Neck Tests
Spurling's test
The purpose of this manoeuvre is to test for a cervical nerve root compression causing cervical radiculopathy.
Patient position:
Seated comfortably.
Therapist position:
Stands behind the patient. Interlocks fingers and rests of the volar aspect of both hands on top of the patient's head.
Action of the test:
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.
Positive result:
The test is considered positive when it reproduces the patient’s symptoms. The test is not indicated if the patient does not have upper extremity or scapular region symptoms.
Special considerations:
The axial compression over the vertebral zone must be applied with caution. The Vertebral Artery Test should be done before any other cervical test. This test should be done in both sides.
Jackson's test
The purpose of this manoeuvre is to test for a cervical nerve root compression causing cervical radiculopathy.
Patient position:
Seated comfortably.
Therapist position:
Stands behind the patient. Interlocks fingers and rests of the volar aspect of both hands on top of the patient's head.
Action of the test:
The examiner applies a downward axial compression making sure not to laterally flex the patient's neck.
Positive result:
The test is considered positive when it reproduces the patient’s symptoms. The test is not indicated if the patient does not have upper extremity or scapular region symptoms.
Special considerations:
The axial compression over the vertebral zone must be applied with caution. The Vertebral Artery Test should be done before any other cervical test.
Vertebral Artery Test or Klein's Test
This manoeuvre is used for testing the blood flow in the vertebral artery.
Patient position:
In supine position.
Therapist position:
Holding the head of the patient with his hands on the occipital bone.
Action of the test:
One should put the patient on his back and perform a passive extension, followed by a passive rotation of the neck, during at least 30 seconds. The rotation should be performed in both directions, and the eyes should be opened during all the manoeuvre.
Positive result:
This manoeuvre causes a reduction of the lumen at the third division of the vertebral artery, resulting in the decreased blood flow of the intracranial vertebral artery of the contralateral side. It causes an ischemia due to blood loss in the pons and the medula oblongata of the brain. This results in dizziness, nausea, syncope, dysarthria, dysphagia, and disturbances of the hearing or vision...
Special considerations:
The Vertebral Artery Test should be done before any other cervical test.
Brachial Plexus Stretch Test
The purpose is to test any compression in the Thoroacic Outlet.
Patient position:
Seated comfortably.
Therapist position:
Next to the patient, near the side to test.
Action of the test:
The therapist laterally flexes the head's patient, and the applies an axial compression on the same side shoulder.
Positive result:
If there exists some kind of release in the patient's symptoms (pain, paresthesia or sensitive alterations).