The Spurling’s Test is a provocative test for cervical radiculopathy. The test is a combination of side-bending to the symptomatic side coupled with compression to reduce the diameter of the neural foramen and elicit the patient's symptoms.
The patient is seated and is asked to rotate the head to the uninvolved side and then involved side. Then the patient places their head in neutral and the examiner applies a downward pressure on their head. If symptoms are produced the test is stopped. If symptoms are not produced the patient is asked to side bend and slightly rotate the head to the painful side. The examiner places a compression force through the top of the head in an effort to further narrow the intervertebral foramen and reproduce the patient’s symptoms.
The test is considered positive when it reproduces the patient's symptoms. The test is also considered positive if pain radiates down into the limb ipslateral to the side at which the head is rotated. The test is not indicated if the patient has no upper extremity or scapular region symptoms.
The Spurling’s test should never be performed on patients who may have cervical spine instability, patients with RA, cervical malformations, or metastatic disease.
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