Spurling Test

What is the Spurling test?

The Spurling test is a physical assessment to diagnose cervical radiculopathy or a pinched nerve in your neck. If you experience neck pain, a healthcare provider may offer this test. The Spurling test can tell your provider if something is squeezing or pressing against a nerve (nerve root compression) in your cervical spine.

During the Spurling test, your provider will tilt and turn your head and neck and gently apply pressure. You may need an imaging test following this assessment to confirm a diagnosis.

You may hear your provider refer to the Spurling test as the maximal cervical compression test or foraminal compression test. This may sound like a formal test, but you can think of it as a physical exam to assess neck pain.

When is the Spurling test performed?

A healthcare provider may perform the Spurling test if you experience symptoms of cervical radiculopathy (a pinched nerve) for at least a month. Symptoms of a pinched nerve in your neck include:

• Neck, shoulder and/or arm pain (usually radiating pain).
• Numbness or tingling.
• Weakness in your arms and hands.

How do I prepare for the Spurling test?

As this is a simple physical assessment, you don’t need to do anything specific to prepare for the Spurling test.

You may want to wear loose, comfortable clothing, especially around your neck, as that’s where the provider will perform the test. For example, you may want to avoid wearing a turtleneck sweater, scarf or heavy jewelry. If you wear a head covering, you can leave that on.

Your provider will do a physical exam and review your medical history before the Spurling test.

Your provider may offer other types of tests instead of this one if you have any of the following conditions:

• Cervical spine instability.
• Cervical spondylotic myelopathy.
• A recent spine injury.
• Rheumatoid arthritis.
• Metastasis (metastatic cancer).

What can I expect during the Spurling test?

The Spurling test is usually done in your healthcare provider’s office and only takes a few minutes to complete.

During the test, your healthcare provider will:

• Instruct you to either stand up or sit down and to stay still.
• Gently place their hands on your head and neck.
• Tilt, turn, rotate, pull and move your head and neck slowly in different positions.
• Apply light pressure on the top of your head.

They’re looking for signs or symptoms of an underlying condition by performing this test. So, it’s important to communicate how you feel with your provider. Your provider will also communicate with you during the test so you know what they’re doing as they’re doing it. They may ask you to raise your hand if you feel pain or describe what you’re feeling as it happens.

What does the Spurling test feel like?

You may or may not feel discomfort during the Spurling test. Discomfort could include pain, numbness or muscle weakness.

If you feel any symptoms, tell your provider when they happen. They’ll change their approach to prevent movements that could cause more pain. They may move your head in a different way to test the extent of the symptom but not in a way to make the pain you feel worse.

What are the risks of the Spurling test?

A healthcare provider will use caution when performing the Spurling test to make sure it’s safe. While very rare, permanent injury or nerve damage is a possible risk of this test.

What are the results of a Spurling test?

The results of the Spurling test are either positive or negative:

• Positive Spurling test: You felt pain or experienced symptoms during the test. Your healthcare provider may order additional testing (like a CT scan or MRI) to confirm a cervical radiculopathy diagnosis.
• Negative Spurling test: You didn’t feel any pain or symptoms during the test. You likely don’t have cervical radiculopathy. Additional testing may be necessary to confirm this.

When should I know the results of the test?

You should know the results immediately after your provider finishes the test. They’ll tell you the results and what to expect as far as next steps during the same appointment.

If the Spurling test is positive, what are the next steps?

A positive Spurling test result may tell your provider that you have nerve compression in your neck. To confirm a diagnosis, your provider may recommend imaging tests or other forms of testing.

Once they confirm a diagnosis, treatment may follow, which could include:

• Taking medications.
• Rest or activity modification.
• Participating in physical therapy.
• Undergoing surgery.

When should I call my doctor?

Contact a healthcare provider if you experience neck pain (or other symptoms of a compressed nerve) for several weeks that get worse or don’t go away. Your provider may run the Spurling test to see how symptoms affect you.