Have you ever felt a tingling sensation that runs from your neck to your shoulder and down your arm? Perhaps this pain increases when you work in front of a computer for a long time, sleep incorrectly, or lift heavy weights. Although many people think that this neck pain is normal, sometimes it can be a symptom of a serious internal problem. So, to find the real cause of this kind of neck pain, there is a very simple but important test that a doctor can perform. Today we are talking about the 'Spurling Test '.
Simply put, what is the Spurling Test?
The Spurling test is a manual physical examination that your doctor performs to find the cause of your neck pain. It is not a blood test or a scan. It is named after Roy Spurling, a neurosurgeon who first introduced the test in 1944.
It works on a very simple concept. Imagine that a nerve that comes out of one of the vertebrae in your neck is pinched for some reason. In this test, the doctor tries to give a very gentle, controlled movement to your neck that pinches that nerve, and see if the pain you normally feel comes back . In other words, this is what is being done to provoke symptoms. If it does, the doctor can get a good idea of where the problem lies.
What does it mean if the test is positive?
Once the test is complete, the result can be 'Positive' or 'Negative'.
A positive result means that when the doctor turns your neck in a specific direction and applies gentle pressure, you feel the same pain, tingling, or discomfort that you always feel along your arm.
A positive result like this often means that a nerve root coming from one of the vertebrae in your neck is being compressed. In medical terms, we call this condition 'Cervical Radiculopathy' .
There can be several reasons why a nerve can become pinched in this way:
- Herniated Disk : To be precise, a jelly-like cushion (disk) between two vertebrae bulges out and presses on a nerve.
- Bone changes: Changes in the vertebrae (arthritis) that occur with age can cause new bone growths to press on the nerve.
- Swelling or scar tissue: Swelling or scar tissue that occurs after an accident can cause a nerve to become compressed.
- Severe muscle spasm : Nerves can also be pinched due to excessive muscle tension in the neck.
Considering your medical history and other symptoms, the doctor can come to a good conclusion about your illness with a positive result from this Spurling Test.
How does the doctor perform this test?
Some people may be a little scared when they hear about this test. But it is done very carefully and under control. If you feel any pain, the test will be stopped immediately.
Here are the steps to usually do this:
1. Step 1: The doctor will have you sit in a chair and, while your head is straight, apply gentle pressure on the top of your head. This is called the Basic Compression Test . If you do not feel any pain or discomfort at this point, you can move on to the next step.
2. Step 2: Now the doctor will tilt your neck slightly towards the side where the pain is . For example, if the pain is going down your right arm, he will tilt your head slightly to the right.
3. Step Three: With the head tilted in this position, the priest again applies gentle pressure on the top of the head.
When this pressure is applied, if you feel that familiar pain, tingling, or electrical sensation that you've always felt, down your shoulder or arm, the test is 'positive'. As soon as you feel that, the doctor stops the test. If no pain is felt, the result is 'negative'.
Very important: You should never try this test at home or have someone else do it for you. This should only be done by a qualified doctor. Doing it incorrectly can damage your neck.
What other tests are done besides the Spurling Test?
The Spurling test is a very specific test for detecting a pinched nerve. This means that if it is 'positive', it is most likely that a pinched nerve is present. However, it is not a very sensitive test. This means that just because the test is 'negative', it cannot be said with 100% certainty that you do not have a problem. It is possible that the pain is caused by another reason.
Therefore, the doctor may also perform several other physical tests to get the full picture. Here are some more such tests.
| Name of the test | How to do it simply and be 'positive' |
|---|---|
| Shoulder Abduction (Relief) Sign | You will be asked to raise the arm on the side of your head that is in pain. If your pain decreases when you do so, the test is 'Positive'. |
| Neck Distraction Test | The doctor will hold your head under your chin and behind your head and gently pull it up. If your pain decreases at this point, the test is 'positive'. |
| L'hermitte's Sign | If, when you bend your head down (towards your chest), you feel an electric shock along your spine or arms and legs, the test is 'Positive'. |
| Hoffman's Sign | The doctor will gently 'snap' the nail of your middle finger. If the index finger and thumb bend spontaneously, the test is 'positive'. |
| Adson's Test | Your head will be turned to the side of the pain, your chin will be lifted, and you will be asked to take a deep breath. At this time, the doctor will check your pulse from your wrist. If the pulse stops, the test is 'Positive'. |
By gathering the information from these tests and referring you for further testing, such as an MRI scan, if necessary, your doctor will determine the most appropriate treatment for you.
Take-Home Message
- The Spurling test is a simple physical test performed by a doctor to check for nerve compression that is causing pain that radiates from the neck down the arm.
- A 'positive' test means there is strong evidence that a nerve in your neck is compressed.
- This test is only one part of the diagnosis. Your doctor will consider this result along with your symptoms, medical history, and other tests.
- Do not attempt to perform this test at home for any reason. It should only be performed by a qualified physician.
- If you are experiencing pain, stiffness, or discomfort in your neck, shoulder, or arm, do not ignore it and definitely see a doctor for proper advice and treatment.
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