Hello! How are you? Neck pain is a problem that many people have these days, right? Sometimes this pain goes down the arm, it becomes numb, and then it also bothers the mind. So today we are going to talk about a simple test that your doctor will do to find the cause of your neck pain. It is called the Spurling test. When you hear this, you may think, "Oh, what is this?" But don't worry, let's talk about it simply.
Do you know what the Spurling Test is?
Simply put, the Spurling test is a physical exam that your doctor will perform to check for nerve root compression that could be causing your neck pain. The nerves that run from your neck to your arms come from the vertebrae in your neck (also called the cervical spine). So, if one of these nerves is compressed in some way, it's called cervical radiculopathy, which is a problem with a nerve in your neck. The Spurling test is used to diagnose this condition.
Doctors may also call this a ``maximal cervical compression test'' or ``foraminal compression test''. These names may sound a bit formal and a big test. But you can simply think of it as a test that the doctor performs to diagnose neck pain. After this, you may also need to do an ``imaging test'' to confirm the condition. But this is an important first step.
When is the Spurling Test performed?
Typically, a doctor will perform this test if you have had symptoms of cervical radiculopathy, or pinched nerve in the neck, for about a month. What are these symptoms? Take a look:
- Neck, shoulder, and/or arm pain. Often, this pain starts in the neck and travels down the arm. Sometimes it can feel like an electric shock or a burning sensation. We call this radiating pain.
- A tingling or prickling sensation in the hand. It may feel like your hand is falling asleep, or like ants are running around. Sometimes the fingertips go numb.
- Weakness and numbness in the hands and fingers. When you hold or lift something, you may feel like you are not strong enough, and you may even drop the object.
Imagine that you've been having neck pain for about a month, and at the same time, your right hand's fingers are numb, and you feel weak when you try to lift a glass of water... At a time like this, a doctor might do this ``Spurling test'' to find out exactly if any nerves in your neck have been affected.
How should I prepare for this test?
This is the best thing, don't be afraid, it doesn't require much preparation! This is a simple physical test, so there's nothing special for you to do.
But, there are a few little things to keep in mind.
- If possible, wear loose, loose-fitting clothing around your neck . For example, it's best to avoid turtleneck sweaters, large scarves, and heavy necklaces, as the doctor will want to examine your neck carefully.
- If you are wearing a head covering, you do not need to remove it.
- Before performing this ``Spurling test``, the doctor will perform a general physical examination and ask about your medical history.
Also, if there are certain medical conditions, the doctor may think twice about performing this test, or may refer you to another test. For example:
- If there is cervical spine instability.
- If you have a condition called cervical spondylotic myelopathy (this is a bit complicated, your doctor will explain it to you).
- If you have recently had an accident to your neck, that is, your spine.
- If you have a joint inflammatory condition such as rheumatoid arthritis.
- If there is a suspicion that cancer cells have spread to other areas (metastasis or metastatic cancer).
For someone with these conditions, the doctor may decide to do a different test than the Spurling test. It's all for your safety and to make an accurate diagnosis.
What happens when you do the Spurling Test? How is it done?
This is something that can usually be done in the doctor's office in a few minutes. No fancy equipment is needed. Here's what happens:
- First, the doctor will tell you to stand or sit in a chair. Then, they will tell you to stay still and relax.
- Next, the doctor will very gently place his hands on your head and neck.
- Then, slowly turn your head and neck from side to side (right, left), tilt it a little to the side, maybe rotate it a little, and pull it up a little. All of this is done very controlled and gently.
- While your neck is in each position, the doctor will apply gentle downward pressure from the top of your head.
At this time, the doctor is looking for signs of an underlying medical condition. So it's important to tell the doctor what you're feeling right away. The doctor will do this by talking to you. They may ask questions like, "How are you feeling now?" or "Do you feel any pain?" You may be asked to raise your hand if you feel any pain, or you may be asked to describe what you're feeling. Don't be afraid to say it.
What does the Spurling Test feel like?
This is a problem that many people have. You may not feel any discomfort or pain. If so, that's fine.
However, sometimes, especially if you have a pinched nerve, you may feel a little pain, numbness, or weakness in your arm during the test. This pain may be the same as the pain you had before, radiating from your neck down your arm.
