Validity of five common manual neck pain provoking tests

The purpose of the present study was to assess five manual tests for pain provocation of the neck to determine their suitability for epidemiological investigations. To 75 randomly selected men, five manual pain-provoking tests were applied in a single-blind design. Prevalence of reported neck dysfunction, sensitivity, specificity, and positive and negative predicted value for each test were calculated. 22 of the 75 reported present neck pain, while the remainder reported freedom from neck pain for at least one year. Palpation over the facet joints in the cervical spine was found to be the most appropriate screening test to corroborate the replies in self-reported questionnaires on dysfunctions of the neck. The outcome of this test was quite consistent with the reported neck pain. The test of the formina intervertebralia and the upper limb tension test caused pain in almost all subjects with reported neck dysfunctions, though not causing referred pain in the arm as an indication of neurogenous tissue origin, as it was aimed to. Neither the neck rotation test nor the active flexion/extension test was sufficiently provocative to confirm the reported neck pain in these subjects, as both were insufficiently sensitive.