Upper Limb Neural Tension Test - Ulnar (ULNT)

Purpose: To assess the contributions of neural tension to the patient’s symptoms.

Test Position: Supine.

Performing the Test: Stand at the side of the tested limb, facing towards the patient’s head. Use the hand closer to patient to depress shoulder and punch into table to keep shoulder in depressed position. Use farther hand on patient’s hand to flex elbow to about 115 degrees, with the forearm pronated. Keep patient’s wrist and fingers extended. Laterally rotate the patient’s shoulder to end range and abduct the patient’s shoulder until neural symptoms are reproduced. Have patient laterally flex or rotate their head away (worsens pain/symptoms) and toward the arm (relieves pain/symptoms) - a positive test.

Diagnostic Accuracy: Unknown.

Importance of Test: As nerves travel through our body they can become adhered to the tissues they come in contact with. When stressed, these nerves reproduce neural symptoms such as pain, tingling, numbness, stretching sensation, etc. This test works by putting the ulnar nerve on tension, because it passes through the thoracic outlet, behind the elbow (cubital tunnel), and along the volar aspect of the ulnar side of the wrist and hand, which explains why flexing the elbow, and extending the wrist and fingers aid in tensioning the nerve. The addition of cervical motion to alter the symptoms can help determine if the cervical region is involved.

Note: tests should only be performed by a properly trained health care practitioner.