Spine
Cervical Spine
Evidence: confirmed
Spurling's Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Cervical Radiculopathy (compression of a nerve root in the neck).
How to Perform
- Position: Patient is seated comfortably.
- Action: Ask the patient to extend their neck (look up) and side-bend the head towards the painful side.
- Compression: Carefully apply a vertical downward pressure (approx. 7kg) on the top of the patient's head.
Interpretation of Results
- Positive Test: Reproduction of radiating pain or tingling traveling down the arm.
- Why: This position narrows the neural foramen (the tunnel the nerve exits through). If the nerve is already compressed, the added pressure reproduces the symptoms.
Diagnostic Accuracy
- Sensitivity: 50%
- Specificity: 86-93%
Clinical Context & Limitations
The Spurling's 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 Spurling's Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. Orthopedic Physical Assessment.
