Doctors use Spurling tests to assess possible causes of neck pain. A positive result can indicate a pinched nerve.

A Spurling test can help a doctor make a quick assessment about the cause of neck pain. They may also use medical imaging to confirm a diagnosis.

About 1 in 10 adults in the United States report having neck pain at any given time. The Spurling test has been in use since the 1940s to assess neck pain.

This article explains what happens during a Spurling test and what the results might mean.

A female doctor performing the Spurling test on a male patient.Share on Pinterest
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A Spurling test works by provoking symptoms to allow a diagnosis.

There are several variations of the test, but doctors will typically perform it by:

  • extending the person’s neck
  • rotating their head
  • placing gentle pressure on their head and neck

These actions compress the openings of nerves that pass through the spinal cord. If they produce symptoms similar to those that the person has been experiencing, the test indicates a possible compressed nerve.

Doctors use the Spurling test to examine people who report neck pain, numbness, or weakness. These sensations may also run down the arms.

They use this test in combination with other tests to make a diagnosis. The results of the Spurling test will guide doctors in deciding which other tests are necessary.

For example, imaging tests such as MRI or CT scans can help identify structural bone, nerve, or muscle problems.

MRI and CT scans can be important tests for diagnosing certain types of neck pain. However, as these procedures are expensive, doctors will generally start with physical exams, including the Spurling test, to determine whether imaging tests would be helpful.

Doctors routinely use the Spurling test to check for cervical radiculopathy, which is the medical term for a compressed or pinched nerve in the neck. Cervical radiculopathy is common among people in their 30s and 40s.

A Spurling test yields a positive result if the maneuver causes:

  • pain to radiate from the neck, shoulder, or arm in the direction that the head is pointing
  • weakness in the neck muscles
  • tingling, numbness, or the sensation of pins and needles in the neck, shoulders, or arms
  • altered tendon reflexes

A positive result can indicate nerve problems, such as a pinched nerve. However, doctors will also consider the results of other diagnostic tests before confirming a diagnosis and suggesting treatment.

Some people will not react to the Spurling test or will have a response that does not indicate a nerve problem.

For example, they could have pain that only affects the neck. They may also experience muscle spasms or neck stiffness — neither of which is indicative of a pinched nerve.

However, a normal result does not necessarily rule out the possibility of a pinched nerve. Further tests will follow to confirm a diagnosis.

A Spurling test can be helpful for quickly assessing possible causes of neck pain.

The test generally shows high specificity but low sensitivity. Test specificity refers to how accurately a test excludes the condition, whereas test sensitivity refers to how well a test identifies the condition.

For example, a 2002 study found that the Spurling test had a sensitivity score of 30% but a specificity of 93%.

Due to this, the test may not be useful as a screening test for a pinched nerve. However, when doctors use it alongside other diagnostic tests, such as an MRI or nerve conduction studies, it can help confirm a diagnosis.

After a Spurling test, doctors may recommend further testing to make a diagnosis. If the tests confirm a pinched nerve, treatment options might include:

  • the short-term use of a soft cervical collar, which limits neck motion and supports inflamed neck muscles
  • physical therapy to strengthen the neck muscles and increase their range of motion
  • over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen
  • gentle traction with the help of a physical therapist or light weights
  • prescription steroid medications to reduce swelling and inflammation in the area
  • a cervical pillow to support a healthy curvature of the neck
  • surgical treatment for severe cases

Approximately 88% of people with pinched nerve pain recover within 4 weeks of starting nonsurgical treatment.

The Spurling test is a quick way to check whether neck pain is due to a pinched nerve. However, as the test has low sensitivity, it may miss some cases of pinched nerves.

Doctors typically use a Spurling test along with other tests to make a diagnosis. Combining the results of several tests helps overcome the limitations of a Spurling test.

The result of the Spurling test is positive if it causes a person to experience symptoms that indicate nerve problems. After confirming the diagnosis, a doctor can prescribe a range of treatments for the pinched nerve.