Introduction
Cervical distraction is a test that developed to detect the existence of radicular ache in the symptomatic limb, which may be caused by cervical nerve root compression.
How to Perform Cervical Distraction Test
The patient lies on their back, with the neck comfortably aligned. The examiner secure grips the patient's one by placing each of his hands around their mastoid processes while standing at their head or placing one hand on their forehead & the other on the occiput.
Gently bend the patient's neck and pull the head towards your torso, using a distraction force. Positive results are the elimination or reduction of symptoms caused by traction.
Tissues being tested
Joint Capsules & Neural Foramen around the Facial Joints of the cervical spine. During this test, the neck extensor muscles are also secondarily observed.
Positive Test
If the pain is alleviated by the movement, the test is positive to nerve root compression or facet joint pressure. The grade of pressure will be determined by the amount of pressure and pain relief during the test.
Common Mistakes
Common mistakes made by the examiner include the incorrect position of the observer or improper position in the hands of the examiner. The most common errors made by patients include not restraining the neck and spine muscles and slumping (not sitting straight up). This can lead to an altered outcome.
Significance of Test
As the height of the disk decreases and the spurs of the bone get deposited, the space available for nerves to enter & exit the vertebral canal becomes smaller. Due to the reduced space, there may be more pressure on neural roots or other internal structures, which can cause weakness and pain. And to relieve pressure on nerve roots with distraction. The joint space is increased, thereby reducing the symptoms.
In addition, this test has been done in a group of special trials to identify more accurate of cervical radiculopathy using a clinical forecast rule.
The test item group contained:
- Positive distraction test
- Included cervical rotation shorter than 60 degrees
- Positive Upper Limb Tension Test (median)
- Positive Spurlings test
LR+ 30.3 if all four tests are positive.
Some Related Tests
- Spurling Test: It is better than the distraction test because it will be more precise to the same side or part of the affected cervical spine.
- Cervical Compression Test: This is the exact same test as the cervical distraction, except that it tests for the same tissues. However, instead of relieving pain, the movement reproduces the pain.