Arm Squeeze Test
Original Editor - Fasuba Ayobami
Top Contributors - Anthonia Abraham, Kim Jackson, Fasuba Ayobami, Vidya Acharya, Claire Knott and George Prudden
Definition[edit | edit source]
Arm Squeeze Test is a clinical test used to distinguish cervical nerve root compression from shoulder disease in case of doubtful diagnosis.[1] Nerve compression syndrome is typically agitated when the middle third of the upper arm is squeezed or compacted.
Clinical Relevant Anatomy[edit | edit source]
The Cervical Nerves are spinal nerves originating from the cervical vertebra[2]. Through the brachial plexus, these nerves communicate via the cervical-axillary canal in the neck and armpit region. The cervical nerves are responsible for the sensation and motor function of muscles, including the nerves that supply muscles in the arm.
These nerves can be compressed by internal and external causes, resulting in a cervical root compression.
For more detailed information on anatomy of the Cervical nerves
Purpose[edit | edit source]
This is a new clinical test that may be useful to distinguish between Cervical radiculopathy from other shoulders related pathology[1]. The anatomic reasoning behind this test is that because the musculocutaneous nerve (cervical root from C5 to C7), the radial nerve (from C5 to T1), the ulnar nerve (from C7 to T1), and the median nerve (from C5 to T1) are relatively superficial in the middle third of the arm and easy to elicit a painful provocation response by squeezing the arm. A moderate compression of skin, subcutis, and muscle by squeezing the middle third of the upper arm (brachial biceps and triceps area) on the side with shoulder pain elicits an intense reaction of local pain only in patients with cervical nerve root compression from C5 to T1, not when the pain arises from the shoulder.[1]
Technique[edit | edit source]
- The examiner stands behind the patient
- Squeezes the middle third of the patient's upper arm with the thumb (examiner) on the patient's triceps while the rest of the fingers is on the patient's bicep with a moderate compression[1]
- This is a video illustrating how to perform the Arm squeeze test:
Results[edit | edit source]
The test is positive if the patient reports 3 or higher on VAS with pressure on the middle third of the upper arm compared with the acromioclavicular joint and subacromial area.[1][4]
Evidence[edit | edit source]
A study by Gumina et al. on 305 patients with cervical nerve root compression, 903 patients with rotator cuff tears, and 350 healthy volunteers found that when comparing patients with cervical nerve root compression to controls and patients with shoulder diseases, the test had a sensitivity of 0.96 and specificity from 0.91 to 1. They concluded that in cases of doubtful diagnosis, the Arm Squeeze Test may be useful in distinguishing cervical nerve root compression from shoulder disease. A positive result from this test could indicate cervical aetiology of shoulder pain.[1]
Related Tests[edit | edit source]
Reference[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Gumina S, Carbone S, Albino P, Gurzi M, Postacchini F. Arm Squeeze Test: a new clinical test to distinguish neck from shoulder pain. European Spine Journal, 2013;1558–1563.
- ↑ Joshua W, Vamsi R, Bruno B.Anatomy, Head and Neck, Cervical Nerves. StatPearls.
- ↑ Strongerdadproject. Arm Squeeze Test. Available from:https://www.youtube.com/watch?v=JS-dphAKL8Y [last accessed 29/9/2023]
- ↑ Joshua C, Shane K, Jonathan S. Netter's Orthopaedic Clinical Examination. USA: Elsevier, 2015.
