Cervical Spine

Spurling's Maneuver

• Active/Passive

• Tests for cervical disk herniation, cervical nerve root compression

• Technique

  • Patient seated rotates, extends, and laterally flexes the cervical spine.  

  • Examiner in front of or behind patient places hand on top of the patient's head and applies an axial load (Some hold the load for up to a minute, while others provide the axial load in short bursts. I personally apply and hold the compression for 10-30 seconds.)

  • The maneuver should be performed with the C-spine rotated to both sides

  • A positive result occurs when the maneuver elicits symptoms/pain down the arm

  • A negative result is when there is no pain or symptom recreation with the maneuver

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

Lumbar Spine

Straight leg raise/Bragard Test​

• Passive

• Tests for lumbar herniated disk

• Technique

  • Patient supine

  • Examiner to affected side of patient and lifts each leg, individually, from the ankle to angle of 30-70°, then the ankle is dorsiflexed and the big toe extended

  • A positive result occurs when the maneuver elicits symptoms/pain in the leg and/or back, and worsens with ankle dorsiflexion and big toe extension

  • A negative result is when there is no pain with the maneuver

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

Flip Test

• Passive

• Tests for lumbar herniated disk, sciatica

• Technique

  • Patient seated with legs dangling

  • Examiner in front of patient

  • Examiner straightens each leg, individually, from the heel

  • A positive result occurs when the maneuver elicits symptoms/pain in the leg to the back, causing the patient to lean backward

  • A negative result is when the patient does not experience symptoms that cause him/her to lean backward

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​