Spurling's test posture variant: How is Spurling's test typically performed?

• A. Seated with axial compression as described
• B. Supine with head rotated and distracted
• C. Prone with neck flexion
• D. Standing with scapular depression

Answer: (A)

Spurling's test aims to provoke cervical nerve root irritation by applying an axial load to the cervical spine. The typical posture is the patient seated, and the clinician places hands on the crown of the head to deliver a downward compressive force through the skull. To accentuate foraminal narrowing and increase the chance of reproducing radicular symptoms, the neck is usually held in slight extension and directed to side-bend toward the symptomatic side as the axial load is applied. A positive finding is the reproduction of the patient’s concordant radicular pain along the expected dermatomal distribution.

The other postures described don’t deliver the same targeted foraminal compression through the cervical nerve roots as Spurling’s test. They involve different motions or test other structures and are not the standard method for this provocative test.