Much like the Atlas in Greek mythology who supported the entire world, the function of the atlas bone is critical: it supports your entire head. The atlas bone (C1) connects your skull to your spine, and — with the support of the axis vertebra (C2) just below — the atlas determines your head’s full range of motion.

Misalignments in the atlas bone can cause chronic pain, stress, decreased range of motion, and tension in the head or neck.

Keep reading to understand this critical vertebra and determine when a misaligned atlas may be causing you issues.

What Is the Atlas Bone?

The atlas bone is the top bone or first cervical vertebra connecting your skull to your spine. It’s also known as the C1 vertebra in your cervical spine.

Your whole spine has 7 cervical vertebrae that connect to the 12 thoracic vertebrae, which connect to your 5 lumbar vertebrae. Those lowest 5 vertebrae make up the lumbar spine and connect to the sacrum, then the coccyx at the base of your spine.

Uniquely among vertebrae, the atlas vertebra at the very top of your spine lacks a vertebral body, spinous process, and the intervertebral discs found elsewhere in the spinal column.

The atlas is a ring-like structure that joins the occipital bone above it with the axis, or C2 vertebra, below it — thanks to both the atlantooccipital joint and the atlantoaxial joint.

These joints belong to a class of synovial joints that act as pivot points in the body. In this case, the pivot is your head movements.

How does the atlas bone affect overall health? A misaligned atlas bone directly impacts headaches, migraines, neck pain, range of motion, and balance. A dysfunctional atlas may indirectly contribute to chronic pain, inflammation, brain fog, and mental health problems.

Let’s dive into the atlas bone’s support structure and general anatomy to get a deeper understanding of how it works. Here are the major parts of your atlas bone:

  • Lateral masses
  • Transverse process
  • Anterior arch
  • Posterior arch
  • Vertebral foramen

Lateral Masses

The lateral masses (Massa lateralis atlantis) of the atlas bone are its thickest and sturdiest parts, which is by design. The pair of masses support the weight of your skull.

Superior and inferior facets, or small joints, are found on each side of the lateral masses.

The superior articular facets on the superior surface connect to the occipital condyles on your occipital bone. These structures allow for neck flexion and nodding movements of the head. This part of your atlas allows you to nod your head “yes” — why the atlas is also called the “yes bone.”

The inferior articular facets on the inferior articular surface allow articulation with the axis, or second cervical vertebra, and head rotations. Essentially, these facets are where the two joints meet.

Transverse Processes

The transverse processes are large projections from the lateral masses that attach to the muscles here and help you rotate your head and neck. These muscles include the rectus capitis lateralis, a small muscle important to lateral bending of the occiput, or the back of your head.

The transverse foramen in the transverse processes is a hole for your vertebral artery.

Anterior Arch

The anterior arch is concave on one side and convex on the other.

That shape allows it to work as a connecting segment for the odontoid process (dens) of the axis below and the transverse ligament. From above, it attaches the long muscle of the neck (longus colli muscles) with the anterior tubercle.

The upper border of the anterior arch attaches to the anterior atlantooccipital membrane. The lower border attaches to the anterior atlantoaxial ligament and the anterior longitudinal ligament. Most importantly, these connections are a pivot point with the axis.

Posterior Arch

The thin posterior arch that ends behind the posterior tubercle makes up about two-fifths of the circumference of the atlas ring.

The posterior tubercle sits at the apex of the posterior arch and serves as an attachment site for the nuchal ligament (ligamentum nuchae), which spans the 7 vertebrae of the cervical spine.

A groove in the posterior arch allows the vertebral artery to pass through here and the foramen magnum and continue along the spinal column.

Defects in this area that lead to interference between the atlas and your skull can cause neurological problems down the line if left untreated.

From Anatomy, Head and Neck: Atlantoaxial Joint (© 2024, StatPearls Publishing LLC)

Vertebral Foramen

The vertebral foramen is a large opening in the bone for both the spinal cord and the odontoid process of the axis.

On the axis side, it serves as the start of a pivot point for your C2 vertebra.

Read Next: Trigeminal Neuralgia vs TMJ, What Are They?

Atlas Misalignment

Atlas misalignment may cause various health problems and impact the structural integrity of your spine over time.

How does your atlas get misaligned? Your atlas can get misaligned due to injury, abnormalities in your bone structure, or a variety of conditions affecting the spine and musculoskeletal system. Poor posture can also cause atlas misalignment over time.

One rare injury that directly affects the atlas is a Jefferson fracture, most often seen alongside spine or head injuries. Generally, atlas fractures are more common in the elderly.

