Spurling Test

 Spurling Test

  • Spurling Test is a Musculoskeletal assessment of the cervical spine when looking for cervical nerve root compression causing Cervical Radiculopathy.

  1. The patient is seated and asked to sidebend and slightly rotate head to the painful side.
  2. The clinician places a compressive force of approximately 7 kg through the top of the head in an effort to further narrow the intervertebral foramen.
  3. If the patient tolerates this initial step of the test, it is then repeated with the cervical spine extended as well.

  • The Spurling test is considered positive when it reproduces the patient’s symptoms. The test is not indicated if the patient does not have upper extremity or scapular region symptoms.
  • Simultaneous extension of the cervical spine narrows the intervertebral foramina by 20 to 30%.
  • In conditions such as cervical stenosis, spondylosis, osteophytes, trophic facet joints, or herniated disks, the foramina may already be smaller than norm al.
  • The test is not considered to be positive if there is neck pain only, without radiation into the shoulder or arm.
  • Pain radiating to the arm specific to a certain dermatome suggests nerve root irritation.
  • Pain that is already present w ill be increased by this movement. Myalgia and whiplash syndrome can cause pain on the opposite side.
  • This is called a reverse Spurling sign and suggests pain on the side of muscles that have been stretched from muscle strain or functional disturbance with muscle foreshortening. 

  • Sensitivity: 50 %
  • Specificity: 86 %

  • Pain on the concave side indicates nerve root irritation or facet joint pathology (Spurling sign).
  • Pain on the convex side indicates muscle strain (reverse Spurling sign).
  • The Spurling test is an aggressive cervical compression test, and the patient should be prepared for each step of the examination.
  • The test should not be performed when cervical fracture, dislocation, or instability are suspected.


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