The most important thing is to tell your doctor as soon as you feel any discomfort. The doctor will then stop the movement and perform the examination in a way that is not too painful for you. You may be asked to turn your head in a different direction to see how far the symptoms are, but never in a way that increases your pain.
Remember, the purpose of this test is not to cause you more pain, but to help you find the cause of your pain. The doctor is always thinking about you.
Are there any risks with this test?
When a doctor performs this ``Spurling test``, he does it very carefully, thinking about your safety. This is generally a very safe test.
However, although very rare , there is a small chance of permanent injury or nerve damage. The chance of that happening is very small, because doctors do this very carefully and with great control. If you feel pain, they stop right away, so there is less chance of serious damage.
What are the results of the Spurling Test?
Once the test is completed, the doctor can receive one of two results: either the test can be ``positive`` or it can be ``negative``.
- A positive Spurlin test means that you feel pain or other symptoms (like the numbness we talked about earlier, pain that goes down your arm) during the test. This means that there is a high chance that you have a pinched nerve in your neck (cervical radiculopathy). If this happens, your doctor may order further imaging tests, such as a CT scan or MRI, to confirm the diagnosis.
- A negative Spurlin test means that you did not experience any pain, new symptoms, or worsening of a pre-existing symptom during the test. If so, you probably do not have cervical radiculopathy, a condition that causes a pinched nerve in the neck. However, your doctor may need to do other tests to confirm the diagnosis, as they will need to rule out other causes.
When will I know the results of this test?
This is another good thing! As soon as the test is done, the doctor will tell you the results. "Your test is positive/negative" will be told right away. He will also explain to you what to do next, whether more tests are needed, what kind of treatment is available. This is also a good time to ask any questions you may have.
If the Spurling Test is positive, what happens next?
Okay, let's say your Spurling test is ``positive.'' That means the doctor suspects that you may have a pinched nerve in your neck.
Next, the doctor may recommend other tests to confirm the diagnosis, especially imaging tests like a CT scan or MRI. These can look at exactly what's going on inside the neck, where the nerve is being compressed, and how tight it is.
Once the diagnosis is confirmed, the doctor will start the appropriate treatment for you. This treatment may vary from person to person. Some common treatments include:
- Use of medications: Painkillers, special medications to reduce nerve pain, and possibly muscle relaxants may be given.
- Rest and activity modification: It is recommended to temporarily stop or reduce activities that are hard on the neck (such as lifting heavy objects or staying in the same position for a long time).
- Physical therapy: This is a very important treatment. A physical therapist will teach you things like neck exercises, exercises to strengthen your neck muscles, and correct posture (sitting, standing, sleeping). These can help reduce pain and prevent the condition from recurring.
- Surgery: In most cases, this condition can be managed with medication and physical therapy. However, in severe cases, such as when the pain is unbearable, the hand has lost a lot of strength, or when other treatments do not help, surgery may be necessary.
Your doctor will decide which treatment is best for you based on your condition, your symptoms, and the results of your tests.
What time should I see a doctor?
If you've had neck pain (or any of the symptoms of a pinched nerve we talked about – pain radiating down your arm, numbness, weakness) for a few weeks, if it's getting worse, or if it's not getting better, definitely see a doctor. Also, if the pain is making it hard to do your daily activities or if you're having trouble sleeping, tell your doctor about it too.
Your doctor can examine you and, if necessary, perform the ``Spurling test'' to help determine the cause of your symptoms.
Finally, take-home message
Okay, now you know a lot about the `(Spurling test)`, right?
Simply put, the Spurling test is an important, simple test that can help doctors find the cause of your neck pain before they go for a more serious imaging test, like an MRI. When you go to the doctor with pain, it's normal to feel a little nervous, like, "Oh, will this test make it worse?" I understand that.
However, the doctor will talk to you and stop the test immediately if you feel any discomfort. If the test is ``positive,'' meaning it shows there is a problem, the doctor will tell you what to do next and what treatments may be available to help you.
So, if you have persistent neck pain or numbness in your hand, don't ignore it. Don't just assume it will "just go away." It's always best to see a doctor and get advice. That way, you can get relief quickly.
Wishing you a speedy recovery!
` Neck pain, Spurlin test, nerve compression, cervical nerve root compression, numbness, medical tests, cervical radiculopathy, cervical spine, neck pain
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