Shoulder Abduction Test for Cervical Radiculopathy

The Shoulder Abduction Test for Cervical Radiculopathy is an orthopedic examination used to assess any possible nerve root impingement in the neck and upper back regions. The patient is instructed to slowly raise their affected arm out at the side until it is level with the other arm. Pain or additional symptoms such as paraesthesia or weakness during the movement may indicate an impingement of the nerve root, which may indicate a diagnosis of cervical radiculopathy. The

Transcript

00:00:0400:00:07
This is Brent of the Brookbush Institute, and in this video I'm going to show you
00:00:0400:00:07
...blank
00:00:0700:00:11
the shoulder abduction test for cervical radiculopathy. I'm going to have my friend
00:00:1100:00:15
Yvette come out, she's going to help me demonstrate. This is a fairly simple test,
00:00:1500:00:19
but it's a test that I think has transference to things you might
00:00:1900:00:23
see in the individuals daily activity. So I want you to keep your eyes out for
00:00:2300:00:26
this one, here's how this works. Somebody comes in with cervical
00:00:2600:00:33
radiculopathy signs. So maybe on our subjective exam Yvette was complaining
00:00:3300:00:38
about some right-sided neck pain. Maybe she has some tingling tight stuff, maybe
00:00:3800:00:43
some cramping in one of her arm muscles, right like you know how like sometimes
00:00:4300:00:48
cervical radiculopathy patients get that unremitting fatigue feeling
00:00:4800:00:51
right, and she's getting some tingling in her fingertips. So we know some
00:00:5100:00:54
nerve involvement is happening and we know the neck is involved because that's
00:00:5400:00:59
where she's got this pretty harsh pain. The test itself goes like
00:00:5900:01:03
this, hey in this position any change in your symptoms? (No).
00:01:0300:01:09
So you still feel all the stuff? Okay that's that's unfortunate. Do me a
00:01:0900:01:17
favor, if you do this, how does that feel? (Better). That feels better, okay that's a positive
00:01:1700:01:21
test, that's it, that's it. This is the shoulder abduction test, not a
00:01:2100:01:26
complicated test, a specific test though. So if you get a positive, research shows
00:01:2600:01:29
that actually that's a pretty good indicator that we have cervical
00:01:2900:01:34
radiculopathy, not very sensitive so don't give much weight to the no, but
00:01:3400:01:37
let's do that one more time and think about this for a second.
00:01:3700:01:41
Can you move that one more time for me. So can you imagine
00:01:4100:01:47
if we do this, she just took a bunch of tension off her brachial plexus.
00:01:4700:01:53
She probably took some tension off a couple of the nerves in her arm
00:01:5300:02:00
just by kind of bending at the elbow, going into a little bit of of elevation
00:02:0000:02:05
at the scapula. The rest of this is all in a nice relaxed position, so if
00:02:0500:02:11
I take some tension off these nerves you can imagine how symptoms should go
00:02:1100:02:16
down. Now here's what I was talking about with keeping in mind with daily
00:02:1600:02:22
activity, how many people have you seen walk in to
00:02:2200:02:29
the clinic or maybe just even around a restaurant, or even at home and the first
00:02:2900:02:36
thing they want to do when they sit down is what? So if somebody comes
00:02:3600:02:43
in with neck pain and their first position they want to get into when they
00:02:4300:02:49
try to relax is this, I would think in the back of your head wow that
00:02:4900:02:53
could be a cervical radiculopathy sign. I'm not saying
00:02:5300:02:57
catastrophize this, that doesn't mean that everybody who rocks is like this
00:02:5700:03:01
has cervical problems, that is not what I'm saying at all, but if someone comes
00:03:0100:03:06
into your clinic with neck pain and you were not thinking cervical radiculopathy
00:03:0600:03:14
before, maybe seeing somebody do this as their relaxation position is a good
00:03:1400:03:20
indicator for you to do your cervical radiculopathy cluster. So
00:03:2000:03:24
that we do get a good indication of whether that is the diagnosis that we're
00:03:2400:03:29
working with, because that might change the way we treat just a little bit. All
00:03:2900:03:33
right so again just a quick review, super easy,
00:03:3300:03:37
you're going to assess the patient's symptoms in sitting and try to be
00:03:3700:03:40
consistent about the way you sit, like I would make Yvette sit with pretty decent
00:03:4000:03:44
posture here, I wouldn't let her slouch, and then I would ask her how her
00:03:4400:03:50
symptoms are in this position. If she's a fairly irritable cervical radiculopathy,
00:03:5000:03:55
she has some pretty good symptoms we're still pretty acute with this, chances are
00:03:5500:03:59
just sitting here is going to be a little rough. Alright and then all I am going to
00:03:5900:04:02
have you do, hey do me a favor Yvette can you just put your hand on top of your
00:04:0200:04:07
head, so I'm unweighting some of the nerves, unstretching stretching some of the
00:04:0700:04:12
nerves from brachial plexus on down; and if she goes hey does that help at all,
00:04:1200:04:18
and that helps her symptoms, and be careful with the question
00:04:1800:04:22
you ask, the symptoms you were talking about when you walked in. So
00:04:2200:04:26
this is the right-sided neck pain, is that better? Yeah it is, yeah and then the
00:04:2600:04:30
nerve stuff is a little bit? Yeah, right so that's that's a positive. If her
00:04:3000:04:33
symptoms go down that's a positive. If you have any
00:04:3300:04:38
questions about this test, this very easy test, please leave me a comment in the in