Spurling's Test

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Purpose

To test for a cervical nerve root compression causing cervical radiculopathy

Technique

The patient is seated comfortably while examiner stands behind the patient. Examiner interlocks fingers and rests the volar aspect of both hands on top of the patient's head. The examiner laterally flexes the patient's neck approximately 30 degrees to the affected side and then applies a downward axial compression making sure not to laterally flex the patient's neck any further.

Evidence

Diagnostic Accuracy

Sensitivity= .50

Specificity= .88

-LR = .58

+LR= 3.5

Reliability

Kappa= .60

Resources

De Hertogh WJ; Vaes PH; Vijverman V; De Cordt A; Duquet W; The clinical examination of neck pain patients: The validity of a group of tests.Manual Therapy, 2007 Feb; 12 (1): 50-5.

Tong HC, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine. 2002:27(2):156-9.

References

Flynn TW, Cleland JA, Whitman JM. Users' Guide to the Musculoskeletal Examination. Buckner: Evidence in Motion; 2008.

Konin JG, Wiksten DL, Isear JA, & Brader H. Special Tests for Orthopedic Examination. Thorofare: SLACK Incorporated; 2006.

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: 16: 307-319.

Shah KC, Rajshekhar V. Reliability of diagnosis of soft cervical disc prolapse using Spurling's test. British Journal of Neurosurgery. 2004: 18(5): 480-483.