Spurling's test is a diagnostic technique that can identify the presence of a compressed nerve in the neck. It involves the movement of a patient's head and neck in a particular manner to assess any pain that occurs subsequently. Neck and arm pain are a positive sign of nerve compression in the test. Possible causes of the nerve compression include injury to the vertebrae, a slipped disc or muscle spasms.
Pain in the neck or in the arm can be a sign of nerve compression in the cervical vertebrae of the spine. The cervical vertebrae are those in the neck area, and include the first seven vertebral bones, from the skull to the eighth vertebra, which attaches to the top ribs. The nerves that run through the cervical vertebrae are those that supply the top of the body, such as the neck and the arms, with sensation.
For Spurling's test, the patient normally sits or lies down. Then the medical professional extends the neck vertically, and turns the head toward the side that the patient feels pain on. After the head is turned, the medical professional places pressure downward on the head, and increases the pressure slowly until the patient displays a symptom such as pain, at which time the test should be stopped. Other indications to stop the test include other nervous symptoms such as numbness or tingling. If the cervical nerves are involved, these sensations tend to be in the neck and the arm areas.
If pain is produced during Spurling's test that is the same as the pain previously felt by the patient, then nerve compression is indicated. Various medical problems can cause compression, and these include muscle spasms, broken vertebral bones and slippage of the discs that act as cushions between the individual bones. Sometimes, though, Spurling's test results in a false positive if the patient is actually suffering from muscular strain or ligament problems which are unrelated to nerve compression.
This type of test carries a risk of serious damage to the patient, as movement of the spine when injured can be dangerous and may actually result in paralysis. This risk increases if the professional performing the test does not take special care to cause as little pain as possible, which is a sign of injury. For this reason, the test should not be performed by an untrained person, and possible spinal injuries should be investigated by a doctor.
