special tests for cervical spondylosis and cervical disc herniation

                               SPECIAL  TESTS  FOR  CERVICAL  SPONDYLOSIS                                            AND CERVICAL  DISC  HERNIATION 

The  neck pain become a part  of  our  daily life  because of poor posture  or other causes.  Identify  and  plan  a specific  treatment  protocol  for  patients  suffering  from  neck  pain is main goal  of  a   physiotherapist. 

Here I am going  to  describe  some  specific  special  tests  which are  most commonly  used  in clinical  settings  for  identify  causative  factor  of  neck pain .

1) FORAMINAL  COMPRESSION  OR SPURLING TEST:-

-The  test is  performed if  the  patient  has  a history of  redicular  pain  to upper limb.

- The test  is  designed   to provoke  symptoms. 

-The  test is  performed  in three  stages:-

Stage-1:- Ask the  patient  to  keep  his head in neutral position  .

                 Now   therapist  carefully presses  straight  down  On head. 

Stage-2:-Ask the  patient  to  keep the  head  in extension.

                Now therapist  carefully  applies  compression  force.

Stage-3:- Ask the  patient  to  extend  and rotate the  head  first  to                  the  unaffected  side  and  then affected  side.

                  Now same way the  therapist  applies  compression  force .

               The test is  performed  in three  stages  ,each of which is increasingly  provocative,  if  symptoms  are produced,  one  does't proceed  to next stage.

Positive  test  indicates    pain radiates into arm toward which the  head  is  side flexed during compression.

                          FORAMINAL  COMPRESSION TEST

2) DISTRACTION  TEST:-

-The test is  performed  in patients  with  history  of  redicular   pain  .

-It is  used to elevate  syndromes.

-For  this  ask the  patient  to  palce head in neutral  position. 

-Now  the  examiner  place one  hand  under chin and  other  hand  around  occiput.

-The  examiner  slowly  lifts  the  head  .

-The test  is  positive  if pain  is relieved  by when head  is lifted or distracted. 

                                  DISTRACTION  TEST 

3) JACKSON 'S COMPRESSION  TEST :-

-The  test is a modification  of the  foramen  compression  test .

-Ask the  patient  to  rotate  the  head  to one  side.

-The  examiner  then carefully  presses  straight  down  on the  head  .

-The  test  is  repeated  with head rotated to other  side.

-The  test is  positive  if pain  radiates  into arm , indicating  pressure on nerve root.

                            JACKSON'S COMPRESSION TEST

OTHERE TESTS RELATED  TO  NEUROLOGICAL  SYMPTOMS :-

1)BRACHIAL  PLEXUS  COMPRESSION  TEST :-

-The  patient  sits  in  comfortable  position  .

-The  examiner  applies  firm compression  to brachial  plexus  by squeezing  the  plexus  under thumb or fingers.

-The test  is  positive  only if pain radiates  into  the shoulder  or upper  extremity.

-It is positive  for mechanical  cervical  lesion having  mechanical  component. 

2)SCALENE  CRAMP TEST :-

-Ask the  patient  to  sit comfortably  with head  in neutral  position. 

-Now ask the patient  to  rotate  the  head  to affected  side and pull chin down into the hollow  above  the clavicle by flexing the cervical  spine.

-If pain is increases it indicates  trigger points  of scalenes muscle toward  the  head  rotates.

-Redicular  sign indicates  plexopathy or  thoracic  outlet  symptoms.

3) SHOULDER  ABDUCTION  TEST:-

-This test  is used to test for  redicular symptoms, specially  those involving  C4 or C5 nerve  roots.

-The patient  sits  or Lie  down  comfortably  .

-The examiner  passively  or patient  actively elevates arm through  Abduction so that armeans or forearm  rests on top of head. 

-A decrease  or relief  of symptoms  indicates  positive  test  for  nerve compression  , disc herniation  or epidural  vein compression.

                             SHOULDER  ABDUCTION  TEST 

4)SHOULDER  DEPRESSION  TEST :-

-The  test is  used to evaluate  brachial  plexus  lesion. 

-The  examiner  side flexes  the  patient 's head to one side while applying  a downward  pressure  on the opposite  shoulder. 

-If pain  increases, it indicates  irritation  or compression  of nerve roots  .

                       SHOULDER  DEPRESSION  TEST