Cervical Distraction Test

What is the Cervical Distraction Test?

The cervical distraction test is used to detect the presence of cervical radiculopathy (radicular pain in the symptomatic limb caused by cervical nerve root compression).

The cervical distraction test is also known as the traction distraction test. This test is very simple as well as very specific, as research has shown that cervical distraction has a high specificity ranging between 90 to 97 % and low sensitivity of 44%.

How to Perform The Cervical Distraction Test?

The cervical distraction test is performed by two methods one is in the supine lying position, and the other is in the seated position. Let me explain to you the procedure of both the test individually.

In Supine Lying position

One more interesting thing is that there are also three methods in the supine lying position. As all three methods are performed in the supine lying position but with only a little bit of change in their position. As all these 3 positions give choice to the examiner to choose the best and most comfortable position for them.

Note – As the variety of positions is only for the examiner’s comfortability, they give a choice to the examiner to choose the best and most comfortable position for them. And also, one good thing about these positions is that the effect of all three positions remains the same (distraction of the cervical spine).

Let me explain to you all the three positions.

1 – Cuff the Inferior Aspect of the Occiput

  • The patient lies in the supine lying position, and the neck is in a comfortable position.
  • The examiner takes his index finger and cuffs the inferior aspect of the occiput. The patient is completely relaxed as this is a complete passive test.
  • And now the examiner will distract the occiput as this will distract the cervical spine and open up the intervertebral foramina (opens up the space in between the two vertebrae). A foramina is an opening present between each pair of spinal vertebrae. A number of structures pass through the foramina like the root of each spinal nerve, spinal artery, and veins. The opening of intervertebral foramina helps to take the pressure off from pinched spinal nerve.

intervertebral-foramina

A positive cervical distraction test is the reduction of the radicular symptoms going from the neck down the arm. And if that occurs (a cervical distraction test is positive), it indicates cervical radiculopathy.

2 – One Hand On the Occiput And One Hand on the Forehead

  • The patient lies in the supine lying position, and the neck is in a comfortable position.
  • The examiner places one hand under the occiput and the other hand on the forehead.
  • Now the examiner flexes the patient’s cervical spine into a position of comfort.
  • Now the examiner will apply the traction force to distract the cervical spine. This will open up the intervertebral foramina (opens up the spaces in between the two vertebrae). This will help to take the pressure off from pinched spinal nerve.

A positive test is a relief of pain or reduction of the radicular symptoms going from the neck down the arm. And if that occurs (a cervical distraction test is positive), it indicates cervical radiculopathy.

3 – One Hand On the Cervical ridge And One Hand Under the Chin

  • The patient lies in the supine lying position, and the neck is in a comfortable position.
  • The examiner places one hand under the patient’s cervical ridge and the other hand under the patient’s chin, as shown in the video below.
  • Now the examine will apply a distraction force. In other words, the examiner will pull the patient’s neck to the end of the range in traction (end of the arthro-kinematic range), as shown in the video below.

A positive test is a relief of pain or reduction of the radicular symptoms starting from the neck going down the arm. And if that occurs (a cervical distraction test is positive), it indicates cervical radiculopathy.

Now all the three positions of the supine lying position are explained above. Now let me explain how to perform the cervical distraction test in a seated position.

In The Seated Position

  • Ask the patient to sit in a good posture.
  • The examiner takes the palm of his left hand and grasps or cups the inferior aspect of the occiput. And the other hand is just slightly placed on the patient’s forehead.
  • Now the examiner will lift the patient’s head in the upward direction (distracting the cervical spine).
  • Now the examiner will ask the patient if there is a reduction in the radicular symptoms.

Lifting the occiput upward helps to distract the cervical spine and opens up the intervertebral foramina. This will help to take the pressure off from pinched spinal nerve. This will reduce the radicular symptom in the arm.

A positive test is a relief of pain or reduction of the radicular symptoms starting from the neck going down the arm. And if that occurs (the cervical distraction test is positive), it indicates cervical radiculopathy.

cervical-distraction-test

What if the pain increases while performing the Cervical Distraction Test?

If the distraction increases the pain, it indicates functional impairment in the cervical spine due to ligamentous or muscular, or articular pathology.

You May Also Read – 

Cervical Flexion Compression Test – To identify if there is a herniated disk in the cervical spine (Cervical Radiculopathy or Cervical Disc Herniation)

Cervical Extension Compression Test – To Detect the Presence of Posterolateral Disk Extrusion (Disk herniation) with an intact annulus fibrosus

Spurling Test – For Diagnosing Cervical Radiculopathy

Soto Hall Test – For Detecting Problem in Patient’s Neck (Cervical Spine)

Adam’s Forward Bend Test – For Detecting The Presence of Scoliosis (either function or structural)

Resources

Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup

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