Upper limb tension test (ULTT/ULNT A)
For: Cervical radiculopathy
Irritation or compression of a nerve root in the neck, usually by a disc bulge or bony narrowing. Causes arm pain, and sometimes pins and needles, numbness or weakness along that nerve.
A weak test on its ownCaution: Pooled at very low certainty (Thoomes 2026); the original study (Wainner 2003) reported LR− 0.12 and the 2026 validation (Grondin) LR− 0.54.
What the numbers mean
- Positive result: a small shift: a positive result nudges the diagnosis up, but does not settle it.
- Negative result: a small shift: a negative result nudges the diagnosis down, but does not exclude it.
Source
Thoomes EJ, Arvanitidis M, van Geest S, et al. Diagnostic accuracy of physical examination tests for painful cervical radiculopathy: update of a systematic review and meta-analysis. BMC Musculoskelet Disord. 2026;27:338. Journal article (DOI) · systematic review
Also cited: Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003;28(1):52–62. PubMed
Also cited: Grondin F, Cook C, Hall T, Maillard O, Perdrix Y, Freppel S. An independent validation of a clinical prediction rule for the diagnosis of cervical radiculopathy with radicular pain. Braz J Phys Ther. 2026;30(3):101581. Journal article (DOI)
Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 2 October 2026.
Get the book for the neck questions that matter: nerve root or referred pain, which myelopathy signs count, and when a neck after trauma needs imaging
This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.
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One study, one test, once a month
Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.