Cervical compression test

The cervical compression test is used many times daily in every chiropractic clinic. Below is a magnificent video clip from Swan Lake showing how it is done in the arts; be sure not to miss it.

How is the procedure done? With the patient seated, the examiner gently applies axial, downward pressure on her head. First, do no harm, was Hippocrates' admonition; done too enthusiastically any orthopaedic test can worsen the condition.

The patient's head is grasped with both hands and gentle axial compression is applied.

  1. In the neutral position
  2. Rotated, first left and then right
  3. Laterally flexed, left and right
  4. Slightly extended.
  5. Rotation, extension + lateral flexion to the same side (Kemp's test)

Truly astonishing display of the Compression Test aka SWAN LAKE. Watch to the end.


  • Increased Peripheral pain > Increased pressure on nerve roots (IVF encroachment, radiculopathy).
  • Increased local pain > Joint damage, facet lock, meniscoid entrapment.
  • Increased tingling or pain in the arm with the compression + Kemp's test is pathognomic of a nerve root impingement syndrome.

Whiplash and the joints of Luschka as well as facet syndromes and disc injuries should be considered. Why you should always consult a chiropractor after a motor vehicle or diving accident.

Clinical Notes 

With radicular symptoms, further evaluation is warranted; a detailed neurological examination and diagnostic imaging.

From the coal face

Kid on shoulders causing arm pain.

"Doc, I have terrible pain in my arm?"

"When did it start, Mr Vermeulen."

"After we went to the Pink Pop concert."

"Did anything unusual happen?"

"I can't think of anything. It was quite a long and tiring day. The kids found it boring."

"How old are they? You didn't carry one of them on your shoulders by any chance?"

How bad is my arm pain?

The ache in the upper extremity is often severe, disturbing sleep. Unlike the leg, you often can't find a comfortable position. Patients may think they must be hypochondriacs. Almost certainly, they are not but the arm pain quickdash test gives you a pretty objective measure of how severe your condition is.

One possible mechanism explaining the radiating arm after carrying a child on your neck shoulders is the thoracic outlet syndrome.

An aching, painful arm is a frequent complaint heard at the chiropractic coalface. Sometimes it is caused by a compromise of the subclavian artery and brachial plexus as they emerge from the thorax.

Passing through the interscalene triangle, a muscle spasm or fixated first rib or fibrosis from an old fracture of the first rib or clavicle the vascular and neurologicasl structures may be compromised; a cervical rib too may be the spoke in the wheel, remembering that a large part of it may be cartilage and unseen on an xray. 


Neck and arm pain

To reiterate, with any of the tingling, nerve-type pain syndromes of the arm, like Carpal Tunnel Syndrome for example, a thorough work of the cervical spine and first rib is mandatory. Neck and arm pain is so common at the Chiropractic Coalface, and the root of many tennis arm, rotator cuff and frozen shoulder type syndromes is very frequently in the cervical spine.


Like all chronic medical conditions, no one is able to cure chronic neck pain. Research shows once you have had neck pain for six months, you will almost certainly have it for the rest of your life. And if you have had it for four months, what then? Do something now, or it is for ever.

Neck pain for more than six months? Chiropractors agree that chronic neck pain is best managed with an occasional, but regular, treatment.

Nevertheless chiropractic maintenance care remains controversial.

Cervical compression test

Cervical compression test is a lighthearted look at a very basic procedure. This is great fun.

Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

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Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.