Neural Tension Tests for Median, Radial, and Ulnar nerves are used to differentiate what?

• A. Differentiate between nerve root involvement and thoracic outlet for each neural tension test
• B. Diagnose carpal tunnel syndrome
• C. Assess rib out of joint
• D. Evaluate diaphragmatic motion

Answer: (A)

Neural tension tests assess how nerves stretch and tolerate movement along their entire path from the spinal nerve root out to the peripheral branches. When you apply controlled tension to the median, radial, or ulnar nerves, you’re probing where along that pathway pain or paresthesias originate.

If symptoms are driven by tension at the nerve root due to radiculopathy, reproducing the dermatomal symptoms with neck positions that lengthen the nerve root helps confirm nerve root involvement. If symptoms arise in a pattern more consistent with entrapment of the brachial plexus as it passes through the thoracic outlet, these tests help distinguish thoracic outlet syndrome from a spinal nerve root problem. In short, the tests differentiate between root-level nerve irritation and peripheral/proximal entrapment (thoracic outlet) for each nerve pathway being tested.

These tests are not used to diagnose carpal tunnel syndrome, rib-out-of-joint issues, or diaphragmatic motion.