Test: Extension Compression

Video Link

Background/Purpose

Palpation and ROM assessment indicates pain in multiple directions. Extension compression is used in conjunction with additional compression tests to differentiate between joint capsule damage or muscle tendon damage. As with other compression tests the goal is to create foraminal encroachment leading to nerve root pressure or apophyseal capsulitis. This text presses the disc anterior and if the test causes referred pain to the head, face, neck, arms, shoulders and chest, and even in the low back outside of a radicular pattern then disc disease may be indicated.

Procedure

Similar to maximal foraminal compression test, except that the head is not rotated. The patient is seated and the doctor stands behind the patient. The patient actively extends their head about 30 degrees. Doctor places both hands on the patient’s forehead and axially compresses along the plane of cervical articular pillars. When done correctly the posterior disc is compressed. A positive test is when local or radicular pain is created with the compression. Please note that tears are most frequent postero-lateral because of the absence of the anterior/posterior longitudinal ligament, where the annulus fibrosis is thin.(41) Because of this the maximal foraminal compression test is usually more provocative for discogenic pain. If disc disease is suspect MRI or CT scan may be ordered to confirm.
Performed: Unilaterally

Dialog

Compression on forehead with neck in extension

Criteria

• No pain or discomfort

Measurement

0.00

LOINC Code

0

Scale/Grading

Pass/Fail