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Spurling test

Authoring team

Spurling’s Test was first reported by neurosurgeons Spurling and Scoville in 1944 to assist in identifying patients with ‘radiculitis’ (1,2):

Spurling's Test

  • is designed to reproduce symptoms by compression of the affected nerve root
  • the cervical extension is used to induce/reproduce posterior bulging of the intervertebral disk
  • in the Spurling's test
    • the examiner first has the patient sit and then gently tilts and rotates the head to the affected side
    • the examiner then applies downward axial compression to the top of the head, which can be intensified by adding extension
  • rotation of the head causes narrowing of the neuroforamina in the cervical spine
    • axial compression is applied to amplify these effects with the aim of exaggerating the preexisting nerve root compression

A video of an examination using Spurling's test

A Positive Spurling's test:

  • a positive result is the reproduction of the patient's radicular symptoms, such as pain or numbness, radiating down the arm;neck pain alone is not considered positive
    • result of a positive Spurling test is a reproduction of cervical radiculopathy symptoms
      • cervical radiculopathy can involve the neck, shoulder, or arm
      • may also present as muscle weakness, sensory symptoms, or diminished deep tendon reflexes
        • any, or all, of these symptoms, may be present in a patient, and any of them may be elicited in response to provocative testing
    • study evidence showed a sensitivity of 30% and a specificity of 93% (3)
      • study authors concluded that the Spurling test is not very sensitive, but it is specific for cervical radiculopathy diagnosed by electromyography

Reference:

  1. Jinright H, Kassoff N, Williams C, Hazle C. Spurling's test - inconsistencies in clinical practice. J Man Manip Ther. 2021 Feb;29(1):23-32.
  2. Jones SJ, Miller JMM. Spurling Test. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
  3. Tong HC, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine (Phila Pa 1976). 2002 Jan 15;27(2):156-9.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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