O’Donoghue Test – For Cervical Spine

What is O’Donoghue Test/Maneuver?

The O’donoghue test helps in differentiating between muscular pain (strain) and ligamentous pain (articular problem) in the back of the neck (cervical spine).

After ligamentous pain, the word articular is written in the bracket. The reason behind writing the word articular is that if the ligaments are compromised, the articular surfaces are also compromised.

As stretched ligaments cause increased movement of articular surfaces and therefore result in irritation and inflammation in the joints.

The procedure of Performing the O’Donoghue Test/Maneuver?

The O’donoghue test is performed by two methods one is by

1 – Passive movement – The doctor or examiner will move the neck (cervical spine), and there will be no involvement of the patient.

2 – Active movement against resistance – In this, the patient will move the neck (cervical spine) against the resistance applied by the examiner.

As the O’donoghue test is performed by two methods, so the procedure of performing both tests will also be different. So let me explain to you the procedures of both the test individually.

The Procedure of Performing the O’Donoghue Test by Passive movement

  • Ask the patient to be in a seated position.
  • The examiner then passively tilt the patient’s head to one side (left side) and then to the other (right side).
O’donoghue-test
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The Procedure of Performing the O’Donoghue Test by Active motion against resistance

  • Ask the patient to be in a seated position.
  • The patient is then asked to tilt or rotate his/her head to one side (left side) against the resistance of the examiner’s hand resting on the zygomatic bone and temple. Here tilt means left lateral flexion and right lateral flexion of the neck. And rotate means left rotation and right rotation of the neck.

left-and-right-lateral-flexion-and-left-and-right-rotation-of-neck

  • The exact process is performed for the other side (right side).
O’Donoghue Test
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Note – In this procedure, the examiner resists the patient’s movement by applying resistance in the opposite direction.

Result

Result of Test Performed by Passive method

Occurrence of pain during passive lateral bending of the cervical spine indicates a functional impairment involving ligaments (or articular). Here passive means (the examiner will move the joint, and there will be no involvement of the patient).

Why does passive movement indicate functional impairment involving ligaments (or articular)?

The passive movement stresses the articular surfaces and the ligaments.

Result of Test Performed by Active motion against resistance

The occurrence of pain during active head movement (tilting or rotating the head to one side, either left or right side) against the resistance applied by the examiner’s hand resting on the zygomatic bone and temple indicates muscular dysfunction. 

In other words, the occurrence of pain during this active head movement with isometric tensing of the ipsilateral and contralateral paravertebral musculature indicates muscular dysfunction. Paravertebral muscles are involved in the left and right lateral flexion as well as left and right rotation of the neck (cervical spine).

Role of Isometric Contraction

The word “Iso” means the same, and “metric” means muscle. So therefore in an isometric contraction, the length of the muscle remains the same, and the tension in the muscle increases.

When a muscular force fails to move a joint, the contraction is termed isometric contraction. During an isometric contraction, the muscle contracts in a fixed position. It remains the same length because the force it generates is equal to the resistance or load it is pulling on.

Now here what happens is that the patient is trying to laterally flex or rotate his neck, but the examiner resists that movement by applying the resistance in the opposite direction.

So this mechanism activates the paravertebral muscles but without moving the joint. And if this reproduces the pain, it indicates muscular involvement (strain).

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) 

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

Spurling Test – For Diagnosing Cervical Radiculopathy

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

O’Donahue’s Test Explained: strain vs. sprain

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