Will RSD show up on a nerve conduction test?
 

M neuro wants me to have a nerve conduction test/emg on June 19th and on the advice of people here, I'm thinking of not doing it. Will a nerve conduction test even show RSD? What's the point of even doing it? I was first diagnosed with RSD in 2003, but I've never had a nerve conduction test. The doctor said it was to confirm RSD, but does she mean it's to rule out other nerve entrapments to confirm it's RSD?

this test can only tell the dr more about what is affected.. there is no tried and true test for rsd. ruling out is all they have.. I haven't heard or seen anything to say different

It won't confirm RSD. It could show nerve entrapment that if surgically repaired could possibly calm things down... Maybe.

Why now, though? Some WC docs just insist that all their patients have them done. Is it being performed at his/her office? If so, it could be for monetary reasons.

Have you had a bad reaction to needles from either blood draws or IV's? If so, this will be significantly worse. That being said, I underwent one rather than jeopardize my WC benefits.

http://www.rsdrx.com/rsdpuz4.0/puz_99.htm

http://www.rsdrx.com/rsdpuz4.0/puz_21.htm

The only test that can diagnose CRPS is a Triple phase bone scan, and at that it's only good around 65% or less of the time. As said they can use the Nerve conduction test to find areas where there is a problem that might respond to surgery or some other treatment that might help. Of course the if's are there if they find an area that shows problems, if whatever they try helps rather than hurts by causing the CRPS to spread... The one thing I know from people that have had the test done after getting CRPS is it's going to hurt like the dickens! Odds are also good that it will 'cause a flare.. Good luck with whatever you decide to do!

http://rsdfoundation.org/test/history.html

http://www.rsdfoundation.org/en/en_c...uidelines.html

I think these 2 links might help.

Good luck.

My only concern is the needles. I had this done early on and it showed a nerve system with no response, but Dr. said that was NOTHING. Mind you this was one of the 14 Docs that I went to and never got a DX.

It did hurt a lot and I would never get it done again or any type of invasive procedure for that matter. Fondly-Carol

This test and the hand scan show problems with my good hand. Well, I have RSD in it now but it's different than the originally affected hand in such a way that I can still use it a lot.

The nerve conduction test will often provide "false positives" early in the disease course and you're usually lucky if no operates. While there really is a conduction problem it is secondary to RSD and the one thing RSD hates most is being cut on or further injury.

Thanks everyone for all the great information. Thank you to Lit Love, those links you included were very helpful. The information was great. When I had my first go round with RSD, there wasn't this much information out there. Or at least I couldn't find it. I think maybe the neuro wants to cover all the bases and make doubly sure it's not a nerve entrapment. Ordinarily I would have asked her this when I was in the appointment, but all the pain has made my brain mushy. Perhaps I'll call her Tuesday to check.

She said she wanted to do the nerve conduction test to "confirm it was RSD." At first, I thought she meant the nerve conduction test would show RSD. But maybe she meant, if nothing showed on the nerve conduction test, it's definitely not a neuropathy, thus definitely RSD again.

I think despite the pain and risks involved, I may have to do the nerve conduction test. I'm on short-term disability leave from work, and I think they need some objective clinical evidence to give creedence to the RSD diagnosis, especially if I don't go back to work after my short-term disability runs out. The only "test" the docs have done is a neck MRI. Because I've had RSD before, they were pretty quick to say it's RSD again. I'm confident it is too, but they haven't made me do as many tests as I did the first time, so there's not as much info to give the disability company.

I know the nerve conduction test will be painful, is there anything I can do to make it less so? Will pain killers help?

I had Lidoderm patches and break through meds in my pocket to take as soon as the test was completed. I should have requested a driver, because my ride fell through, so I had to wait in my car for a good hour to make sure I was safe to drive--and that probably was still on the questionable side.

If this is a new area that recently developed, it might nor be as bad. I've gone through them prior to onset, early during onset, maybe 5 years post, 10+ years post. The last one was significantly worse, even though I wasn't properly medicated during the 3rd one.

Take a warm bath with Epsom Salts right away if this gives you relief.

It might not be that bad. (I totally can relate with having to go through with it even though I knew it was a bad idea. Going through with it meant they had no excuse to deny some of the more important referrals I've had during the past year--including WC paid Ketamine infusions.) Just be prepared if it causes a major flare. Speaking of which, a better diagnostic test would be a sympathetic block--and you could get some relief from it as well. A bone scan might be an option as well, or a thermogram (make sure this is done somewhere that has extensive RSD experience.)

