Cervical Instability - cause of Eagles or the other way around?

Do a lot of us Eagle’s Syndrome patients also have Cervical Instability (messed up vertebrae in the neck)?
I have both and was told the collapsing vertebrae in my neck might have caused the Eagle’s (the styloid gets closer to veins and nerves).
I wondered if the other way is possible - Eagle’s causes blood flow issues (directly by compressing veins/arteries and via the general inflammation) and that causes the vertebrae to not get nutrients and have issues? And/or we are contorting due to the Eagles pain causing other neck issues?
Has anyone had Eagle’s surgery and had overall cervical instability improve?


Among the other things related to skeletomuscular system’s issues, I’ve been contemplating about the possibility that Eagle’s syndrome may cause neck instability too. My thinking was that it might be possible that presence of elongated styloid processes induces changes in the patterns we move our neck, including changes in muscular balance between various groups of muscles. At least there is anecdotal correlation between the elongated styloid processes and “military neck” or loss of cervical lordosis.
At least that’s what I noticed on many X-rays: when elongated styloid processes are present, very often that person also has loss of cervical lordosis at least to some degree, sometimes even turning into kyphosis.
Similarly, I think these skeletomuscular changes may induce constant overstretch of certain segments of the neck beyond the “healthy” range leading to instability. Maybe the military neck itself is a sign of some level of instability - I am not sure about it.


Thank you for the reply.

Yes, I have military neck too…
I have these neck issues: loss of lordotic curvature (military neck) and impingement of spinal tissue in C4 and C6.
ES looks to be on both sides but the left is causing the most pain (neck, ear, Eustachian tube )
I wonder if there is a pattern:

  • Do ES patients usually have cranial instability, military neck?
    if so,
  • Are the vertebrae issues similar for those with mostly left side ES pain vs those with right side ES pain?

That still doesn’t prove what caused what.
I guess mine is just anecdotal. I didn’t have crunching or any noticeable neck, jaw issues before I got sick from mold, virus, bacterial infections (in sinus, ear).
If you believe ES can happen due to infections then it appears I went from
infections → ES → neck issues

I even had an infected gallbladder (diseased, didn’t function). The ENT found this because one of the sinus infections was of a bacteria that is usually found in the gut. The theory is that the gut bacteria gets to the sinus via the lymph (chyli cisterna) which in most people dumps out on the left side of the neck.
Chicken or the egg?
I kept hearing the neck issues caused the styloid to rub where it shouldn’t and cause the ES but I would like to think the other way might be possible (ES caused the neck issues).
Why do I want to believe that?
I am biased : ) I hope the ES surgery will help with the other neck issues (at least take away the irritation and allow things to heal better).

I am trying to work in physical therapy and chiro too but that is dicey (I want to lift all boats but I don’t want to make things worse).
Maybe they can’t do much though until the ES structural issue is fixed.

@juliezuber - We have both members w/o CCI & those who do have it so there are obviously causes besides neck instability that instigate ES. Here are some speculative causes for ES:
•Genetic predisposition - there are several members who’ve been diagnosed then found some of their children have it or other relatives.
•Hormonal factors - e.g. parathyroid dyfunction - the parathyroid regulates the calcium balance in the blood so when blood calcium gets too high it can begin depositing where it doesn’t need to be in the body.
•Injury - head/neck injury - these stress the soft tissues of the neck alerting the brain that greater stability is needed so the body lays down calcium in the soft tissues (i.e. stylohyoid & sometimes stylomandibular ligaments) &/or elongates the styloid processs(es) to try to achieve this.
•CCI/AAI due to EDS or other causes - again, the brain perceives the instability & attempts to stabilize by laying down calcium in the styloids, s-h & possibly other ligaments & even potentially the hyoid bone (which can create Hyoid Bone Syndrome w/ symptoms very similar to ES).

I believe military neck can be the result of our necks’ compensations for ES which stresses the soft tissues w/in the neck & causing them to move in unnatural ways. It’s also known that military neck is the result of spending a lot of our waking ours looking down at cell phones, computer screens, doing household & other chores, reading books, etc. Our shoulders roll forward, our upper backs begin to become excessively kyphotic, our chest “cave in”. This process has a name - upper crossed syndrome & along w/ it goes lower crossed syndrome. This is the result of the upper back postural muscles becoming stretched long, & therefore, weakened, & the chest muscles becoming short & tight (that’s a very abbreviated explanation). There are videos on YouTube which discuss this & provide simple exercises for working on “fixing it” in our bodies. @vdm has also written extensively about this on our forum & has provided images of & links for physical tools he’s used to help reverse his military neck. You can use the magnifying glass icon in the upper right to search for posts which talk about military neck. There are many on here.

Re: chiropractic care & PT, chiropractic care can be helpful as long as there is no rapid neck jerking done to adjust the cervical spine. PT can help, too, if the PT is familiar w/ ES & doesn’t do any crazy neck manipulation or give aggressive neck exercises. Some of our members have found that PT &/or chiropractic work prior to surgery makes their symptoms worse. Both can be helpful once your styloid(s) are removed


Not much to add to what has been said by @Isaiah_40_31.

The only thing that I’d mention is that based on testimonies on some other groups, some people develop neck instability after chiropractor treatment(s) including upper cervical chiropractor. Also there is very real possibility of chiropractic manipulations, even mild ones, causing a stroke if the patient has elongated styloid processes, so my (non-medical) advice would be to avoid them completely.

