In this video, we will show you the best way to perform the Spurling's test. Hi and welcome back to Physiotutors. The Spurling's test is a test with a low sensitivity of 50% and a good specificity of 83% to diagnose cervical radiculas syndrome according to Wainner et al. in the year 2003. Several authors have shown that this test has a rather low sensitivity, but a high specificity. For these reasons, we consider this test of moderate clinical value. However, there are several modifications of the Spurling's, which is why Anekstein et al. have compared six different modifications with each other in their diagnostic study in the year 2011. The Spurling's test is a test designed to provoke the patient's symptoms, which are usually neck pain with radiating pain or paresthesias down the arm. This is done by reducing the diameter of the intervertebral foramen, which causes symptoms in patients with cervical radicular syndrome. According to the study results, the Spurling's test is most provocative, with the highest VAS score and most distally elicited pain with your patient's neck in extension, lateral bending to the affected site, and axial compression. It is important to elicit distal pain distribution to be able to distinguish between patients with actual radiculopathy and cervical spondylosis. Other test versions were not able to distinguish between those groups, as pain was mostly experienced proximally in the neck. However, this maneuver with extension lateral bending and compression was the least tolerable, which is why you should gradually build up this test. So you should always start with just extension and lateral bending and only add axial compression if symptoms are not reproduced. Alright, we hope this video has convinced you to conduct the Spurling's test in this way in the future. And if you like this video, please click on the thumbs up icon, hit the subscribe button and follow us on Facebook, Instagram or our website physiotutors.com.. This was Kai for Physiotutors. I'll see you next time. Bye.