radicular signs and symptoms

[jim2010]

hi,
sorry if this is an easy answer.
but i am looking into to a few tests into cervical spine which say that it is a test used for testing radicular symptoms/signs.
could anyone help me on what these are ??

thank you

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[Dr Damien]

Dear Jim

Take good history, neurodynamic tests (upperlimb tension tests 1, 2, 3), muscle strength etc...these tests are provocative and if they are not necessary and too painful for the client why do them when you can tell what the issue is anyway...Hope that was helpful

cheers

[jim2010]

thanks for your reply.
one of the tests was;
distraction test
-'the distraction test is used for patients who have complained of radicular symptoms in the history and show radicular signs in the examination'
this is what was described for the test but i was confused as to what this tests for exactly in relation to radicular signs and symptoms

thanks

[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

[yelufem]

Hi jim,radicular signs is a report of either impingment of the nerve trunk or a compression of its root.These are confirmed by delivering a longitudinal pressure on the cortex which transfer the effect to the cervical spine.A compression of the incriminating nerve root would trigger radicular signs.It is called provocative test.Distraction of the spine along same axis is expected to relieve the symptom.Vertical oscilatory pressure on the spine in question could trigger localised or referred pain along the radicular course.I hope u know a plain xray could be a very good diagnostic measure.This is just in addition to what Dr demien has said.yelufem