Cervical Compression Test

The Cervical Compression Test (sometimes called the Foraminal Compression or Neck Compression Test) is a clinical orthopedic assessment designed to help identify cervical nerve root compression (radiculopathy) or facet joint pain. The test is often considered an early or “screening” maneuver before the more provocative Spurling’s Test.

How the Test is Performed

• Client position: Seated with the spine upright and relaxed.

• The examiner places one hand on top of the client’s head and applies gentle downward/axial pressure (about 5–7 pounds of force).

• This may be performed with the head in neutral, or in extension, rotation, or side-bending positions depending on the specific variation of the test.

• The examiner asks if the client experiences pain, numbness, tingling, or “electric” sensations during the test.

• A positive test: Reproduction of the client’s typical neck and/or arm pain, especially if it radiates down the arm into a dermatome, indicates nerve root compression.

  • Pain only in the neck (no radiation) may be more indicative of facet joint compression or local cervical dysfunction.

Clinical Significance

• A positive Cervical Compression Test supports the diagnosis of cervical radiculopathy (nerve root impingement) or facet joint irritation.

• It may provoke symptoms from herniated discs, osteophytes, foraminal stenosis, or spondylosis.

• High specificity—arm symptoms are highly suggestive of nerve involvement, especially with reproducible radiating pain.

• This test should be interpreted along with client history and response to other maneuvers (e.g., Spurling’s, Distraction Test).

Assessment

• Use this test for clients presenting with neck pain, pain radiating to the arm, numbness, tingling, or weakness—especially if symptoms worsen with head compression or certain movements.

• Document which positions (neutral, extension, side-bending) provoke symptoms, and whether pain is local or radiates down the arm.

• Do not use the test with clients who have cervical instability, fracture, tumor, severe osteoporosis, or recent cervical surgery.

Treatment

• If positive:

  • Avoid deep tissue massage, heavy mobilization, or any compressive/manual traction techniques on the cervical spine.

  • Use gentle soft tissue therapy for the neck, shoulders, and upper thoracic region, with an emphasis on pain reduction and support.

  • Educate about head/neck postural mechanics, neural tissue care, and ergonomic modifications.

  • Refer for further assessment and possible imaging if neurological symptoms are progressive, severe, or unremitting.

  • Collaborate with physiotherapy or medical teams for multidisciplinary care if needed.

Safety and Referral

• Urgently refer clients with new or worsening motor weakness, progressive numbness, or loss of bladder/bowel function.

• Continue to monitor symptoms over time and document any change with intervention.