Spurling's Test | Cervical Radicular Syndrome

Summary

This video from Physiotutors explains the Spurling's test, a diagnostic tool for cervical radicular syndrome with low sensitivity (50%) and high specificity (83%). The test aims to provoke symptoms like neck pain and radiating discomfort by reducing the intervertebral foramen diameter. The most effective method involves neck extension, lateral bending toward the affected side, and axial compression, though this approach is challenging for patients. The video emphasizes the importance of starting gently and progressively increasing intensity. Viewers are encouraged to adopt this testing method and connect with Physiotutors for more insights.

Takeaways

• 😀 The Spurling's test is used to diagnose cervical radiculopathy, with a sensitivity of 50% and specificity of 83%.
• 😀 Despite its low sensitivity, the Spurling's test is considered to have moderate clinical value.
• 😀 Modifications of the Spurling's test exist, and a study by Anekstein et al. in 2011 compared six different versions.
• 😀 The test aims to provoke symptoms like neck pain and radiating pain down the arm by reducing the intervertebral foramen diameter.
• 😀 The most effective Spurling's test variation includes neck extension, lateral bending to the affected side, and axial compression.
• 😀 Eliciting distal pain helps differentiate between radiculopathy and cervical spondylosis.
• 😀 Other test variations primarily cause proximal neck pain, making them less effective for diagnosis.
• 😀 The extension and lateral bending should be done gradually, adding axial compression only if symptoms do not reproduce.
• 😀 The test can be uncomfortable for patients, so a gradual approach is essential.
• 😀 The video encourages viewers to adopt the recommended Spurling's test procedure and to engage with the Physiotutors' content.

Q & A

What is the Spurling's test used for?

The Spurling's test is used to diagnose cervical radicular syndrome by provoking the patient's symptoms, which typically include neck pain and radiating pain down the arm.

What are the sensitivity and specificity rates of Spurling's test?

According to Wainner et al. (2003), the Spurling's test has a sensitivity of 50% and a specificity of 83%.

Why is the Spurling's test considered to have moderate clinical value?

The Spurling's test is considered to have moderate clinical value due to its low sensitivity and relatively high specificity in diagnosing cervical radicular syndrome.

What modifications exist for the Spurling's test?

There are several modifications of the Spurling's test, and Anekstein et al. (2011) compared six different versions in their diagnostic study.

What symptoms does the Spurling's test aim to provoke?

The test aims to provoke symptoms such as neck pain, radiating pain, or paresthesias down the arm.

How does the Spurling's test work mechanically?

The test works by reducing the diameter of the intervertebral foramen, which causes symptoms in patients with cervical radicular syndrome.

What is the recommended technique for performing the Spurling's test?

The recommended technique involves having the patient in neck extension, lateral bending towards the affected side, and applying axial compression to provoke symptoms.

What distinguishes patients with radiculopathy from those with cervical spondylosis during the Spurling's test?

Eliciting distal pain distribution during the test helps distinguish between radiculopathy and cervical spondylosis, as patients with cervical spondylosis usually experience proximal pain in the neck.

What precautions should be taken when performing the Spurling's test?

It is important to gradually build up the test by starting with extension and lateral bending, adding axial compression only if symptoms are not reproduced, as the latter can be the least tolerable for patients.

How can viewers engage with Physiotutors after watching the video?

Viewers can engage with Physiotutors by clicking the thumbs up icon, subscribing to their channel, and following them on Facebook, Instagram, or their website, physiotutors.com.