Orthopedic Exam / Special Tests for Physical Therapy: HEAD & NECK
Special Test: Cervical DISTRACTION TEST: (Procedure Below)
The cervical spine refers to the seven cervical vertebrae; bones in the neck that connect the back of the skull to the thoracic spine in the upper back. The muscles in the neck support and protect the vertebral bodies, cord, and nerve roots by absorbing forces transmitted to the neck directly, or through the head or trunk.
There are eight cervical nerve roots arising from the cervical spinal cord, which exit the vertebral canal through foramen (circular openings between the vertebras that house the spinal cord). The size or diameter of the vertebral canal and foramen vary in size, depending on the person. After exiting the canal, the lower cervical nerve roots become interwoven with each other to form the brachial plexus, a series of nerves that supply sensation and motor function to the arms and hands.
Compression or stretching of a nerve root or the brachial plexus; referred to as “burners” or “stingers”, occur from either a pinching (compression) of the nerve on the same side the neck is flexed/extended or a stretching of the nerve on the opposite side of where the neck is flexed/extended. Those affected may experience sharp, burning pain that may radiate into the shoulder and down the arm to the hand. The symptoms only occur on one side and may include weakness and paresthesia (numbness or tingling) in the involved extremity for several seconds to several minutes. Raising the arm (deltoid), flexing the elbow (bicep), and rotating the arm outwards (using the external rotator muscles of the rotator cuff) may be restricted as a result of motor weakness.
Special Test: Cervical DISTRACTION TEST
- To confirm and relieve pressure on the cervical nerve roots; (may be used after Spurling’s or Cervical Compression Tests).
Video Demo Instructions, Procedure, Positive Test:
Special Test: Cervical DISTRACTION TEST: Video Demo
Special Test: Cervical DISTRACTION TEST: Procedure:
• Patient is supine or seated. (Patient’s head is in a neutral position at all times throughout the procedure.)
• Therapist grasps the patient’s head at occiput and temporalis. One hand on either side of the head.
• Slowly traction the patient’s head in a superior direction.
• Maintain the traction for at least 30 seconds.
Special Test: Cervical DISTRACTION TEST: Positive Sign:
• Relief of patient’s symptoms.