Execution
- 1Have the patient sit or lie supine with the cervical spine supported.
- 2Place one hand under the chin and the other around the occiput.
- 3Slowly lift or distracts the head to apply gentle cervical traction.
- 4Monitor the patient's arm and neck symptoms during the traction.
- 5Release traction gradually and note whether symptoms return.
Positive outcome
Reduction or relief of the patient's radicular arm symptoms during cervical distraction is considered positive. Increased pain may suggest non-radicular sources such as muscle spasm, ligament strain, dural irritability, or disc-related pain.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Wainner et al. (2003) | 0.88 | 44 | 90 | 4.40 | 0.62 |
| Viikari-Juntura et al. (1989) | NA | 43 | 100 | 43 | 0.57 |
CommentA positive distraction test is more helpful for ruling in nerve root involvement than ruling it out, especially when paired with Spurling and ULNT findings. Because the test aims to relieve symptoms, it is often preferred when symptoms are irritable. Methodological note: Viikari-Juntura 1989 reported Sp = 100% in a small sample (n ≈ 43); LR+ is mathematically infinite and the cited value of 43 is a small-sample artefact rather than a stable point estimate. Read the rule-in strength as "promising" rather than as a precise multiplier.
High Clinical Value