Spine
Cervical Spine
Evidence: confirmed
Shoulder Press Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Differentiating Nerve Root pain from Muscle/Facet pain.
How to Perform
- Position: Patient seated.
- Action: Examiner pushes the shoulder downward while tilting the patient's head to the opposite side.
Interpretation of Results
- Nerve Pain: Pain/tingling on the stretched side (neck/shoulder) indicates nerve root irritation.
- Joint Pain: Pain on the compressed side (the side the head is tilting towards) suggests facet joint pathology.
Clinical Context & Limitations
The Shoulder Press Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Shoulder Press Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Clinical Tests for the Musculoskeletal System 3rd Ed. Book.
