Diagnostic accuracy of upper limb neurodynamic tests for the assessment of peripheral neuropathic pain: a systematic review

Abstract

Purpose: Entrapment neuropathies (EN) such as carpal tunnel syndrome (CTS) and cervical radiculopathy contribute to the socioeconomic burden of occupational related musculoskeletal complaints and the associated costs. EN are also associated with severe pain, depression and functional limitations. Clinically upper limb neurodynamic tests (ULNTs) are used by musculoskeletal physiotherapists to assess the integrity of the peripheral nervous system and for neuropathic pain. Establishing diagnostic utility of ULNTs for the presence of neuropathic pain is required to inform timely ongoing management, without the need to wait for the established, more costly approaches e.g. imaging, nerve conduction studies. The aim therefore of this study is to provide a current evidence synthesis and evaluation of the diagnostic utility of ULNTs to identify peripheral neuropathic pain in patients with arm and/or neck symptoms.