Shoulder Abduction Relief Test Explained

Shoulder Abduction Relief Test
Purpose:	assess nerve root pain

The shoulder abduction relief test, also called Bakody's test, is a medical maneuver used to evaluate for cervical radiculopathy.^[1] Specifically, this test is used to evaluate for nerve root compression at C5-C7. It is often used when a patient presents with neck pain that radiates down the ipsilateral upper extremity.^[2] The patient's shoulder is abducted by lifting the affected arm above their head either actively or passively. A decrease in radicular symptoms upon shoulder abduction would be considered a positive Bakody's sign and is indicative of nerve root compression.^[3] __TOC__

Mechanism

Reduced tension at the nerve root upon shoulder abduction has been identified as the probable mechanism that leads to relief of the pain.^[4] Studies on the effect of shoulder abduction on neuroforaminal pressures have provided some support for this claim.

Accuracy

A 2007 meta-analysis described the shoulder abduction relief test as having low to moderate sensitivity and moderate to high specificity.^[5] Another study in 1981 found that 15 of 22 patients with unremitting radicular pain reported relief with shoulder abduction.

Notes and References

1. Davidson . R. I. . Dunn . E. J. . Metzmaker . J. N. . 1981 . The shoulder abduction test in the diagnosis of radicular pain in cervical extradural compressive monoradiculopathies . Spine . 6 . 5 . 441–446 . 10.1097/00007632-198109000-00004 . 0362-2436 . 7302677. 23523267 .
2. Farmer . J. C. . Wisneski . R. J. . 1994-08-15 . Cervical spine nerve root compression. An analysis of neuroforaminal pressures with varying head and arm positions . Spine . 19 . 16 . 1850–1855 . 10.1097/00007632-199408150-00010 . 0362-2436 . 7973984. 21584580 .
3. Web site: Bakody sign Taber's Medical Dictionary . www.tabers.com . 29 August 2023 . en.
4. Fast . A. . Parikh . S. . Marin . E. L. . May 1989 . The shoulder abduction relief sign in cervical radiculopathy . Archives of Physical Medicine and Rehabilitation . 70 . 5 . 402–403 . 0003-9993 . 2719545.
5. Rubinstein . Sidney M. . Pool . Jan J. M. . van Tulder . Maurits W. . Riphagen . Ingrid I. . de Vet . Henrica C. W. . March 2007 . A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy . European Spine Journal. 16 . 3 . 307–319 . 10.1007/s00586-006-0225-6 . 0940-6719 . 2200707 . 17013656.