What does the distraction test assess, and what does relief of radicular pain imply?

• A. Distraction worsens symptoms.
• B. Longitudinal traction applied to the head to decompress neural elements; relief of radicular pain implies foraminal compression that is dynamic or blocked by loading.
• C. Distraction test is not used in cervical radiculopathy.
• D. Occurs only in acute trauma.

Answer: (B)

The distraction test is used to determine if cervical radicular symptoms come from nerve root compression in the foraminal space. By applying gentle longitudinal traction to the head, you widen the neural foramen and decompress the nerve roots. If the radicular pain is relieved with this maneuver, it supports a compressive origin of the symptoms—typically foraminal stenosis or a disc herniation affecting a cervical nerve root—and suggests the pain is neurogenic rather than purely axial neck pain. If there’s no improvement (or if pain worsens), it points away from a foraminal nerve root compression and toward other causes such as facet joint pain or soft-tissue strain.