Spurling’s Test assesses whether cervical extension, rotation, lateral flexion and compression reproduce familiar arm symptoms. A positive result may support cervical radiculopathy reasoning when paired with neurological findings and history, but it does not diagnose cervical radiculopathy on its own. A 2021 diagnostic accuracy study found that Spurling’s Test, reduced reflexes and selected history items can assist diagnosis, while warning that there is no perfect gold standard and values should not be overinterpreted.
A client reports neck pain with symptoms travelling into the arm or hand. Symptoms may worsen with certain neck positions and reduce with unloading or placing the hand on the head. Spurling’s Test may help assess whether cervical loading reproduces familiar arm symptoms.
The test should be performed carefully and stopped if symptoms escalate. It is not simply a neck pain provocation test. Reproduction of familiar arm symptoms is more meaningful than local neck discomfort alone.
Test name: Spurling’s Test
Also known as: Foraminal Compression Test
Body region: Cervical spine and upper limb
Purpose: Assess cervical radicular symptom response to cervical loading
Positive finding: Reproduction of familiar arm pain, paraesthesia or radicular-type symptoms
Negative finding: No familiar arm symptom reproduction
Best used with: Cervical distraction, Bakody Sign, upper limb neurodynamic testing, neurological screen and cervical ROM
Key limitation: It does not diagnose cervical radiculopathy on its own
Spurling’s Test is a cervical provocation test. The client’s neck is moved into extension, rotation and/or lateral flexion toward the symptomatic side, and gentle axial compression may be applied depending on the variation.
The aim is to reproduce familiar upper-limb symptoms, not simply to create local neck pain.
The test is used when cervical radicular symptoms are part of the assessment.
It may help determine whether neck loading reproduces familiar arm symptoms and whether further cervical, neurological or neurodynamic assessment is needed.
Spurling’s Test assesses symptom response to cervical foraminal loading. It does not directly identify the exact nerve root, confirm compression or diagnose disc pathology.
This test may be useful for clients with neck-related arm pain, paraesthesia, numbness, radiating symptoms, grip symptoms or symptoms that appear influenced by neck position.
Use when the client has arm symptoms that may be cervical in origin and cervical loading can be performed safely.
Use caution with severe neck pain, acute trauma, suspected fracture, instability, cervical myelopathy signs, progressive neurological deficit, dizziness, vascular symptoms, inflammatory disease or symptoms that worsen rapidly.
Do not use strong compression.
Chair or treatment table
Pain and symptom scale
Measurz recording workflow
Optional neurological screen notes
Position the client sitting upright.
The client sits relaxed with the head in neutral before the test begins.
Stand behind or beside the client.
Hands may guide the head and apply gentle axial compression if appropriate.
Maintain control and avoid sudden movement.
Move the neck into extension, rotation and/or lateral flexion toward the symptomatic side. Apply gentle axial compression only if clinically appropriate.
Ask the client to report arm pain, tingling, numbness, familiar symptoms, neck pain, dizziness or symptom spread.
A positive finding is reproduction of familiar arm symptoms, such as radiating pain, paraesthesia or numbness.
A negative finding is no familiar arm symptom reproduction.
Stop if symptoms increase sharply, neurological symptoms worsen, dizziness occurs, vascular symptoms appear or the client cannot tolerate the position.
Local neck pain alone should be recorded but should not be overinterpreted as a radicular positive result.
A positive Spurling’s Test may support cervical radicular symptom reasoning when it reproduces familiar arm symptoms and aligns with history and neurological findings.
A negative test does not exclude cervical radiculopathy or cervical contribution, especially when symptoms are intermittent or not reproduced during testing.
Interpretation is stronger when paired with cervical distraction, Bakody Sign, upper limb neurodynamic testing, neurological screen, cervical ROM and symptom distribution.
A 2021 prospective diagnostic accuracy study reported that Spurling’s Test and reduced reflexes were useful to assist in diagnosing cervical radiculopathy, but the authors cautioned that diagnostic values should not be overinterpreted because there is no perfect gold standard for cervical radiculopathy.
No single sensitivity, specificity or likelihood ratio value is listed here because the test result should be interpreted with history, neurological findings and other clinical tests.
A 2025 scoping review reported heterogeneity in neurological examination procedures and diagnostic accuracy for cervical radiculopathy, reinforcing the need to combine Spurling’s Test with neurological findings and clear symptom documentation.
Reliability depends on consistent neck position, compression force, symptom criteria and examiner technique.
Common errors include applying too much compression, treating local neck pain as a positive radicular result, not recording symptom distribution, ignoring dizziness or neurological worsening, and diagnosing cervical radiculopathy from one test.
Limitations include symptom fluctuation, variable technique, safety considerations, overlap with shoulder and peripheral nerve symptoms, and imperfect diagnostic reference standards.
Use Spurling’s Test to document whether cervical loading reproduces familiar arm symptoms. It is most useful when combined with neurological screen, cervical distraction, Bakody Sign and upper limb neurodynamic testing.
Record test name, side tested, result, pain score, symptom location, symptom quality, neck position, compression used or not used, arm symptoms, neurological symptoms, dizziness or vascular symptoms, comparison side, confidence in result, irritability and reason for stopping.
Add related cervical ROM, neurological screen, reflexes, myotomes, dermatomes, grip strength, cervical distraction, Bakody Sign and upper limb neurodynamic findings.
Cervical Distraction Test
Bakody Sign
Upper Limb Tension Test
Cervical ROM Tests
Adson’s Test
Roos Stress Test
Grip Strength Test
Neurological Screen
It assesses whether cervical loading reproduces familiar arm symptoms.
A positive finding is reproduction of familiar radiating arm pain, paraesthesia or numbness.
Local neck pain should be recorded, but it is not the same as familiar radicular arm symptoms.
No. It may support clinical reasoning but does not diagnose cervical radiculopathy on its own.
Record side, symptoms, neck position, compression used, pain score, neurological symptoms and stopping reason.
Spurling’s Test is a cervical radicular symptom provocation test.
Familiar arm symptoms are more meaningful than local neck pain alone.
Use gentle force and stop if symptoms escalate.
Interpret the test with neurological findings and related tests.
Measurz should capture symptom distribution, neck position and safety notes.
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.
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.
