I have had 4 EMG's before I realized they most likely will show nothing on them. They are very painful also. Mine were done to diagnose Thoracic Outlet and every idiotic Neurologist I had thought if it didn't show anything then there wasn't anything. I don't know what kind of Dr. you are seeing but I would hope he won't be like those I've seen. I will say too it can cause a worse flare for sure. The ones I had did. I finally said never again on EMG's.

Hopefully it will not be RSD that you are dealing with. If it turns out to be, learn all you can about it and pick and choose what treatments you will let a Dr. do. Pick and choose your Drs. too, no matter how many you have to see.

Welcome to the forum.

Ada

Since I probably have neuropathy now, an EMG would be a test for that. I discussed it with my PM doc at Clev Clinic last week. She said she never recommends them to anyone with RSD. And, she said it won't affect the outcome. Not like the would find a broken bone or something that can be fixed. EMGs just confirm diagnosis of some things. Maybe it's different if you have RSD from a cut nerve or something.

My wife (who has RSD) has had at least 2 EMG to check for trapped nerves. Why so many is beyond me. She dreaded the tests but she seemed to deal with it ok and said the last one wasn't too bad.

I have read of RSD cases where the patient had all or most of the signs of RSD and in one case in particular the patient was treated for RSD for several years, as I recall, until they found a trapped nerve. They removed or untrapped the nerve which cured all symptoms. This patient used to post on this RSD forum.

Hi there. The problem is that "small-fiber neuropathy," the hallmark of RSD/CRPS isn't picked up by an EEG/Nerve Conduction Study. See, The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology, Grazia Devigili, ValeriaTugnoli, Paola Penza et al, Brain (2008), 131, 1912-1925, FULL TEXT @ http://brain.oxfordjournals.org/cgi/...131/7/1912.pdf:

Abstract
Small fibre neuropathy (SFN), a condition dominated by neuropathic pain, is frequently encountered in clinical practise either as prevalent manifestation of more diffuse neuropathy or distinct nosologic entity. Aetiology of SFN includes pre-diabetes status and immune-mediated diseases, though it remains frequently unknown. Due to their physiologic characteristics, small nerve fibres cannot be investigated by routine electrophysiological tests, making the diagnosis particularly difficult. Quantitative sensory testing (QST) to assess the psychophysical thresholds for cold and warm sensations and skin biopsy with quantification of somatic intraepidermal nerve fibres (IENF) have been used to determine the damage to small nerve fibres. Nevertheless, the diagnostic criteria for SFN have not been defined yet and a 'gold standard' for clinical practise and research is not available. We screened 486 patients referred to our institutions and collected 124 patients with sensory neuropathy. Among them, we identified 67 patients with pure SFN using a new diagnostic 'gold standard', based on the presence of at least two abnormal results at clinical, QST and skin biopsy examination. The diagnosis of SFN was achieved by abnormal clinical and skin biopsy findings in 43.3% of patients, abnormal skin biopsy and QST findings in 37.3% of patients, abnormal clinical and QST findings in 11.9% of patients, whereas 7.5% patients had abnormal results at all the examinations. Skin biopsy showed a diagnostic efficiency of 88.4%, clinical examination of 54.6% and QST of 46.9%. Receiver operating characteristic curve analysis confirmed the significantly higher performance of skin biopsy comparing with QST. However, we found a significant inverse correlation between IENF density and both cold and warm thresholds at the leg. Clinical examination revealed pinprick and thermal hypoesthesia in about 50% patients, and signs of peripheral vascular autonomic dysfunction in about 70% of patients. Spontaneous pain dominated the clinical picture in most SFN patients. Neuropathic pain intensity was more severe in patients with SFN than in patients with large or mixed fibre neuropathy, but there was no significant correlation with IENF density. The aetiology of SFN was initially unknown in 41.8% of patients and at 2-year follow-up a potential cause could be determined in 25% of them. Over the same period, 13% of SFN patients showed the involvement of large nerve fibres, whereas in 45.6% of them the clinical picture did not change. Spontaneous remission of neuropathic pain occurred in 10.9% of SFN patients, while it worsened in 30.4% of them.

