Cervical radiculopathy refers to the condition in which a nerve root in the cervical spine becomes compressed or irritated, leading to symptoms such as pain, numbness, tingling, or weakness in the neck, shoulders, arms, or hands. Various tests are used to diagnose cervical radiculopathy, as well as to identify the specific location of the nerve compression and assess its severity. These tests include physical examinations, special tests, and diagnostic tests such as EMG. Below is a detailed explanation of the tests for cervical radiculopathy.

Cervical Radiculopathy Test

• What It Is: A cervical radiculopathy test generally refers to a clinical evaluation process performed by a healthcare professional to assess the symptoms, strength, and reflexes associated with cervical radiculopathy. This includes a combination of patient history, physical examination, and special tests designed to reproduce the radicular pain (pain that radiates along the nerve distribution).
• Purpose: The goal is to confirm nerve root involvement in the cervical spine and rule out other possible causes of symptoms, such as muscular or joint issues.

Special Test for Cervical Radiculopathy

• What It Is: Special tests are designed to elicit specific signs and reproduce symptoms that suggest nerve root compression. These tests are commonly used during a physical examination to assess whether the symptoms are consistent with cervical radiculopathy.
• Common Tests:
  • Spurling’s Test: A classic test for cervical radiculopathy that involves applying a downward compressive force on the patient’s head while the neck is tilted to the side. A positive result occurs if the test reproduces symptoms of pain radiating down the arm, indicating nerve root compression.
  • Distraction Test: This test is used to relieve pressure on the cervical spine. The patient is gently pulled by the head to provide traction to the cervical spine. If the symptoms improve, it may indicate that the source of pain is nerve root compression.

Cervical Radiculopathy Diagnostic Tests

• What It Is: Diagnostic tests such as MRI and X-rays are commonly used to confirm the diagnosis of cervical radiculopathy and identify the exact cause of nerve compression.
• MRI (Magnetic Resonance Imaging): MRI is the most common imaging modality to diagnose cervical radiculopathy, providing detailed images of the cervical spine, intervertebral discs, and nerve roots. It can show herniated discs, bone spurs, and narrowing of the foramen (the spaces through which nerves exit the spine).
• X-rays: X-rays can be used to check for degenerative changes in the cervical spine, such as narrowing of the intervertebral discs or the presence of bone spurs, which may contribute to nerve compression.

Cervical Radiculopathy Test Cluster

• What It Is: A test cluster refers to a group of tests that, when combined, help increase the likelihood of diagnosing cervical radiculopathy. A test cluster is more reliable than any single test on its own.
• Common Clusters:
  • Spurling’s Test: A positive Spurling’s test helps confirm nerve compression.
  • Distraction Test: Relief of symptoms during this test supports the diagnosis.
  • Upper Limb Tension Test (ULTT): Involves placing tension on the nerve roots to see if it reproduces symptoms. A positive test suggests nerve involvement.
  • A combination of these tests can improve diagnostic accuracy when diagnosing cervical radiculopathy.

Cervical Spine Test for Radiculopathy

• What It Is: A cervical spine test is part of the physical exam used to assess for signs of cervical radiculopathy. Tests are designed to evaluate the function and integrity of the cervical spine and nerve roots.
• Key Tests:
  • Range of Motion (ROM): Assessing the patient’s ability to move the neck in different directions can help identify areas of pain and discomfort which may be associated with nerve compression.
  • Strength Testing: The healthcare provider may assess the strength of the upper limbs to determine if there is weakness in specific muscles, which can be a sign of nerve root involvement.
  • Reflex Testing: Reflexes in the upper limbs may be tested to identify any abnormalities in nerve function.

Distraction Test for Cervical Radiculopathy

• What It Is: The distraction test is a special test where the healthcare provider applies traction to the head or neck, attempting to relieve compression in the cervical spine.
• How It’s Performed: The patient is seated, and the clinician gently pulls the head upward, applying a traction force to the cervical spine. If symptoms improve during the test, this is a positive sign, suggesting that nerve compression may be the cause of the pain.
• Purpose: A positive result (symptom relief) suggests that the symptoms are due to nerve root compression, as the traction relieves pressure on the affected nerve.

EMG Test for Cervical Radiculopathy

• What It Is: EMG (Electromyography) is a diagnostic test that measures the electrical activity of muscles and nerves. It is used to assess nerve function and detect the presence of nerve root compression in cervical radiculopathy.
• How It’s Performed: Small needles are inserted into muscles, and electrical activity is measured while the muscle is at rest and during contraction.
• Purpose: An abnormal EMG result may indicate nerve damage or dysfunction, confirming cervical radiculopathy and localizing the affected nerve root. It can also help differentiate radiculopathy from other conditions causing similar symptoms.

Spurling Test for Cervical Radiculopathy

• What It Is: The Spurling test is a diagnostic manoeuvre used to assess nerve root compression in the cervical spine.
• How It’s Performed: The patient’s head is tilted toward the side of the pain (laterally) while the examiner applies downward pressure. If this causes an increase in symptoms, such as pain radiating into the arm, it indicates that a cervical nerve root is being compressed.
• Purpose: This test helps confirm that the pain radiating into the arm is due to nerve root compression in the cervical spine, a key feature of cervical radiculopathy.

Upper Limb Tension Test (ULTT) for Cervical Radiculopathy

• What It Is: The Upper Limb Tension Test (ULTT) is a special test used to assess for nerve irritation or compression in the upper limbs and cervical spine.
• How It’s Performed: The patient’s arm is positioned in a series of movements (e.g., shoulder abduction, wrist extension) to place tension on the brachial plexus (a network of nerves that controls the arm). Symptoms such as tingling or pain along the arm suggest nerve involvement in the cervical spine.
• Purpose: A positive ULTT is indicative of nerve root irritation or compression in the cervical spine, helping to confirm a diagnosis of cervical radiculopathy.

References

1. Cervical Spine Research Society, 2020. Cervical Radiculopathy Diagnosis and Management. Available at: https://www.spine.org/Patients/Diagnostic-Tests-for-Cervical-Radiculopathy [Accessed 16 February 2025].
2. Physiopedia, 2023. Cervical Radiculopathy: Special Tests and Examination. Available at: https://www.physio-pedia.com/Cervical_Radiculopathy [Accessed 16 February 2025].
3. National Institute of Neurological Disorders and Stroke (NINDS), 2021. Cervical Radiculopathy. Available at: https://www.ninds.nih.gov/health-information/disorders/cervical-radiculopathy [Accessed 16 February 2025].
4. American Association of Neurological Surgeons (AANS), 2021. Diagnostic Evaluation of Cervical Radiculopathy. Available at: https://www.aans.org/en/Patients/Cervical-Radiculopathy [Accessed 16 February 2025].