Spurling's test is used to provoke cervical radicular pain. How is it performed, and what indicates a positive result?

• A. Seated with the examiner behind the patient, hands interlocked on top of the head, and axial compression; pain provokes a positive result.
• B. Supine with neck traction and reproduction of radicular pain.
• C. Seated with jaw clenching and no pain.
• D. Standing with the head rotated and pain relief.

Answer: (A)

Spurling's test checks for cervical nerve root compression by narrowing the neural passages where the roots exit the spine. The clinician seats the patient and places hands on top of the head, then applies a downward axial pressure along the cervical spine. If this load reproduces the patient’s radicular pain that follows a specific arm dermatomal distribution, the result is positive, indicating cervical radiculopathy from foraminal encroachment or disc-related nerve root irritation. Sometimes extension and side-bending toward the affected side are added before the downward pressure to further close the foraminal space and increase the likelihood of a positive response.