Clinical tests for cervical radiculopathy, compared
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.
The 4 tests in the library for cervical radiculopathy, side by side, each with the published accuracy figures that exist for it. Click a test for what each result means, any caution, and the source.
| Test | Sensitivity | Specificity | LR+ | LR− | Verdict |
|---|---|---|---|---|---|
| Cervical distraction test | 44% | 90% | 4.4 | 0.62 | A weak test on its own |
| Cervical rotation <60° (towards symptomatic side) | 89% | 49% | 1.75 | 0.22 | Treat with caution |
| Spurling's test | 53% | 92% | 3.28 | 0.51 | A weak test on its own |
| Upper limb tension test (ULTT/ULNT A) | 70% | 71% | 2.45 | 0.42 | A weak test on its own |
Reading the table
A high LR+ makes a positive result useful for ruling the condition in; a low LR− makes a negative result useful for ruling it out. A test can be good in one direction and weak in the other, and the figures come from different studies and patient groups, so compare them with care.
These four tests make up the Wainner cluster; no single test reliably rules radiculopathy in or out, and the book reads them as a set.
Tests for the same problem are rarely independent, so a second positive adds much less than its own figure suggests. Do not multiply their figures together. Where a combination has been tested as a cluster or a decision rule, Rule It In, Rule It Out gives that published result.
To turn a figure into a probability for your patient, use the probability calculator.
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 each test, what counts as positive, how to read the result, and, where studied, whether combining tests helps.
Coming in late 2026 as a PDF and a paperback. Join the list to hear when it's out
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.
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