Elvey test (also known as upper limb tension test) is used mainly to check for cervical radiculopathy.
- The patient lies supine.
- During all the tests the examiner flexes the shoulder in a proximal anterior position with one hand while using the other hand to guide the patient’s arm to the set positions.
The tests as described by Elvey are divided into four examination segments:
- Test 1: The examiner abducts the shoulder to 110°, extends the elbow, supinates the forearm , extends the wrist, and extends the fingers and thumb.
- Nerve bias: median nerve, anterior interosseous nerve, C5/C6/C7.
- Test 2: The examiner places the shoulder at 10° abduction, extends the elbow, supinates the forearm , and extends the wrist, fingers, and thumb. From this position, the shoulder is externally rotated.
- Nerve bias: median, musculocutaneous, and axillary nerves.
- Test 3: Starting position: shoulder abduction 10°, elbow extension, forearm pronation, wrist flexion and ulnar deviation, finger and thumb flexion. The examiner internally rotates the arm .
- Nerve bias: radial nerve.
- Test 4: The examiner successively abducts the shoulder from 10 to 90° and guides the hand toward the ear with the elbow maximally flexed and the forearm supinated. The wrist is extended and radially abducted, the fingers and thumb extended. The shoulder is externally rotated.
- Nerve bias: ulnar nerve, C8 and T1 nerve roots.
- The elvey test causes narrowing of the intervertebral foramina.
- Radicular pains already present are worsened by these movement patterns.
- The occurrence of localized pains in the cervical spine without radicular symptoms suggests facet irritation.
- Pain on the convex side of the cervical spine indicates muscle dysfunction (of the sternocleidomastoid muscle, for instance).
- The Elvey tests for the cervical spine are equivalent to the Lasègue test for the lumbar spine