Which describes the Spurling test protocol?

Which describes the Spurling test protocol?

• A. Seated; neck extended, laterally flexed and rotated toward the symptomatic side, and axial compression is applied downward for several seconds.
• B. Seated; neck extended and rotated away from the side; no compression.
• C. Supine; neck extended with manual traction only.
• D. Standing; neck rotation with downward pressure applied.

Answer: (B)

Spurling’s test is a provocative maneuver used to detect cervical radiculopathy from foraminal compression. The patient sits comfortably while the neck is positioned to narrow the foraminal openings—typically extended and laterally flexed toward the side where symptoms are present, often with a slight rotation toward that same side. Then downward axial pressure is applied through the top of the head. If this compression reproduces sharp pain radiating along the corresponding nerve root distribution, the test is considered positive and suggests foraminal encroachment affecting that nerve root. Understanding why this works helps differentiate it from other neck maneuvers. The key is that the test relies on compressing the neural foramina to provoke a root-level pain, which is why directing the movement toward the symptomatic side and applying downward pressure matters. Moving away from the symptomatic side or omitting the axial compression would not reliably provoke the radicular pain associated with nerve root compression, so those variants are not consistent with the Spurling protocol.

Spurling’s test is a provocative maneuver used to detect cervical radiculopathy from foraminal compression. The patient sits comfortably while the neck is positioned to narrow the foraminal openings—typically extended and laterally flexed toward the side where symptoms are present, often with a slight rotation toward that same side. Then downward axial pressure is applied through the top of the head. If this compression reproduces sharp pain radiating along the corresponding nerve root distribution, the test is considered positive and suggests foraminal encroachment affecting that nerve root.

Understanding why this works helps differentiate it from other neck maneuvers. The key is that the test relies on compressing the neural foramina to provoke a root-level pain, which is why directing the movement toward the symptomatic side and applying downward pressure matters. Moving away from the symptomatic side or omitting the axial compression would not reliably provoke the radicular pain associated with nerve root compression, so those variants are not consistent with the Spurling protocol.