ES Causes

Hi Warriors!
I have a diagnosis of ES, Vascular. It appears my styloids are very close to my C1. Which leads me to this question: Is there a known cause of this? I have heard it’s my anatomy. Perhaps traumatic childbirth (I was breech and forceps were forcefully used/ Also born with hip dysplasia, large leg length discrepancy).Can it be from whiplash? I really went downhill after a trigger point injection using Depomedrol in my neck area. Anyone have a guess how this happens???

Hi @Brandy,

The causes of ES are speculative. These things have been suggested as possible causes:

Tonsillectomy - scar tissue build up in the throat which puts pressure on the soft tissues which alert the brain there needs to be more support in that area of the neck. The brain’s answer is to elongate the styloids/calcify the stylohyoid ligaments. This is what Dr. Eagle believed caused ES, however, there have been quite a number of people diagnosed w/ ES who haven’t had a tonsillectomy.

Head/neck trauma i.e. whiplash/traumatic childbirth, strangulation injury, heading the ball in soccer, etc.

Genetic predisposition - we have several families on our forum where several family members have ES

Hormone imbalance this is often based in the parathyroid glands which manage calcium balance in the body.

Braces(?) A member recently asked if tooth movement caused by braces could cause ES, & I believe it could based on how much the jaw position is shifted during orthodontic treatment. This could impact soft tissue pressure at the back of the skull which could potentially ignite styloid growth.

I feel like I’m missing something, so hopefully someone else will chime in if there’s more info to provide.


A few more to add, though again, not all cases lead to the Eagle’s:

  • TMJ problems
  • Isotretinoin use (ro-accutane, accutane etc)
  • Neck instability
  • There is some correlation with straight neck (aka military neck, or loss of cervical lordosis), though causation is unclear

Yes! I believe my neck instability could have possible lead to ES. I have damaged ligaments. When I visit Denver to see Hepworth’s PA, I also scheduled a visit to see Dr. Centeno. His imaging is the first one to say possible ES. Although he didn’t think I had it. Of course, he says removing my styloids will create more instability. Dr. Annino said no. This is where the stress comes in…

I had ES symptoms for quite a while- I believe from a whiplash injury- but only developed the vascular symptoms later on. It happened at the same time as I had a prolapsed disc C5-C6, so I wonder if that very slight shift was enough to bring the styloids into contact with the IJVs…
A difficult decision for you with your instability concerns :hugs:

@Brandy, the styloids really don’t serve much a stabilizing purpose. They’re more of an anchor point for some ligaments & muscles in the area. The stylohyoid ligaments play a minor role in swallowing so they’re really not missed once they’re gone. I agree w/ Dr. Annino on this point.

1 Like

Yes, but everything seems to be attached to one another. Doesn’t removing something affect how these muscles or ligaments function? I just don’t want to be able to not lift my head!

I believe mine happened after a steroid injection. Who knows. Can I ask what your vascular symptoms are?

It doesn’t seem to have any effect after removing them, I’ve never noticed any difference with swallowing, moving etc since surgery, other than reducing symptoms of course!
The vascular symptoms I had were head and ear pressure, dizziness and off-balance feeling, pulsatile tinnitus, and weird symptoms like feeling I was falling, being closer to the ground than I was, and a weird rolling, sucking sensation in my head.
Frustrating that one of the treatments used for ES has maybe caused your symptoms :hugs:

1 Like