A study of upper limb pain and paraesthesiae following neck injury in motor vehicle accidents: assessment of the brachial plexus tension test of Elvey.

Abstract

The brachial plexus tension test (BPTT) appears to offer a means of examining the extensibility and mechanosensitivity of the neural tissues related to an upper limb. This test was used to evaluate possible cervical or brachial plexus neural involvement causing arm pain syndromes in 37 patients presenting for assessment following neck injury in motor vehicle accidents. The BPTT was considered positive in 55 of the 61 symptomatic arms. There were no false-positive responses in the 13 asymptomatic arms although a slight loss of extensibility was evident in five arms. Twenty patients without clinical evidence of current or previous neck pathology were similarly examined. There were no reports of pain on BPTT in this group. In 36 of the 40 arms a full range of extensibility was present. In the other four arms the loss of extensibility was slight. This study suggests that arm pain and paraesthesiae which follow neck injury in motor vehicle accidents arise from irritable cervical neural tissues. The study also highlights the persistent nature and widespread distribution of the pain in these patients.