EMG's and RSD
 

Are they bad for RSD.. what have been your experiences with EMG's and have they shown anything?

Dear Sandra -

Having had a bunch of them (at least 6) I can say that while they are not comfortable at all, they didn't do anything so far as I could tell to make my RSD/CRSP worse. (Although one unusually aggressive young doctor once managed to temporarily dislocate my knee cap, while manipulating my lower leg with a thin needle/electric probe stuck in the calf muscle: OUCH!!!) That said, while they can pick up all sorts of peripheral neuropathies, they do not catch the "small fiber neuropathy" that Dr. Oaklander has identified as emblematic of our common condition. "Evidence of focal small-fiber axonal degeneration in complex regional pain syndrome-I (reflex sympathetic dystrophy)," Oaklander AL, et al, Pain, 2006;120:235-243. [Available on the RSDSA Medical Articles Archive page at http://www.rsds.org/2/library/articl...ive/index.html - scroll down to the heading "Research" where it's listed alphabetically by author.]

For that, recent work has shown that the centuries old "pin prick sensitivity test" remains probably the best measure. See, "Concordance between epidermal nerve fiber density and sensory examination in patients with symptoms of idiopathic small fiber neuropathy," David Walk et al, Journal of the Neurological Sciences 255 (2007) 23–26, and attached below.

That said, it is my understanding that doctors must on occasion rule out other forms of neuropathies or sometimes look for neuropathies than can be triggered by various treatments, including such things as thalidomide. I look at it as a necessarily evil and know that I will probably have to do it every year or two for the duration.

Mike

For me, I had 1 and thankfully that was it. The Neuro I was seeing wanted to do it just to be sure there was no nerve damage anywhere in my legs or back.

It was quite uncomfortable and though he was an idiot in every other way, I really have to give him a thumbs up. He did it very quickly lower back and both legs down to ankles. He was so gentle and quick I didn't once have to tell him to stop. :-) My only good experience with a WC doc. LOLOL

A couple hours after my legs and back felt very sore though. It felt like I was bruised but within 3 days it went away and it only caused a slight increase in my overall pain level. I guess I can be very thankful that at that the time I didn't have touch sensitivity just air. Would I do it again now? Ummm NO! LOL I DO have touch sensitivity now so would probably be really painful.

As to the results they were negative for any sort of nerve damage which as Mike pointed out above, that is all EMG's are used for.

Karen

emg
 

i would have to agree with the other replies regarding the discomfort of emgs, i have had a lot of procedures care of my crps and the emg ranks right up there with the most uncomfortable. i think the most significant factor in deciding whether the pain will equate to gain (in other words if anything will be determined as a result) is if your doctor is trying to establish if nerve damage is involved or not. if you are diagnosed with type I and your doctor doesnt believe nerve damage is involved i would ask your doctor if he really thinks its necessary. if nerve damage is a possibility i would probably ask if a catscan could be done first. the catscan results will at least give the doctor a better idea of the nerves that might be involved and then the emg isnt done for provitive value but for verfication, limiting the number of needle inserts, which i think is a good thing on two levels. one it reduces the number of punctures, which depending on the area are extremely uncomfortable. second if there is a concern that the emg will result in flare, the opportunity is limited. i also agree that if you are touch sensitive it is probably a very bad idea.
however, if you have type II an emg can be effective in determining the damage it has caused to different areas of the body. i have type II and there was some correlation to the fluxuation of nerve activity to the areas of concern. i have emgs every 6 months, on all 4 extremities to try to map the disease.
i would probably talk to my doctor about my concerns and what information is he/she trying to gather, and ask if they think this is the only way they can get the data they need.
good luck
if you do have to have on i have learned a little trick, ask your doctor for lidocain gel and rub it on before the emg. it is cool temp (feels pretty much like cool air or water) if you can tolerate it i would recommend it. :)

Hi Sandel,
I am in complete agreement about the discomfort that EMG'S cause considering the lack of useful information that comes from them.
I have had one only and will never put up my hand for another one unless I thought there was some absolute evidence that what they found could positively impact my care.
Best wishes
Tayla:hug:
PS-I don't think it made my RSD/CRPS worse in a permanent way, but it did take a very long time for things to settle down after:(

Hi Sandel,
 

I have had 3 of them and they were all painful. Some more then others. I hurt for days after having 2 of them.

Mine were to rule out TOS and none showed anything. I noticed on the TOS forum that most had experienced the same thing. They showed nothing.

I would never have another one. I think they are so useless and I wonder sometimes if it's the only job a Neurologist knows how to do. That's been my experience with all of the Neurologist accept the one I have now.



As for me, I'm with Tayla they would have to chase me down to give me another one.

I don't know if it made the RSD worse but as I said, but my pain didn't settle down for days. I was that way with examinations also though. I got to where I wouldn't let Drs. touch me and it made some mad.

I do hope that it does what you want it to do if you have it.

Ada

I'm going to try avoiding them in the future. They haven't been horrible but each seems to be a little worse and they always come up negative. I tend to be a little more likely to have a flare up after one but with only 5 it might be coincidence. It may be caused by just all the movement and touching rather than the shocks themselves. One doc hit a nerve in my affected hand which momentarily paralyzed the thumb and caused... ...you guessed it... ...a lot of pain.

I personally don't feel I will ever have another one done. One dr thought that the reason I have such severe RSD is because I might have nerve damage in my C spine. They were going to attempt to do both arms and legs but the dr decided (because of the amount of pain it would cause) to do it in just my arms. It was AGONY it send me into horrific spasm and caused one of the worst flare/ deterioations I have ever had. I know they are useful for picking up stuff like nerve damage but I would seriously think before you have one done.

Loads of love

Frogga xxxxx