What is the purpose of the distraction test in cervical evaluation?

• A. To assess vascular status
• B. To elicit myelopathy signs
• C. To evaluate muscle strength
• D. To reduce nerve root compression and determine if pain improves, suggesting radiculopathy

Answer: (D)

Distraction in cervical evaluation uses gentle axial traction to decompress the neural pathways. By lifting the head and neck, the intervertebral foramina and surrounding structures open slightly, reducing pressure on exiting nerve roots.

If arm or radicular pain improves with this traction, it suggests that nerve-root compression is contributing to the symptoms—consistent with radiculopathy due to foraminal stenosis, disc herniation, or facet impingement. This relief helps distinguish radicular pain from non-radicular neck pain. It’s not aimed at assessing vascular status, eliciting myelopathy signs, or testing muscle strength; those require different maneuvers. A positive relief response doesn’t rule out other issues, but it strongly supports a compressive nerve-root mechanism as the pain source.