Cervical Distraction Test: Relieving Nerve Root Pain

The Cervical Distraction Test is a unique orthopedic maneuver. Unlike most tests that try to provoke pain, this test aims to alleviate symptoms to confirm a diagnosis of cervical radiculopathy.

1. Purpose

The primary purpose of the Cervical Distraction Test is to **identify Cervical Radiculopathy**. Unlike most tests which provoke pain, this is a "relief test". It works by mechanically widening the neural foramen and relieving pressure on the compressed nerve roots.

2. How to Perform

1. The patient is positioned in supine (lying on their back) or sitting. Supine is often preferred for better muscle relaxation.
2. The examiner places one hand under the patient's occiput (base of the skull) and the other under the chin (or both hands under the occiput/mastoid area for comfort).
3. The examiner gently applies an axial traction force (pulling the head upwards/away from the shoulders).
4. The position is held for a few seconds to observe the effect on the patient's current symptoms.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test is indicated by the reduction or complete elimination of the patient's existing radicular symptoms (pain or tingling in the arm/neck). This confirms that the symptoms are likely caused by compression that is relieved by traction.

Negative Sign (Test is NEGATIVE):
A negative test is when there is no change in symptoms or an increase in pain (which might suggest muscular strain or ligament injury rather than nerve root compression).