Cervical distraction test: how to relieve (and diagnose) radicular pain

Sometimes the best way to confirm where pain is coming from is to take pressure off the area and see what happens. That's exactly what the cervical distraction test does: instead of provoking pain (like other tests), it tries to temporarily relieve it through gentle neck traction, which points toward a cause related to compression of cervical structures.

It's especially useful when a client presents with neck pain radiating down the arm (cervicobrachial pain).

What does this test measure?

The cervical distraction test assesses whether gentle axial traction of the cervical spine reduces or eliminates pain (especially if it radiates down the arm), which suggests the pain is related to compression of a nerve root or cervical joint structures that's relieved by "separating" the vertebrae.

Equipment needed

• Nothing essential
• A treatment table where the client can lie down, although it can also be done seated

Test protocol

1. The client lies supine (or sits, depending on preference and comfort)
2. Place one hand under the client's chin and the other under their occiput
3. Apply gentle, progressive axial traction (as if gently "stretching" the neck upward), maintaining a neutral cervical spine position
4. Hold the traction for about 10-15 seconds
5. Ask whether the pain (especially if it radiated down the arm) decreases, disappears, or stays the same

Common mistakes

• Applying traction abruptly rather than progressively
• Not starting from a neutral cervical position (forced flexion or extension can alter the result)
• Not specifically asking about radiating pain, focusing only on the sensation of traction in the neck

How to interpret the results

Result	Interpretation
Positive (relief): pain (especially radiating pain) decreases or disappears with traction	Suggests the pain is related to compression of cervical structures (e.g., nerve root involvement) — traction temporarily "decompresses"
Negative: no change, or pain increases with traction	Less suggestive of a compression mechanism relieved by distraction; consider other causes

A positive cervical distraction test (pain relief) is a favorable clinical finding: it points toward a mechanism where decompression/mobilization techniques may be helpful, and is interpreted alongside the rest of the cervical exam.

How it relates to other tests

The cervical distraction test pairs especially well with:

• Cervical compression (Spurling) test — its "opposite": tries to reproduce the pain through compression, while distraction tries to relieve it
• Adson's test — if there's doubt about whether the component is more cervical-radicular or related to thoracic outlet syndrome

Track progress with Movalytics

If cervical distraction relieves a client's pain, that's useful information for justifying certain mobility approaches or, where appropriate, referral to physiotherapy for decompression techniques. In Movalytics you can note whether the test was positive (with relief) or negative at each assessment, and relate it to the progression of neck pain and response to treatment.

Frequently asked questions

Can the cervical distraction test cause harm? Applied with gentle, progressive traction, it's a safe test, although it should be avoided in people with suspected significant cervical instability or undiagnosed bone pathology. If it relieves the pain, does that mean it's already "fixed"? No, it's an assessment finding that guides clinical reasoning, but it doesn't replace treatment or a more complete evaluation. Can it be combined with the cervical compression test in the same session? Yes, in fact it's common to do both in the same assessment to compare how the pain responds to both stimuli (compression vs. distraction).