Spurling Test

What is the Spurling Test? (Definition) It is a procedure used to assess the musculoskeletal function of the cervical spine, especially in diagnosing cervical radiculopathy. Other terms for Spurling test are:

  • Maximal cervical compression test
  • Foraminal compression test
  • Spurling compression test
  • Spurling maneuver (1, 2)
Spurling test image

(Spurling test is used to check for the presence of cervical radiculopathy.)

What is cervical radiculopathy?

It is a condition in which the nerve in the neck is pinched near the part where it branches away from the spinal cord. There are various reasons why cervical radiculopathy occur such as degenerative changes in the body as you age and a herniated disc. The clinical manifestations are:

  • A feeling of numbness in the arm and hand muscles.
  • Pain across the shoulders, neck, and upper back.
  • Pain and weakness

By performing a Spurling test the doctor will be able to check for cervical radiculopathy and at the same time be able to rule out other possible causes. (1, 2, 3, and 4)

How is the Spurling test done?

The test is done while the patient is sitting down in a chair on an examination table. The test can be done in various ways and these are the following:

  1. Spurling test A – The examiner/doctor bends your head towards the side of your body, specifically in the side where you feel the symptoms. The pressure is applied to the top of the head.
  2. Spurling test B – Aside from bending the head toward the side where symptoms are felt, the doctor will also extend and rotate the neck while pressure is applied to the top of the head. (3, 4, 5, and 6)

Positive Spurling test

The test is positive if you feel pain radiating towards your arms during the procedure. As soon as you complain of pain, the doctor will immediately stop the examination. Depending on the symptoms, the doctor might perform additional testing. (5, 6)

Normal test result

The result of the test is normal if the patient does not complain of any pain during the examination. However, just because the test is normal does not necessarily mean that you do not have cervical radiculopathy. If the result is normal, the doctor might want to perform more tests to check for other signs and symptoms of cervical radiculopathy or other health conditions. (6, 7)

Spurling test and pain

Additional tests that your doctor might perform include the following:

  • Upper limb tension test – A force is applied on the nerves that run from the neck down the arm. The nerve is stretched to check if symptoms of cervical radiculopathy exist.
  • Shoulder abduction test – The palm of the affected arm is placed over the top of the head. The test is positive if your symptoms subside after performing the test.
  • Nerve conduction study – the procedure is done to assess the movement of nerve impulse through the nerve and check for nerve damage.
  • Imaging test – Imaging studies might be performed to thoroughly inspect the affected area. These imaging studies include x-ray, MRI, and CT scan. (7, 8, and 9)

Is Spurling test accurate and reliable?

The Spurling procedure is highly specific but not that sensitive. The test tends to produce a normal result in people without cervical radiculopathy at least 92% of the time. The sensitivity rate of Spurling test is about 60%. In other words, only 60% of people with cervical radiculopathy test positive for Spurling test.

Spurling test is not always accurate. However, it is helpful in ruling out the possible causes of your symptoms. It can also be used by your doctor as a parameter in ruling out other possible conditions related to your symptoms. (3, 9, and 10)

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