Hello Surgeon

X

How can we help you today?

Special Test

Cervical Distraction Test Overview

The cervical distraction test is utilized primarily to evaluate patients who present radicular symptoms, such as pain radiating from the neck down to the arms, often accompanied by neurological signs. This test serves not only to diagnose but also to alleviate symptoms by applying traction to the cervical spine.

Cervical Distraction Test is the opposite of spurling test. It helps to determine whether pain in the back of the neck, shoulder, and arm is radicular in origin or is due to ligamentous or muscular causes.

See Also: Spurling Test

Indications for the Test

This test is particularly useful for patients who report radicular pain in their medical history and exhibit corresponding signs during physical examination. It helps to pinpoint the presence of nerve root compression in the cervical spine.

See Also: Myotomes of the Upper Limb

How to Perform the Cervical Distraction Test

To conduct the test effectively:

  1. Position yourself behind the seated patient.
  2. Place one hand under the patient’s chin and the other around the occiput (the back part of the skull).
  3. Gently lift the patient’s head to apply upward traction to the cervical spine.
  4. Observe any changes in the patient’s symptoms during the traction.
Cervical Distraction Test
Cervical Distraction Test

Interpreting Test Results

A positive Cervical Distraction Test result is indicated by a decrease or relief of pain during the head lift, suggesting that nerve root pressure is alleviated by the traction. Conversely, an increase in pain might suggest muscle spasms, ligament strains, or other spinal issues such as disc herniation.

Besides diagnosing cervical radiculopathy, the cervical distraction test can also be used to assess referred pain to the shoulder complex. When traction is applied, if the patient simultaneously abducts their arms and reports symptom relief, it further supports the involvement of specific nerve roots like C4 or C5.

Cervical distraction test allows healthcare providers to better differentiate between cervical spine issues and other potential pathologies. This distinction is crucial for determining the appropriate treatment and management plan for patients with radicular symptoms.

Distraction of the cervical spine reduces the load on the intervertebral disks and exiting nerve roots within the affected levels or segments while producing a gliding motion in the facet joints. Reduction of radicular symptoms, even in passive rotation, when the cervical spine is distracted is a sign of discogenic nerve root irritation. Increased pain during distraction and rotation suggests a functional impairment in the cervical spine due to muscular or ligamentous pathology or articular, possibly degenerative processes.

Test Reliability

  • Sensitivity: 44%
  • Specificity: 90% to 97%

Conclusion

The cervical distraction test is a valuable component of the neurological examination for patients with neck pain and associated symptoms. Mastery of this test can significantly enhance diagnostic accuracy and guide therapeutic strategies in clinical practice.

References & More

  1. Orthopedic Physical Assessment by David J. Magee, 7th Edition.
  2. Dutton M. Orthopedic Examination, Evaluation and Intervention. New York: McGraw Hill; 2004.
  3. Jones SJ, Miller JMM. Spurling Test. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: Pubmed
  4. Rubinstein SM, Pool JJ, van Tulder MW, et al. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. 2007. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: Pubmed
Angle Meter App for Android & iOS
  • Lifetime product updates
  • Install on one device
  • Lifetime product support
One-Click Purchase
Orthopedic FRCS VIVAs Quiz
  • Lifetime product updates
  • Install on one device
  • Lifetime product support
One-Click Purchase
Top 12 Best Free Orthopedic Apps
  • Lifetime product updates
  • Install on one device
  • Lifetime product support
One-Click Purchase
All-in-one Orthopedic App
  • Lifetime product updates
  • Install on one device
  • Lifetime product support
One-Click Purchase