The Spurling maneuver tests which condition?

• A. Cervical radiculopathy
• B. Thoracic outlet syndrome
• C. Carpal tunnel
• D. Lateral epicondylitis

Answer: (A)

The Spurling maneuver is used to identify cervical radiculopathy from nerve root compression in the neck. It’s performed by extension of the neck, then lateral flexion toward the side of suspected nerve involvement, with downward axial pressure applied to the top of the head. If this reproduces the patient’s arm pain in a dermatomal distribution, it strongly suggests compression of a cervical nerve root, such as from a herniated disc or foraminal stenosis. This is why it’s the best choice for testing cervical radiculopathy. It isn’t used to diagnose thoracic outlet syndrome (which involves the brachial plexus or vessels with tests like Roos or Adson), carpal tunnel syndrome (median nerve compression at the wrist), or lateral epicondylitis (tennis elbow, a tendinopathy at the elbow). A positive Spurling test guides toward cervical nerve root pathology and would typically lead to imaging, like an MRI, to confirm the level and cause.