🚩 Safety: Vertebral Artery / VBI Screen First
- Nausea
- Dizziness / vertigo
- Nystagmus
- Dysarthria
- Dysphagia
- Drop attacks
- Diplopia
- Apprehension
Reference: OSTEOPATHY Cervical & Thoracic Spine Assessment; OSTEOPATHY Manipulation Notes.
Cervical Tests
| Test | Assesses | Position | Positive Finding | Modification |
|---|---|---|---|---|
| Compression | Foraminal stenosis / NRC | Seated | Arm radicular symptoms | Geriatric: very gentle force. |
| Distraction | Nerve root compression relief | Seated/supine | Symptom relief | Pregnancy: seated preferred. |
| Spurling / Quadrant | Cervical radiculopathy | Seated | Ipsilateral radicular pain | Use minimal force in elderly/paeds. |
| Valsalva | Space-occupying lesion / disc | Seated | Radicular symptoms | Avoid if hypertensive or late pregnancy. |
| Swallowing | Anterior cervical pathology | Seated | Pain/dysphagia | No major modification. |
| Adson's | TOS / subclavian artery | Seated | Pulse diminishes / symptoms | Monitor carefully in pregnancy and elderly. |
| Vertebral Artery Test | VBI safety | Supine/seated | VBI signs | Use seated alternative if supine unsafe. |
| Brachial Plexus Stretch | Plexus tension | Seated | Radiating arm pain | Gentle only in paeds. |
| Tuning Fork | Fracture / bony pathology | Seated/supine | Local bony pain | Refer if suspected fracture. |
🧒 Paediatric Warning
Down syndrome or juvenile rheumatoid arthritis may involve atlanto-axial instability. Avoid cervical HVT and aggressive end-range tests.