Assesses for cervical radiculopathy through long-axis traction of the cervical spine.

  • Pettman’s Distraction Test
  • Traction Test

  • Cervicalgia and upper extremity pain/neurologic symptoms (numbness, paresthesia, etc.)

Patient Position
  • Seated
Examiner Position
  • Standing behind the patient
Steps of Performance
  1. Place both hands on either side of the patient’s head, with the base of the palms on the mastoid process and the thumbs below the occiput
  2. Apply a slow upward axial force (longitudinal traction), unloading the weight of the patient’s head from their cervical spine, with up to 30 pounds of lifting pressure
  3. Optional: Hold distraction for 30-60 seconds
Alternative Methods

Method 1

  • Place one hand on the patient’s forehead and the other on the occiput while applying longitudinal traction

Method 2

  1. Patient Position: Supine
  2. Examiner Position: Facing the apex of the patient’s head
  3. Steps:
    • Place both hands on either side of the patient’s head
    • Position fingers on and below the occiput with thumbs on the mastoid process
    • Patient is instructed to relax
    • Examiner distracts the cervical spine by tractioning the patient’s head superiorly

The cervical distraction test releases pressure on the intervertebral foramen, leading to decreased pressure on nerve roots and cervical facets. This concurrently puts tensile stress on extensor muscles and ligaments of the neck and may slightly elongate the spinal cord.

General

Positives

Decreased Peripheral Paresthesia’s or Pain

  • Cervical radiculopathy

Pertinent Negatives

Decreased Local Pain

  • Possible facet irritation

Increased Local Pain

  • Possible sprain, strain, or joint dysfunction

DATA
TAGS
References
Vizniak NA, Buse M. Evidence-Informed Orthopedic Assessment. Professional Health Systems Inc.; 2019.
Wainner RS, Fritz JM, Irrgang JJ, et al. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine.  2003;28(1):52–62.
Viikari-Juntura E, Porras M, Laasonen EM. Validity of clinical tests in the diagnosis of root compression in cervical disc disease. Spine.  1989;14(3):253–257.
Rubinstein SM, Pool JJ, van Tulder MW, Riphagen II, de Vet HC. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine. 2007;16(3):307-319.
Lady S. Cervical Orthopedic Tests. 2005;31.

Assesses for cervical radiculopathy through long-axis traction of the cervical spine.

  • Cervicalgia and upper extremity pain/neurologic symptoms (numbness, paresthesia, etc.)

Patient Position
  • Seated
Examiner Position
  • Standing behind the patient
Steps of Performance
  1. Place both hands on either side of the patient’s head, with the base of the palms on the mastoid process and the thumbs below the occiput
  2. Apply a slow upward axial force (longitudinal traction), unloading the weight of the patient’s head from their cervical spine, with up to 30 pounds of lifting pressure
  3. Optional: Hold distraction for 30-60 seconds
Alternative Methods

Method 1

  • Place one hand on the patient’s forehead and the other on the occiput while applying longitudinal traction

Method 2

  1. Patient Position: Supine
  2. Examiner Position: Facing the apex of the patient’s head
  3. Steps:
    • Place both hands on either side of the patient’s head
    • Position fingers on and below the occiput with thumbs on the mastoid process
    • Patient is instructed to relax
    • Examiner distracts the cervical spine by tractioning the patient’s head superiorly

The cervical distraction test releases pressure on the intervertebral foramen, leading to decreased pressure on nerve roots and cervical facets. This concurrently puts tensile stress on extensor muscles and ligaments of the neck and may slightly elongate the spinal cord.

General

Positives

Decreased Peripheral Paresthesia’s or Pain

  • Cervical radiculopathy

Pertinent Negatives

Decreased Local Pain

  • Possible facet irritation

Increased Local Pain

  • Possible sprain, strain, or joint dysfunction