Mobility of the cervical spine – what is normal?

The cervical spine is much more mobile than the thoracic or lumbar spine. The first and second of the seven cervical vertebrae are mainly responsible for this. These cervical vertebrae are also called atlas and and axis.

They have a special joint connection which enables a very high degree of mobility. The upper vertebra, the atlas, is mainly responsible for stretching the neck, whereas the second vertebra, the axis, is responsible for the rotation of the head. The interaction of these two vertebrae and many other tissues (muscles and tendons) allows us to move the head very far in all possible directions. Tense muscles in the shoulder and neck area can lead to a pinched nerve, which then severely restricts mobility.

Neutral Zero Method

With special examination methods, the mobility of the cervical spine can be depicted factually. One of these methods is the so-called Neutral Null Method. In the Neutral Zero Method, the mobility of the cervical spine is recorded on three levels.

The starting point for the measurement is the head posture in the normal state, which serves as the zero point in this method. An example: The physician measures a patient’s lateral inclination to the left of 40° and a lateral inclination of 30° on the right side. Documented the whole thing would look like this: 40-0-30 li/re.

From this the doctor can see that there is a movement restriction on the right side. The same principle applies to the other levels. The normal zero method is a method of measuring the degree of movement restriction in the cervical spine from the zero/neutral position.

  1. Mobility to the front and back, also called flexion and extension (sagittal plane)
  2. Mobility to the side, i.e. the lateral inclination of the head (frontal plane)
  3. Rotation of the head, rotation (transverse plane)

Standard values

In order to have an orientation when examining the mobility of the cervical spine, there are the so-called standard values. If the results of a cervical spine examination are within the range of the standard values, i.e. within the normal range, there is no restriction of movement. These standard values lie in the following ranges for the cervical spine: Based on these standard values, the treating physician can determine a movement restriction in the cervical spine after viewing the results and initiate appropriate therapy measures to correct or at least improve the restriction if possible. In addition to the Normal Null Method, there are other methods to measure the mobility of the cervical spine.

  • Mobility to the front and back 35-45
  • Lateral inclination 45°.
  • Rotating frame 60-80
  • On the one hand, the distance between chin and chest can be measured, which should be 0cm at maximum forward tilt and 18cm at maximum backward tilt.
  • On the other hand, the distance between the back of the head and the wall can also be measured, which should normally be 0cm when the patient is leaning straight with his back against the wall.