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The patient rotates their head to the affected side and extends their neck, while the examiners applies downward pressure to the top of the patient's head. A positive Spurling's sign is when the pain arising in the neck radiates in the direction of the corresponding dermatome ipsilaterally. [1] It is a type of cervical compression test.
However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar-sacral spine can be manifested with symptoms in the foot.
The lower joints in the neck and those of the upper back create a supportive structure for the head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain. Neck pain affects about 5% of the global population as of 2010. [7]
In many people, it is elicited by bending the head forward. [2] It can also be evoked when a practitioner pounds on the cervical spine while the neck is flexed; this is caused by involvement of the posterior columns. Lhermitte phenomenon is named after the French neurologist Jean Lhermitte. [3]
A common form of radiculitis is sciatica – radicular pain that radiates along the sciatic nerve from the lower spine to the lower back, gluteal muscles, back of the upper thigh, calf, and foot as often secondary to nerve root irritation from a spinal disc herniation or from osteophytes in the lumbar region of the spine.
People with degenerated joints in the upper spine will often feel pain radiating throughout the upper neck and shoulders (cervical facet syndrome.) That said, symptoms often manifest themselves in the lumbar spine, since they are highest here due to the overlying body weight, mobility and geometry.