radicular signs and symptoms

[Dr Damien]

Dear Jim

There are many tests out there, most of them are neurodynamic tests especially when radicular symptoms are being reported in the subjective history, they probably will come with different names but generally suggesting the same thing. I cannot say I am familiar with this distraction test (unless it has another name). The upperlimb tension tests 1, 2 and 3 tests the stretch reaction of the median, ulnar and radial nerves (this order i have put them may not follow with the numbers). A distraction will likely pull on the brachial plexus if a traction injury is suspected. Maybe this is what this test you mention tests for...

Having said that...physio 101, sustained traction to the cervical spine should relieve radicular signs of cervical origin( maybe this is what you mean)

I do not think it is so much the name of the test that matters as it is what you are doing specifically. Again these tests generally are used in combination with variety of physical examination procedures to arrive at a very close diagnosis. The reason being generally any stretch put on a nerve will likely cause a reaction even if the nerve is not known to be experiencing a pathological state,so it is easy to get a false positive if one relies on these tests alone. If I were assessing the cervical spine my assessment may look something like below...

Take a subjective history ( age, occupation, onset, diurnal pattern, FSH, systemic signs i.e mutliple joint problems- specifically asking about Rheumatoid Arthritis, drug history, gross neuro signs, investigations done etc)
Assess general posture cervical spine, shouldes, thorax, scapulae, pelvis, lowerlimbs etc
Assess verterbrobasilar insufficency
check active and passive range of motion (looking for a capsular or non capsular pattern)
check povocative maneouvres if the patient can tolerate it (to assess facet joints)
Do a resistance test to exclude muscular problems
Apply traction (as above)
check sensation
Assess upperlimb for sensation, check passive range of motion, muscle weakness(active range and resistance)
apply upperlimb tension tests if the patient can tolerate it
assess scapular movements and thorax

This is just in brief what my assessment may look like, it may be shorter in real life or longer depending on what im seeing

I hope this has been of help

[jim2010]

thank you. that was very helpful. i think i start to understand it a bit more now.

thanks