Now when it comes to alleviating symptoms, surgery may help or may not, as each case is very unique. Often, when done by experienced surgeon, and in the presence of evidence of Eagle’s syndrome, the surgery helps. There are not so happy stories too, as this is a major and serious surgery that not every ENT is willing to do.

As for

It seems that CCI/AAI is another area where diagnosis is often very delayed and sometimes inconclusive, delayed, or missed, as people with mild cases might not demonstrate typical symptoms… Also people with connective tissue disorders sometimes are just written off as “hypermobile and that’s it, live with it” without detailed investigation of the neck issues…


Have you found any exercises helpful for military neck? I feel if we current the curve, we can become asymptomatic to elongated styloid since the neck will be able handle general tension better and possibly shift the styloid and c1 to more neutral positions that doesn’t affect the IJV much.

I know for sure my ES symptoms started after i started to bend my head forward in the hope of correcting cervical hinging (neck extension). So I believe there is a positive correlation.

@Lababila Unfortunately I couldn’t find “one size fits all” set of exercises (I wish I did!), so it was more about studying anatomy, relationship between various bones and muscles, biomechanics, and then listening to the body. I am more and more inclined to the idea that military neck is the result of the misalignments all over the body, from ankles to knees to hips to pelvis to lumbar and, especially, thoracic spine. Over the time, muscles elongate/shorten to adapt to the misalignments, as the overall goal of the body is to ensure you don’t fall when you stand upright without any support. For that, everything should be in balance, and the head as being quite heavy, is a good tool for the body to use to help with keeping upright.


I totally agree with you. I also started to develop tension in thoracic spine.

I saw a thread on reddit where one guy reversed his military neck with before and after images. I am just looking for a more friendly exercise for those of us who already have laxities and potential instabilities over the neck.

What are your thoughts about cervical pillows? I found that they seemed to have reduced my ES symptoms after using for two weeks but i had to stop it since they extend my neck and i have problems with extension of neck

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It would be really interesting to see that Reddit thread!

As for cervical pillows, I tried quite a few of them, and finally found what it feels best for me: a medium-firm “cervical” pillow, but I ripped it apart, scooped out some deeper pit where the back of the head goes, and that’s it.

Also it felt more or less comfortable to use a pillow made of small bits of memory foam so that one can add/remove some of them to achieve desired firmness. But I didn’t like the smell of it, though it was another story. There are different brands made, I’m sure, from slightly different materials.


Thats the thread

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I have a very weak neck, or rather I don’t use the correct muscles and am using the bigger muscles to support and turn my head and it has increased the hypermobility in my neck. I am seeing a physiotherapist and we did gentle exercises for the small muscles between the vertebrae yesterday. He felt my neck and I had to basically learn how to squeeze those small muscles… no idea how I did it, but I managed to get these muscles online at the end :slight_smile: he also uses like an arm cuff for measuring blood pressure and puts it under the neck and I have to squeeze these muscles and change pressure as he gives instructions to move the little arrow on the pressure indicator, then also with one arm in the air, one leg… both arms… its quite hard to do. He also does a SCM and masseter release because of the burning pain in my mouth. I use an extra pillow at night that I hug and place under my chin (I am a side sleeper) and this helps prevent me from tucking my chin in, which I normally do when I sleep. This pillow hack has helped me decrease my pain and dizziness by 80%, I know it sounds crazy to have this much pain relief but yeah, I found something that makes me feel normalish again. However it does further confirm that my styloids probably need to go.


I guess we talk about this pic?

I’m not quite sure though if that is exactly an example of a military neck before, and normal neck curve after.

Without x-rays it’s really hard to say, as the curve may be lost in both cases, or be intact in both cases…

I’d assume, forward neck posture may not necessarily be caused by military neck and vice versa.

I just found this video:

Somehow I think, the guy’s AFTER image is one that might have military neck based on how stiff he looks.


You are right

I will look through the video and let you know my thoughts

Sounds really good

I wosh i could visualise these exercises

That’s really good news, @Rozmarincek, that your physical therapist is giving your neck a good but gentle workout. Interesting about using a pillow under your chin to help keep your neck in extension vs. flexion when you sleep. What a simple, but good idea! I’m so glad to hear that between PT & the pillow, you’ve been able to significantly reduce your symptoms. I do agree though, if your styloids were gone, you might not need PT or the pillow. :blush:

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I also agree, @vdm. In the top picture, the posture on the left looks forced. In the picture to the right, the guy just looks like he’s standing up straighter. Shoulders are almost rolled forward more in the second picture than in the first one. I think this is two different men. :joy:

@Lababila - People w/ military neck, lack cervical “extension”. Their necks are rigidly straight so the goal is to regain the ability to get the cervical spine into a more normal slightly extended position i.e. restore the lordotic curve.

It’s interesting that you have too much extension as I would think this would cause the opposite of forward head posture i.e. a head in a leaned back position i.e. locating the head behind the shoulders, which would really throw off one’s center of balance. Can you please describe how having too much extension affects your posture?

I don’t have too much extention; i have problems with extending and cervical hinging

My theory is that the hinging causes symptoms because of either/

  1. An instability with the atlas
  2. My very low CXA of about 132 degree
    3 Or some damage to the spine over time ( i doubt this).

See this link to get what i mean by cervical hinging


Thank you for your reply & the video links. I learned something new today.

In regards to the burning pain in your mouth, u said the releases help that. 9s your pain in a certain area of your mouth like tongue or throat? Is it constant or triggered by anything such as food? Hoping u feel better