What Is the Spurling Test?
What is the Spurling test used for?
The Spurling test helps to diagnose cervical radiculopathy. It’s also called the Spurling compression test or Spurling maneuver.
Cervical radiculopathy occurs when a nerve in your neck is pinched near the area where it branches away from your spinal cord. Several things can cause this, including a herniated disc or degenerative changes that happen naturally as you age. Common symptoms include pain, weakness, or numbness in your arm or hand muscles. You might also feel pain across your upper back, shoulders, or neck.
The Spurling test will help your doctor check for cervical radiculopathy and rule out any other causes of your pain.
How’s it done?
The Spurling test is done while you’re sitting down, either in a chair on an exam table.
There are several variations of the test, but the most common ones are Spurling test A and Spurling test B.
Spurling test A
Your doctor will bend your head toward the side of your body where you have symptoms. They’ll then apply some pressure to the top of your head.
Spurling test B
In addition to bending your head toward your symptomatic side, your doctor will extend and rotate your neck while applying pressure to the top of your head.
What does a positive result mean?
A positive Spurling test result means you’ll feel pain radiate into your arm during the test. Your doctor will stop the test as soon as you feel pain.
Depending on your symptoms, your doctor might do some additional testing to confirm your diagnosis.
What does a normal result mean?
A normal Spurling test result means you didn’t feel any pain during the test. However, a normal result doesn’t always mean you don’t have cervical radiculopathy.
Following a normal test result, your doctor will likely do some additional testing to check for other signs of cervical radiculopathy or another condition that could be causing your symptoms.
Some of these additional tests include:
- Shoulder abduction test. This test involves placing the palm of your affected arm over the top of your head. If your symptoms go away when you do this, it’s considered a positive result.
- Upper limb tension test. There are a variety of upper limb tension tests that are designed to place stress on the nerves that run from your neck down your arm. During these tests, each nerve is stretched (stressed) to see if the patient’s symptoms are produced.
- Imaging tests. Your doctor might use X-rays, CT scans, or MRI scans to get a better look at the affected area. This will help them rule out any other causes of your pain, such as an injury.
- Nerve conduction studies. These tests assess how quickly a nerve impulse moves through your nerve, which can help your doctor identify nerve damage.
How accurate is it?
Medical tests are often evaluated for their sensitivity and specificity:
- Specificity refers to the test’s ability to accurately identify people who don’t have the associated condition
- Sensitivity refers to the test’s ability to identify people who do have associated conditions.
The Spurling test is considered to be highly specific but not very sensitive. For example, a 2017 review found that the Spurling test had a specificity of 92 percent to 100 percent. That means the test produced a normal result in participants without cervical radiculopathy at least 92 percent of the time.
The same study concluded that the Spurling test had a sensitivity rate of 40 to 60 percent. That means it only produced a positive result in about half of the participants with cervical radiculopathy.
While the Spurling test isn’t always completely accurate, it’s an easy way for your doctor to start ruling out possible causes of your symptoms. Your result can also help guide your doctor toward other diagnostic tests that might help them better identify your condition.
The bottom line
The Spurling test is used to help diagnose cervical radiculopathy. If you feel any pain during the test, it’s considered a positive result. This means you may have cervical radiculopathy. A normal result means you don’t feel any pain and suggests you don’t have cervical radiculopathy. Keep in mind that this test isn’t completely accurate, so your doctor will likely do some additional testing.