Scalene Cramp Test

The Scalene Cramp Test is a diagnostic maneuver to identify myofascial pain and potential neurological disturbances related to the scalene muscles in the neck. This examination is particularly useful for diagnosing conditions like thoracic outlet syndrome (TOS) and cervical radiculopathy.

The Scalene Cramp Test is a clinical examination aimed at eliciting discomfort or pain in the scalene muscle group, which may be indicative of myofascial trigger points or other related pathologies. This test is particularly valuable in assessing the presence of thoracic outlet syndrome and related neurovascular symptoms.

Scalene Cramp Test is indicated for patients presenting with:

• Unexplained neck pain
• Radiating pain in the arms
• Symptoms of nerve compression
• Suspected thoracic outlet syndrome
• Scalene Myofascial Pain Syndrome.

How to Perform the Scalene Cramp Test?

Have the patient sit upright on the examination table. Instruct the patient to rotate the head toward the affected side. The patient should then pull the chin downward into the hollow just above the clavicle, flexing the cervical spine. Watch for any signs of discomfort or pain during the maneuver.

See Also: Spurling Test – Foraminal compression test

What is the positive Scalene Cramp Test?

A positive Scalene Cramp Test is characterized by an increase in pain localized to the scalene muscles or the elicitation of radicular symptoms. This suggests:

• The presence of myofascial trigger points within the scalene muscles, this may indicate the presence of Scalene Myofascial Pain Syndrome.
• Possible involvement of the brachial plexus, indicating a plexopathy or thoracic outlet syndrome.

• Increased Pain: Pain localized in the scalene muscles indicates the presence of trigger points.
• Radicular Symptoms: Signs such as tingling, numbness, or radiating pain can suggest a plexopathy or thoracic outlet symptoms.

References & More

1. Travell TG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1. Baltimore: Williams & Wilkins; 1983.
2. Abd Jalil N, Awang MS, Omar M. Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases. Malays J Med Sci. 2010 Jan;17(1):60-6. PMID: 22135529; PMCID: PMC3216145. Pubmed
3. Orthopedic Physical Assessment by David J. Magee, 7th Edition.