What does a positive Spurling's test indicate?

• A. Cervical nerve root compression or foraminal stenosis due to disc pathology or osteophyte encroachment.
• B. Thoracic radiculopathy.
• C. Upper motor neuron lesion.
• D. Myofascial pain.

Answer: (A)

Spurling's test is used to detect cervical radiculopathy by provoking a nerve root irritability in the neck. When you extend the neck and apply downward pressure with the head side-bent toward the side being tested, the intervertebral foramina narrow. If a cervical nerve root is compressed by a disc herniation or osteophyte encroachment, this maneuver irritates the root and a sharp, shooting pain or paresthesias radiating into the arm may be produced. A positive result thus points to cervical nerve root compression or foraminal stenosis. It wouldn’t indicate thoracic radiculopathy, which involves the thoracic region; nor an upper motor neuron lesion, which shows different signs and neural patterns; nor primary myofascial pain, which is typically localized to a muscle without dermatomal radiation.