Median Nerve Tension Test

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Purpose: To assess the contributions of neural tension to the patient’s symptoms, also can be associated with cervical radiculopathy.

Test Position: Supine.

Performing the Test: Stand at the side of the tested limb, facing towards the patient’s head. Use hand closer to patient to depress shoulder and punch into table to keep shoulder in depressed position. Use your second hand on patient’s hand to laterally rotate and abduct the shoulder (about 90 degrees or more). Extend the elbow while the forearm is supinated, wrist and fingers extended. Stop when patient reports neural symptoms. Have patient laterally flex or rotate their head away (worsens pain/symptoms) and toward the arm (relieves pain/symptoms) - a positive test.

Diagnostic Accuracy (for cervical radiculopathy): Sensitivity: .50; Specificity: .86; -LR: .58; +LR: 3.5 (“Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy”).

Importance of Test: As nerves travel through our body they can become adhered to the tissues they come in contact with. When stressed, these nerves reproduce neural symptoms such as pain, tingling, numbness, stretching sensation, etc. This test works by putting the median nerve on tension in the upper limb, because it passes through the thoracic outlet, anterior to the elbow, and on the volar aspect of the wrist (carpal tunnel) and hand, which is why finger, wrist, and elbow extension aid in tensioning the nerve. The addition of cervical motion to alter the symptoms can help determine if the cervical region is involved. This test, when combined with others, can be useful in identifying patients experiencing symptoms due to cervical radiculopathy (check out the cervical home page!).

Note: tests should only be performed by a properly trained health care practitioner.