Shoulder Depression Test

The Shoulder Depression Test involves assessing the nerve roots for any signs of compression or irritation. Typically used for evaluating brachial plexus lesions, the test aims to replicate the mechanism of injury that affects these nerves.

The Shoulder Depression Test is a highly valuable tool for medical professionals in diagnosing brachial plexus lesions and other nerve root-related issues. Its correct administration and interpretation can significantly improve the diagnostic process, leading to better-targeted treatments and improved patient outcomes.

How is the Shoulder Depression Test Performed?

Patient Positioning: The patient is comfortably seated or standing upright.

Side Flexion: The examiner gently side flexes the patient’s head to one side, commonly the left.

Downward Pressure: Concurrently, the examiner applies downward pressure on the opposite shoulder, typically the right.

Assessing Pain: The patient is asked to report any pain experienced during the test. The examiner assesses the severity and location of the pain, particularly focusing on any signs of nerve root compression or irritation.

See Also: Spurling Test

Interpretation of Results

Increased Pain: Indicates potential irritation or compression of nerve roots. This can be due to foraminal encroachments, such as osteophytes, adhesions around the dural sleeves, or a hypomobile joint capsule.

Dermatome Distribution: A thorough assessment of the dermatome and myotome distribution helps in pinpointing the exact nerve root affected, assisting in accurate diagnosis and treatment planning.

Clinical Significance

Diagnosis: Shoulder Depression Test helps in identifying specific nerve root compression, which is crucial for effective treatment.

Differentiation: Shoulder Depression Test assists in differentiating between conditions like plexopathies and radiculopathies based on the dermatome and myotome distribution of symptoms.

References & More

1. Orthopedic Physical Assessment by David J. Magee, 7th Edition.
2. Rubinstein SM, Pool JJ, van Tulder MW, Riphagen II, de Vet HC. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J. 2007 Mar;16(3):307-19. doi: 10.1007/s00586-006-0225-6. Epub 2006 Sep 30. PMID: 17013656; PMCID: PMC2200707. Pubmed