PMID: 18524793 [PubMed - indexed for MEDLINE] PMCID: PMC2442424

http://www.ncbi.nlm.nih.gov/pubmed/18524793

My neurologist has been mapping the areas in which, in response to a pin prick, I feel pressure but without any sense of sharpness. And quite surprisingly, even though the CRPS has by all appearances been centered in both my feet and ankles, I exhibit the same symmetrical response in all four extremities. There is little if any sense of sharpness "below" my knees and elbows, to the point that I looked down a few years back, and happened to see a hornet grinding its stinger into my wrist, but felt nothing!

And for the classic article tieing CRPS to small-fiber neuropathy, see, Evidence of focal small-fiber axonal degeneration in complex regional pain syndrome-I (reflex sympathetic dystrophy), Oaklander AL, Rissmiller JG, Gelman LB, et al, Pain 2006;120:235-243, FULL TEXT @ http://www.rsds.org/2/library/articl..._pain_2006.pdf.

Mike

I had 3 EMGs over a year and a half by 3 different Dr.s
2 showed no problem but right after the 2nd. one I had surgery on my right wrist only to find the radial nerve completely severed. 10 months after the 1st. nerve surgery I went to another hand Dr.s complaining about burning pain in my hand and that I could not be in any A/C buildings or vehicles. This is when I had the 3rd. EMG along with a ultra-sound. The EMG gave a false positived reading saying the nerve was in tact, the ultra-sound confirmed the radial nerve never grew and was still severed.

Well I had my appointment today, and well, the EMG test was nothing short of absolute, unadulterated, pure torture. The test began simple enough, with the doctor (not the pain doctor, another specialist that travels from office to office) placing electrodes on my leg and shocking my leg. After the second shock, everything he did was total h-e double hockey sticks...my entire leg felt like it was on fire, every muscle was cramping, and every joint was aching tremendously. That wasn't even the bad part. He then stuck this needle in my shin that burned just like a syringe, and began telling me to move my toes...but I couldn't! They were locked up for some reason, so he flexed them upwards by hand. He then progressed to place these needles in my calf, above and behind my knee, and in my lower back. By the time he was doing my back, I was punching the wall above my head, and when I finally sat up I saw a puddle where my face was...didn't even realize I was shedding so many tears during the test! I guess the point of all this is it was awful, and while it's true that it wasn't worse than some of the other stuff I've suffered through since my injury, like Coumadin therapy, it's certainly something I never want to do again.

So there I am, sitting on the table, writhing in pain from this test, thinking that now I'm going to see my pain doctor...nope! I was there only for the test...but I only had three days of my medicine left, and I needed to talk to him about the hydrocodone not working. I was about to freak out.

Well, what happened next made all the other bad stuff I went through a little better. After explaining my med. situation to the receptionist, she called my doctor (I guess he wasn't there) and told him what I told her, and he switched me from 7.5/500 lortab 3x/day to 7.5/325 oxycodone 4x/day...without even seeing me! I'm guessing from that gesture that 1)he's a compassionate human being, and 2) he trusts me. I can't begin to describe how much better I feel about my relationship with him. At least I have one doctor whom I feel really understands me and what I'm going through.

Oh, he didn't see any nerve issues or entrapments...oh boy...

I wish a pain-free day to you all!

Tim

Hi Tim -

As others have mentioned, you can't rely on the results of the EMG's to determine whether or not you have nerve issues. I had an EMG which the doctor said was negative in the early phases of my RSD, but I very definitely have RSD. I wish the EMG had been right, and that there was nothing wrong with my nerves. IMHO, EMG's are pretty much useless as far as RSD is concerned.

If you have to go through another one, you may want to ask for some chill meds in advance.

So sorry for your pain, and I hope you get the treatment you need ASAP. The RSDSA is an excellent resource - see RSDSA.org.

XOXOX Sandy

thanks Sandy!

Oww, an EMG! Hope all goes well for you. It should give your doctor a good starting-point for the diagnosis.

I've had two, and I hope to never have another. I take Valium prior to mine. Really seems to help me relax and be more open to the "honest" results of the exam. The meds help me get over my fear of needles and can give a better "true" result. Good luck!