:)

I noticed your other post in the remission thread and it reminded me--if you're not currently on a course of steroids, that would be a good idea as well. I can't remember if I did or not, but I always have them in for flares, travel, etc. If it's the kind that builds up, you want to be at the strongest dosage the day of the test. If the packs starts at the highest dosage, start it the morning of the test, etc.

And since I'm having a weird flare myself, this was a good reminder for me as well! One of those Homer Simpson "doh!" moments.

I'm not on prednisone right now. They tried it at the beginning of this bout of RSD, but I was non-responsive. I was on a blast for about 2 weeks, but it's over now. While there's some swelling with this round of RSD, there's not as much as there was with my foot the first time I had RSD. Both my neurologist and my rheumatologist (who first diagnosed my RSD in 2003) are dealing with the RSD. I like my rheumatologist more and he's more accessible, so maybe I'll ask him about giving me prednisone for the nerve conduction test.

Also, you mentioned break through pain meds. What are those?

Since I can't drive in general, I do have a driver so I don't have to worry about that. The hospital where I'm having the test is about an hour away, so there's no way I'd make it alone. The joys of living in a rural state. :)

I take time released opiates (Kadian) and immediate release opiates (MSIR). I was a hot mess afterwards...but luckily was 10 minutes from home. (Driving with that level of pain would have been more dangerous than the meds.) Take a max dose of your fastest reacting pain killer as soon as it's over.

I think Tylox is the strongest painkiller I have.

I was one of those who was pressured by my short term disability to have some documentation regarding my diagnosis. When the Neuro insisted on doing this test I refused, even though he suggested that I would not have "documentation" to satisfy my short term disability insurance.

My response was to immediately found another Neuro who I still see today who detailed in my records the high risk of spreading my CRPS with this test.

CRPS is a clinical diagnosis. Carefully documented medical records always trump a specific test. Please do not feel forced into this test. Failure to have this test done will not cause you to lose your short term disability.

If your doc has suggested or implied this find another. About the only thing we have going for us as patients is the ability to protect ourselves from risky procedures and treatments.

The only thing I can think of that is more threatening and frightening than the risk of losing financial security by feeling forced to undergo a risky test is facing a possible spread.

Please take a minute to read the tDCS thread. Since you have such a fresh case you may be able kick it back into remission if it is truly a return of CRPS.

Hoping better days are ahead for you!

Hi Kathrynl
 

I can't tell you what to do regarding the test. I can only tell you that for me personnaly I would not take that test. If there was some other dianostic test they can do, like biopsy, I would do all else first. It would take alot of convincing for me. My problems were addressed without this test, after going to another physician. I am not a wimp, but this particular test is not one I would willing do, unless it was best doctor in the world, being compassionate and telling me how much I need it. Let them try this test first, and then tell you to go through with it. I am sorry not to be so brave, many others did just fine with it, and many others have had to endure so much more pain with diagnostics. I try all the others ways first, before submitting to painful procedures. I slide by all I can....well maybe I am a bit of a wimp. ginnie:hug::eek:

WC rules differ by state. The result of how refusing a diagnostic test will differ greatly based upon many factors. In CA, your primary care doc absolutely has the power to change your status from TTD to P&S, for ANY reason. This can mean an end of income, but it can also put the breaks on moving forward with potential treatment, and/or receiving medications. Many states have very strict rules in place that prevents the injured worker from switching docs. (In part, so that the IW can't doc swap when they're status is changed to P&S.)

If the OP can avoid (or postpone) the test, that is clearly preferred. But, the only person she should trust that it won't effect her WC case, would be her attorney (if she has one.)

In my case, it wasn't my primary, but an IWE. Once agreed upon ahead of time by both parties, you're stuck with them. If I had experienced past episodes of spread from similar procedures, I would have refused. Since I've had no long term pain other than the original RSD site, I was not too worried. My flares have responded quite well to meds. I had a plan in place with my PC, if the worst case scenario happened. Etc. Was it a difficult decision that required significant consideration? Of course.

I had 4 nerve conduction tests.. all with varying results. I had 2 nuclear bone scans. with equal results then the triphase bone scan. plus a truck load of mri,s and X-rays.. the try phase scan is what got me the dx of red. the rest only showed what they already knew.. so if this helps ..

I had a triphase bone scan during my first diagnosis with RSD in 2003 which clinched the RSD diagnosis for me (after multitudes of blood tests and xrays).

I'm a little concerned I'm already experiencing spread in my right arm. I'm starting to feel burning in my right shoulder and upper arm and intermittent prickling pain in my right hand. This is how the RSD started in my left arm. It's not anywhere near as intense as my left definite RSD arm. I'm not sure if I'm just being paranoid and I'm in so much pain that it feels like it's in the right arm, or it's starting to mirror.