The Cervical Distraction Test assesses whether gentle axial traction reduces neck or arm symptoms. Symptom relief may support cervical radicular symptom reasoning when paired with history, neurological screen and other cervical tests. A 2021 diagnostic accuracy study found that cervical radiculopathy assessment should not rely on one test and warned that diagnostic accuracy values should be interpreted cautiously because there is no perfect gold standard.
A client reports neck pain with arm symptoms that worsen with certain neck positions. Symptoms may reduce when the head is supported or the neck is gently unloaded. The Cervical Distraction Test can help assess whether axial unloading changes symptoms.
The test should be gentle. It is not a strength test, and it should not be used to force the neck into traction.
Test name: Cervical Distraction Test
Body region: Cervical spine and upper limb
Purpose: Assess whether gentle cervical traction reduces symptoms
Positive finding: Reduction or relief of familiar neck or arm symptoms during traction
Negative finding: No meaningful symptom change or symptom worsening
Best used with: Spurling’s Test, Bakody Sign, neurological screen, cervical ROM and upper limb neurodynamic testing
Key limitation: Symptom relief does not diagnose cervical radiculopathy on its own
The Cervical Distraction Test is performed with the client usually supine or seated. The professional applies gentle upward traction through the head and neck to reduce compressive loading.
A positive response is usually symptom relief, especially arm symptom reduction.
The test is used when symptoms may be influenced by cervical loading or unloading.
It may help inform whether neck or arm symptoms change with traction and whether further cervical, neurological or neurodynamic assessment is needed.
The test assesses symptom response to cervical unloading. It does not identify the exact tissue source or confirm nerve root compression.
This test may be useful for clients with neck pain, arm pain, paraesthesia, numbness or symptoms influenced by neck position.
Use when the client has symptoms that may be cervical in origin and traction can be performed safely.
Use caution with suspected fracture, instability, severe osteoporosis, inflammatory disease, dizziness, vascular symptoms, acute trauma, severe neurological deficits, worsening symptoms or inability to tolerate head/neck contact.
Treatment table or chair
Pain/symptom scale
Measurz recording workflow
Optional neurological screen notes
Position the client supine or seated, depending on the selected method.
The neck starts in a comfortable neutral position.
Stand or sit at the head of the client.
Support the occiput and lower cervical region comfortably.
Keep the neck relaxed and avoid rotation or extension unless intentionally included in the method.
Apply gentle axial traction through the cervical spine.
Ask whether symptoms reduce, increase, centralise, peripheralise or remain unchanged.
A positive finding is reduction or relief of familiar neck or arm symptoms during traction.
A negative finding is no meaningful change or symptom worsening.
Stop if pain increases, dizziness occurs, neurological symptoms worsen, vascular symptoms appear or the client feels unsafe.
Use gentle force only. Do not continue if symptoms worsen.
A positive Cervical Distraction Test may support cervical radicular symptom reasoning when it reduces familiar arm symptoms and aligns with history, neurological screen and other cervical tests.
A negative test does not exclude cervical radiculopathy or cervical contribution. Some symptoms may not change with traction, and some clients may not tolerate the position.
Interpretation is stronger when paired with Spurling’s Test, Bakody Sign, neurological examination, cervical ROM, upper limb neurodynamic testing and symptom distribution.
A 2021 study on cervical radiculopathy clinical tests reported that cervical distraction showed lower diagnostic accuracy than other provocation and reduction tests, indicating limited diagnostic use when applied alone.
Because cervical radiculopathy lacks a perfect gold standard and diagnostic accuracy varies by test, population and criteria, no stand-alone values are listed here. Interpretation should remain cluster-based and cautious.
Reliability depends on consistent client position, force direction, amount of traction, symptom criteria and communication.
A 2025 scoping review found heterogeneity in neurological examination procedures for cervical radiculopathy and variable diagnostic accuracy, supporting the need to combine symptom relief tests with neurological findings and clear documentation.
Common errors include applying excessive traction, failing to record symptom change, interpreting any relief as diagnostic, ignoring dizziness or vascular symptoms and not pairing the test with neurological assessment.
Limitations include variable force, symptom fluctuation, client relaxation, safety considerations and limited stand-alone diagnostic certainty.
Use the Cervical Distraction Test to document whether symptoms change with cervical unloading. It may help guide further assessment and symptom monitoring, but should not be used in isolation.
Record test name, position used, result, symptom intensity before and during traction, symptom location, symptom quality, traction direction, approximate force level if relevant, duration, neurological symptoms, dizziness or vascular symptoms, comparison with Spurling’s or Bakody Sign, confidence in result and reason for stopping.
Spurling’s Test
Bakody Sign
Upper Limb Tension Test
Cervical ROM Tests
Adson’s Test
Roos Stress Test
Grip Strength Test
Neurological Screen
It assesses whether gentle cervical traction reduces neck or arm symptoms.
A positive finding is reduction or relief of familiar symptoms during traction.
No. It may support clinical reasoning but does not diagnose cervical radiculopathy on its own.
Stop for dizziness, symptom worsening, vascular symptoms, neurological worsening or poor tolerance.
Record symptoms before and during traction, position, force direction, duration and stopping reason.
The Cervical Distraction Test is a symptom relief test.
A positive result is symptom reduction during traction.
It should not be interpreted alone.
Safety and symptom monitoring are essential.
Measurz should capture before-and-after symptoms and traction details.
Sleijser-Koehorst, M. L. S., Coppieters, M. W., Epping, R., Rooker, S., Verhagen, A. P., & Scholten-Peeters, G. G. M. (2021). Diagnostic accuracy of patient interview items and clinical tests for cervical radiculopathy. Physiotherapy, 111, 74–82. https://doi.org/10.1016/j.physio.2020.07.007
Yousif, M. S., Occhipinti, G., Bianchini, F., Feller, D., Schmid, A. B., & Mourad, F. (2025). Neurological examination for cervical radiculopathy: A scoping review. BMC Musculoskeletal Disorders, 26, 334. https://doi.org/10.1186/s12891-025-08560-9