It can be difficult to know how many people have an atlas misalignment, as many patients don’t seek care immediately. Atlas misalignment is among the most common conditions addressed by chiropractic care.

What are the symptoms of a misaligned atlas? The symptoms of a misaligned atlas include:

  • Headaches
  • Migraines
  • Pain in the jaw, neck, and back, and muscle stiffness
  • Hearing problems, e.g. tinnitus, hearing loss, inner ear conditions
  • Shoulder pain or misalignment of the scapulae, or shoulder blade
  • Restricted movement of the head up and down or side to side
  • Dizziness, including vertigo
  • Balance problems
  • Difficulties with coordination and concentration
  • Muscle spasms
  • Pelvic and hip misalignment 
  • Trigeminal neuralgia

What are the dangers of an atlas misalignment? The long-term dangers of untreated atlas misalignment include chronic pain and stiffness, and chronic inflammation, and mental health deterioration. Severe misalignments may affect the natural curves in your neck and spine, impacting your outer appearance.

How is the atlas bone related to headaches? Atlas bone misalignment is a risk factor for chronic headaches. Patients with a history of migraines may find that atlas issues trigger their headaches.

Good news — the atlas can be adjusted to help prevent headache problems and long-term health complications.

When You Need an Adjustment

If you’re experiencing pain or other symptoms that signal issues with the atlas bone, an atlas adjustment may alleviate those symptoms. The first step is contacting a chiropractor who specializes in upper cervical care and cervical instability to diagnose the issue.

How do I adjust my atlas bone? To adjust your atlas bone, a chiropractor who specializes in upper cervical care will lead you through a series of gentle, instrument-assisted adjustments.

Your chiropractor may then show you at-home exercises to support your vertebral column.

How can an atlas bone adjustment benefit overall health? Atlas bone adjustment may reduce headaches, migraines, inflammation, neck pain, range of motion, balance, trigeminal neuralgia, and even some hearing problems.

An adjustment brings the atlas bone back into alignment.

There are at-home techniques to support proper atlas alignment. Stretches for your neck muscles, breaks from computer work, and focusing on proper posture while at a desk may help improve your cervical spine health. Consult your chiropractor for more at-home tips.

How Atlas Orthogonal Treatment Works

Atlas orthogonal treatment is a chiropractic technique that brings the C1 vertebra back into alignment. It is a gentle, precise, and painless approach that typically begins with detailed x-rays ahead of treatment. These scans allow chiropractors to be more precise with their adjustments.

Once trouble spots are noted, your chiropractor uses handheld instruments to deliver the appropriate adjustments. These tools allow for consistent treatment while eliminating the need for excessive pressure in this delicate area of the upper cervical spine.

How often should the atlas be adjusted? The atlas should be adjusted as often as needed for improvement of symptoms. For many patients, that means 1 or 2 adjustments, with follow-up visits down the line as necessary.

Post-treatment X-rays confirm the correct adjustments were made, measure progress, and inform follow-up treatment decisions. Treatment plans vary from patient to patient.


Instrument-assisted treatments used in chiropractic care make treatments much safer and more consistent, but there are possible side effects to any adjustment.

The most common side effect is muscle soreness, but rare side effects include worsening symptoms and bone fractures, especially if you suffer from brittle bone disorders or osteoporosis. Stroke or paralysis are the most severe possible side effects — although exceedingly rare.

Again, instrument-assisted corrections reduce potential side effects dramatically.

Your chiropractor will also share any precautions you should take following adjustments. Here are a few common precautions recommended by upper cervical spine specialists to reduce symptoms and side effects down the road:

  • Focus on your posture. Continued poor posture in the shoulder and neck area can trigger future atlas misalignment.
  • Consider your workday. Look at the ergonomics of your workspace and take stretch breaks throughout the day.
  • Eat right and exercise. A healthy diet and movement routine improve the muscles and ligaments throughout the body.
  • Work with a chiropractor. You already know a chiropractor can bring your atlas back into alignment. They can also get you on track for long-term whole body health.

Seek Help For Your Neck & Spine

It’s important to work with a chiropractor specializing in upper cervical care and precise neck adjustments. The spine affects the entire human anatomy.

Upper cervical chiropractors focus on the atlas and the axis. While the C1 vertebra provides stability, the C2 allows for movement. Both are important to neurological processes, including brainstem function.

Denver Upper Cervical Chiropractic is a leading provider of upper cervical care and addressing pain in those 2 vertebrae. Contact us today to take control of your healing and correct misalignments causing your discomfort.

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