-force techniques including Activator and toggle recoil to assess and manage upper cervical presentations. Individual responses vary.
Is upper cervical adjustment different from a regular chiropractic adjustment?
Yes. Upper cervical techniques are typically lower-force and more specific than general chiropractic adjustments. At Stapleton Chiropractic, Dr Sam Johnson (Chiropractor) uses Activator (a handheld instrument that delivers a precise, low-force impulse) and toggle recoil (a quick, shallow thrust with minimal rotation). There is no broad twisting or cracking. The approach is tailored to the unique anatomy of the C1-C2 region, where the joints are shaped differently from the rest of the cervical spine.
Does upper cervical chiropractic treatment hurt?
Upper cervical techniques used at Stapleton Chiropractic are low-force and generally well-tolerated. Activator delivers a controlled impulse, and toggle recoil uses a shallow, fast contact with no sustained pressure. Some people feel mild soreness in the area for 24 to 48 hours after their first session, similar to post-exercise muscle tenderness. This is a normal adaptive response and typically settles quickly.
Can chiropractic care help with dizziness that comes from my neck?
Cervicogenic dizziness is dizziness that originates from dysfunction in the cervical spine rather than the inner ear. A 2015 randomised controlled trial (Reid et al., Manual Therapy) found that manual therapy directed at the cervical spine may have long-term beneficial effects on cervicogenic dizziness symptoms. A 2022 systematic review and meta-analysis of 13 RCTs (De Vestel et al., Journal of Manual & Manipulative Therapy) also suggests moderate-quality support for manual therapy in reducing cervicogenic dizziness. At Stapleton Chiropractic, we assess whether your dizziness may have a cervical component and manage accordingly. Not all dizziness is cervicogenic, and we will refer you to your GP or an ENT specialist if your presentation suggests a vestibular or other cause. Individual responses vary.
What techniques does Stapleton Chiropractic use for upper cervical care?
Dr Sam Johnson (Chiropractor) primarily uses two techniques for upper cervical care. Activator Method uses a handheld instrument to deliver a precise, low-force impulse to specific joints. Toggle recoil uses a quick, shallow manual contact directed at the atlas or axis with no broad rotation. Both approaches are low-force, which many patients prefer for the upper cervical area. Where appropriate, soft tissue work and targeted exercise advice are also provided.
How many visits will I need for upper cervical care?
There is no fixed number. How you respond depends on what we find at your assessment, how long the issue has been present, and what other factors may be contributing. Some people notice meaningful change within a few visits; others with longer-standing presentations may take longer. We reassess as we go, and the decision about ongoing care is always yours. No lock-in plans at Stapleton Chiropractic.
How much does an upper cervical chiropractic assessment cost?
Your first visit is $69, which includes a thorough upper cervical and full-spine assessment and, where clinically appropriate, hands-on care on the same day. Standard follow-up visits are $60. That is well below the South Australian average of $122 for an initial chiropractic consultation (ACA). We accept all major health funds, and there are no lock-in plans.
Do I need X-rays or imaging before upper cervical treatment?
Not usually. Imaging is recommended only when specific clinical signs suggest a structural issue that may change your management. The vast majority of upper cervical presentations can be assessed through a detailed history and physical examination. If imaging is clinically indicated, we can refer for bulk-billed X-rays or recommend appropriate advanced imaging through your GP. We do not require imaging for every patient.
Do I need a referral to see a chiropractor for upper cervical care?
No. Chiropractors are primary contact practitioners in Australia. You can book directly without a referral from a GP or anyone else. If you have a GP Management Plan (EPC plan), you may be eligible for a partial Medicare rebate for up to five allied health visits per calendar year.
Can upper cervical chiropractic care help with headaches?
Evidence supports the use of manual therapy for cervicogenic headache, which is a headache that originates from dysfunction in the upper cervical spine (C1-C3). A landmark RCT of 200 participants (Jull et al., 2002, Spine) found that manipulative therapy and exercise significantly reduced cervicogenic headache frequency and intensity at 12-month follow-up. A 2016 multi-centre RCT (Dunning et al., BMC Musculoskeletal Disorders) also found that upper cervical and upper thoracic manipulation may produce improvements in headache intensity and frequency. At Stapleton Chiropractic, we assess whether your headache may have a cervical component and manage accordingly. Individual responses vary.
Ready to Get Started? We're Ready When You Are.
Choose a time that works for you. No referral needed.
Dr Sam Johnson (Chiropractor)
B.Sc.(Chiro), M.Chiro.(Macq)
$69
Initial Consultation
Up to 30 minutes, including full assessment
Book Your First VisitPrefer to call? (08) 8297 5277
Text: 0400 105 454 | Email: wecanhelp@stapletonchiropractic.com.au
You will receive a confirmation email with all details immediately after booking.