Why is the Jackson's Peripheral Stretch (JPS) test for the neck not considered a valid diagnostic test?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: November 10, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

The Jackson's Peripheral Stretch (JPS) Test Lacks Validation Evidence

I cannot find any published evidence supporting the validity or reliability of a test called "Jackson's Peripheral Stretch (JPS) test" for cervical spine evaluation in the medical literature provided or in standard clinical practice guidelines.

Why This Test Is Not Considered Valid

The absence of published validation studies means this test has never been subjected to rigorous scientific evaluation for sensitivity, specificity, or clinical utility. 1, 2

Evidence-Based Cervical Spine Testing

The most recent systematic reviews and guidelines identify only specific validated provocative tests for cervical radiculopathy:

Tests with Evidence Support:

  • Spurling's test demonstrates low to moderate sensitivity (30-60%) but high specificity (92-100%), making it useful to rule in cervical radiculopathy when positive 3
  • Upper Limb Tension Test (ULTT) shows high sensitivity (72-97%) but low specificity (11-33%), useful to rule out radiculopathy when negative 3
  • Neck distraction/traction test has moderate sensitivity and high specificity for nerve root compression 3
  • Shoulder abduction test demonstrates low to moderate sensitivity with moderate to high specificity 3

Critical Limitations of Unvalidated Tests

The Bone and Joint Decade 2000-2010 Task Force on Neck Pain found that most commonly used objective tests for neck pain lack validity in the absence of radiculopathy 2. A 2018 systematic review confirmed there is little evidence supporting the reliability and validity of most clinical tests used to evaluate patients with neck pain grades I-III 4.

Key Problems with Unvalidated Tests:

  • No established sensitivity or specificity values 3
  • Unknown positive and negative predictive values 5
  • Lack of standardized technique or interpretation criteria 4
  • No comparison against valid reference standards (MRI, surgical findings) 2

What the Guidelines Actually Recommend

For suspected cervical radiculopathy, a recent meta-analysis concluded there is limited evidence for correlation between physical examination findings and MRI evidence of cervical nerve root compression 1. The American College of Radiology notes that physical examination tests have high rates of both false-positive and false-negative findings 1.

The evidence-based approach prioritizes:

  • Focused history to identify red flags (trauma, malignancy, infection, progressive neurological deficits, immunosuppression) 1, 6
  • Validated provocative tests (Spurling's, ULTT) when radiculopathy is suspected 3
  • MRI without contrast as the imaging study of choice when radiculopathy or red flags are present 6
  • Conservative management for 4-6 weeks without imaging for uncomplicated neck pain 6

Clinical Pitfall

Your 40+ years of experience finding this test "not valid" aligns with the evidence-based literature—tests without published validation studies should not be used for clinical decision-making. 2 The lack of any peer-reviewed publications on the "JPS test" means it has never undergone the methodological quality assessment required to establish diagnostic accuracy 5, 4.

If you are referring to a different test by another name, the validated options listed above represent the current evidence-based standard for cervical spine examination 3.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.