Spurling test

Notes

Cervical spine

Spurling test

The Spurling test is used to help diagnose cervical radiculopathy. It is especially useful for helping physicians determine the appropriateness of performing direct treatment to the cervical spine, such as HVLA, which should be avoided in severe cervical radiculopathy.

Narrowing of the neural foramina can cause referred pain into the ipsilateral arm upon compression of the cervical spine, due to nerve root compression (cervical radiculopathy).

To perform the Spurling test:
  1. Stand behind the seated patient
  2. Extend and side bend the cervical spine to the side being tested and push down on the patient’s head with axial pressure down the cervical spine
  3. The test is positive if pain radiates down the ipsilateral arm

You may sometimes be able to localize the affected nerve root by determining the pain distribution along the arm.
Figure 1. The Spurling test is positive when the patient experiences numbness / tingling or radicular pain through the ipsilateral neck and upper extremity.
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Editor: Robyn Hughes, MScBMC
Illustrator: Jillian Dunbar

Key Takeaways

The Spurling test, also known as the Spurling maneuver, is a physical examination technique used to help diagnose cervical radiculopathy, which is a condition in which a nerve in the neck is compressed or irritated, leading to pain, numbness, and weakness in the arm or hand.

To perform the Spurling test, the examiner stands behind the seated patient and then extends and side-bends the cervical spine to the side being tested, and then pushes down on the patient's head with axial pressure down the cervical spine. The test is positive if the pain radiates down the ipsilateral arm.

A positive Spurling test might be an indication that cervical radiculopathy is present. Further diagnostic tests, such as imaging studies like MRI, may be necessary to confirm the diagnosis and determine the cause of the nerve compression.