Abduction Extension Cervical Nerve Root Stress Test

The Abduction Extension Cervical Nerve Root Stress Test (AECNRST) is performed if the patient complains of radicular symptoms in the history taking process.



Execution: The patient stands and rotates the head away from the symptomatic side. The symptomatic arm is abducted to 80 degrees with the elbow slightly flexed. This can either be perform actively by the patient, or passively by the examiner. The examiner then applies a moderate dorsal pressure on the humeral head and extends the arm to 30 degrees, thereby creating a fulcrum over which the brachial plexus  is displaced to create stress on the cervical nerve roots. This position is held for a few seconds.

Outcome: Reproduction of symptoms, new, or exacerbation of pain, or paresthesia along a dermatome.

Note: Make sure that shoulder abduction does not exceed 90 degrees.

Sensitivity: 79%
Specificity: 98%

(Farshad et al. 2013)

See THESIS, section “Abduction Extension Cervical Nerve Roots Stress Test” for further discussion.