Shoulder Abduction Sign | Cervical Radiculopathy Assessment

The shoulder abduction sign or shoulder abduction relief test is a simple test to assess whether a patient’s peripheral arm symptoms stem from cervical root pathology. 

A systematic review of the literature conducted by Rubinstein et al in 2006 reports low to moderate sensitivity and moderate to high specificity for this test. Pooling was not possible due to heterogeneity of the included studies. The clinical utility of this test is at least questionable. 

To conduct the test the patient is in sitting position.
Provided the patient is experiencing symptoms, the examiner asks the patient to abduct the affected arm in a manner so that the hand rests on top of the head.

Relief of radicular symptoms indicate a positive test. The hypothesized mechanism is reduced tension of the affected nerve root.

Other common tests to assess for cervical radiculopathy are:

• The Cluster of Wainner
• Cervical Distraction Test
• The Upper Limb Tension Test 1 / ULNT 1 / ULNT A
• Neck Tornado Test
• Arm Squeeze Test
• Spurling’s Test

Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003 Jan 1;28(1):52-62.