Spurling’s Test – Physical Exam

The Spurling’s test (also known as Maximal Cervical Compression Test and Framonial Compression Test) is used during a musculoskeletal assessment of the cervical spine when looking for cervical nerve root compression causing Cervical Radiculopathy.

Patients with a cervical radiculopathy (compression of a nerve ‘root’ in the neck) can present with a variety of symptoms, including pain, numbness and weakness. Many other disorders can produce similar symptoms. In addition to the clinical history, the neurological examination may show signs suggesting a cervical (neck) radiculopathy.

Technique:
The patient is seated comfortably while physiotherapist stands behind the patient. The physiotherapist then interlocks their fingers and rests the volar aspect of both hands on top of the patient’s head. The therapist then laterally flexes the patient’s neck 30 degrees to the affected side and then applies a downward axial compression ensure not to laterally flex the patient’s neck any further.[1]

Positive: when the pain arising in the neck radiates in the direction of the corresponding dermatome ipsilaterally

Accuracy:
Spurling’s test is somewhat specific when used for individuals with an abnormal electromyogram study and is a relatively sensitive physical examination maneuver in diagnosing cervical spondylosis or acute cervical radiculopathy. It is not a very sensitive test when used for individuals without classic radicular signs suggestive of cervical radiculopathy. In 2011, one study evaluated 257 patients with clinical cervical radiculopathy and correlated CT scan findings with clinical exam findings using the Spurling’s test. The Spurling’s test was 95% sensitive and 94% specific for diagnosing nerve root pathology.

Source:
– https://www.youtube.com/watch?v=h8GxF73P6GQ
– http://www.physio-pedia.com/Spurling%27s_Test
– https://en.wikipedia.org/wiki/Spurling%27s_test