Neck Orthopaedic Test: Spurling's Test

Spurling's test is a physical examination technique used to assess nerve root impingement in the cervical spine, specifically in the upper cervical region. It is commonly used to help diagnose conditions such as cervical radiculopathy.

Here are the steps to perform the Spurling's test:

1. Position the patient in a seated position with their head and neck in a neutral position.
2. Instruct the patient to laterally flex their head and neck to the affected side.
3. Apply a downward pressure on the top of the patient's head to further accentuate the lateral flexion.
4. Hold this position for a few seconds, and then slowly release the pressure.
5. Repeat the test on the contralateral side.

During the test, the patient may experience pain, tingling, or other symptoms in the affected arm, which may indicate nerve root impingement in the cervical spine.

References:

1. Spurling RG, Scoville WB. Lateral rupture of the cervical intervertebral discs: a common cause of shoulder and arm pain. Surg Gynecol Obstet. 1944;78:350-358.
2. Youdas JW, Garrett TR, Suman VJ, Bogard CL, Hallman HO, Carey JR. Normal range of motion of the cervical spine: an initial goniometric study. Phys Ther. 1992;72(11):770-780.
3. Cleland JA, Fritz JM, Whitman JM, et al. The use of a lumbar spine manipulation technique by physical therapists in patients who satisfy a clinical prediction rule: a case series. J Orthop Sports Phys Ther. 2006;36(4):209-214.
4. Flynn TW, Cleland JA, Whitman JM. User's guide to the musculoskeletal examination: fundamentals for the evidence-based clinician. Evidence in Motion; 2008.