Non-surgical care is usually considered before surgery unless there is an urgent neurological concern. That may include specialized physical therapy, activity modification, pacing, bracing, regenerative treatments like prolotherapy, PRP, ePICL, or MLS laser therapy, pain management, and support for overlapping conditions.

Before my fusion, I ran the gauntlet of conservative care. Atlas Chiropractic. Craniosacral therapy. Prolotherapy. Acupuncture. Occipital nerve blocks. Red light therapy. Bracing. Activity modification. Pain management. Some of it brought me temporary relief. None of it held. The instability between C1 and C2 had progressed to the point that my cervical spine could no longer stabilize itself.

By the time I sat in front of a neurosurgeon at Weill Cornell, I had a documented trail of exactly what my body had rejected. Every failed treatment was still data.

The 2023 international expert consensus on upper cervical instability in joint hypermobility (link) includes rehabilitation guidance, treatment precautions, and recommendations for patients whose symptoms are easily triggered by movement or positioning.