Anyone have inconsistent EMG/Nerve conduction results?
 

Over the last 3.5 years I've had 4 EMG/Nerve conduction tests. The results are all over the place.

Just wondering if anyone else has experienced this and how accurate are these tested considered.

Thanks

Do you have any other symptoms?
Where is the pain located in your hands?
Whole hand, certain fingers, top/palm?

Any thoughts on what triggered your pain/symptoms?

Were the tests all done by the same doctor/facility?

I personally think EMG /NCS testing is very subjective. The experience and technique of the doctor or technician is important and can have a huge bearing on results.

It also matters if your symptoms have changed.

Do you have any other information you can share about your symptoms...where in hands, what type of pain, has it spread, is there numbness, etc.?

And just to note...the skin biopsy is the test needed for small fiber neuropathy SFN. The EMG /NCS cannot determine SFN.

Thanks for the replies
 

My pain is a burning neuropathy feeling in both hands that gets worse in the afternoon through the evening. The pain is non-specific and transitory. One hand burns on the palmar side for awhile, then the other on the dorsal side. There is also finger involement. I do not have any other joint or burning pain excluding my hands and to a lesser degree, my wrists.

I have had CTS and Guyon's canal releases without any relief.

I've also tried many NSAIDS, SSRI's, gabapentin, etc ... without relief.

The EMG/NV tests were conducted at different facilities over a 3.5 year time frame.

Yes, EMG/NCV tests can vary widely--
 

--depending on where they are being done, the skill of the technician/clinician, the placement of the electrodes, and even the temperature in the room (the test is supposed to be done under relatively cool conditions, as heat is the enemy of nerve conduction).

This, of course, doesn't even begin to take into account the possibility that the condition of the nerves themselves can change over time.

Just from the standpoint of consistency, I think it best to have these done by the same facility and the same people with the same equipment over time for purposed of comparison; I realize with insurance considerations and the like this may not be possible.

Because your symptoms are so localized I wonder if a topical product would help you?

1) Biofreeze applied on the tops of your hands might work. You can get this now on Amazon...I'd do the gel and not the roll on, as it is more concentrated.

2) Or the new pain gel by Salonpas... Salonpas Deep Reliving Gel...this is very strong and has a salicylate in it to penetrate and exert anti-inflammatory action.

3) A Lidoderm patch (cut to fit) applied to the back of the hand might work too.

4) Some posters here get an RX compounded transdermal gel with ketamine, gabapentin, lidocaine, and sometimes an NSAID to rub into specific target areas. Yours would be the backs of the hands (the palm skin may be too thick). But you could apply on the inner wrist where the carpal ligament is.

I have found topical agents like these work very well for me and allow me to avoid major drug treatments. (My only RX is a little tramadol at night on really bad days.)

Do you wear support splints to bed? This may help too.
Your issue may be a tendonitis, or a gout thing in your hands.
Ask to have a uric acid level drawn to see if you are elevated.

I am having some urate deposits in two fingers now, but the Salonpas is helping to move them out lately. These deposit along tendons and make whitish hard lumps which may or may not show, but sometimes you can feel them. I knew a fellow once who had huge amounts of urate along his tendons, esp after an illness where his white cell count would elevate. When the cold, or infection was over, these would be removed by the body and that releases lots of purine peptides into the system and some people lack an enzyme (xanthine oxidase) to metabolize them away...so this ends up along tendons. These can be pretty painful, burn and sting.

Do you do repetitive type of work, desk work?
Any tightness in your neck/shoulders at all?
What fingers are involved?

Yes, on the computer everyday. 54 y.o. and starting to notice bad posture and neck tightness.

CTS and guyon's canal releases on right hand with no improvement.

Currently going to a pain doc who has performed Cervical interlaminar and right and left transforaminal epidural steroid injection for C4-5 spondylosis and mild stenosis. No relief yet.

Also, tried Voltaren and Lidocaine gels w/o relief.

I think the pain would be more bearable if I knew the culprit.

Approaching 4 years and no closer to an answer :mad:

Ah,, I suggest you visit our thoracic outlet syndrome forum (aka TOS) you may not have full fledged TOS now but learning about it and the therapies to resolve it are best done before it progresses..

It can become a complex chronic RSI problem if not treated and resolved early.

http://neurotalk.psychcentral.com/forum24.html be sure to explore the Useful sticky threads for a crash course on it.

Having the neck tightness plus the carpal tunnel could be what is called a double crush syndrome. Or the carpal tunnel was a mis dx... very common with MDs that don't know much about TOS...

If you can get some expert PT or perhaps expert chiropractic, for the neck/tightness & posture you may find the hand issues fading..

Your docs might be focusing on the wrong area of treatment..
Hand & arm pain can originate higher up from neck/shoulder/collarbone areas.

Can be trickier if the c spine has some issues but often if your treat the soft tissue & posture things may moderate.

We had another poster over a year ago who had burning hands only. He finally figured out that his exercise routine was causing it...stress on the hand ligaments. (push ups and weight lifting causing compression of the nerves).

When he modified his routines to spare his hands, the issues resolved.

There was also a poster who got a wood preservative fungicide spilled on his hands, and this chemical caused long term burning too.

So look to your environment and see if something you come into contact with could be causing your pain. Once the nerves are irritated, it can take a long time to heal up.