Hi.

Has anyone had an EMG?

Was it painful?

I had a EMG along with a NCV by a physiatrist in 2003.
In my arms- I had no trouble with it, but I have heard that it maybe the skill if the dr doing the needle insert that makes a difference in the pain or not.
Plus if you are in great pain already or not.

[Procedure

To perform EMG, a needle electrode is inserted through the skin into the muscle tissue. A trained medical professional (most often a physiatrist, neurologist, or physical therapist) observes the electrical activity while inserting the electrode. The insertional activity provides valuable information about the state of the muscle and its innervating nerve. Normal muscles at rest make certain, normal electrical sounds when the needle is inserted into them. Then the electrical activity when the muscle is at rest is studied. Abnormal spontaneous activity might indicate some nerve and/or muscle damage. Then the patient is asked to contract the muscle smoothly. The shape, size and frequency of the resulting motor unit potentials is judged. Then the electrode is retracted a few millimeters, and again the activity is analyzed until at least 10-20 units have been collected. Each electrode track gives only a very local picture of the activity of the whole muscle. Because skeletal muscles differ in the inner structure, the electrode has to be placed at various locations to obtain an accurate study.

A motor unit is defined as one motor neuron and all of the muscle fibers it innervates. When a motor unit fires, the impulse (called an action potential) is carried down the motor neuron to the muscle. The area where the nerve contacts the muscle is called the neuromuscular junction, or the motor end plate. After the action potential is transmitted across the neuromuscular junction, an action potential is elicited in all of the innervated muscle fibres of that particular motor unit. The sum of all this electrical activity is recorded as a motor unit potential. This electrophysiologic activity is evaluated during an EMG. The composition of the motor unit, the number of muscle fibres per motor unit, the metabolic type of muscle fibres and many other factors affect the shape of the motor unit potentials in the myogram.

Nerve conduction testing is also often done at the same time as an EMG.

Because of the needle electrodes, EMG may be somewhat painful or extremely painful to the patient, and the muscle may feel tender for a few days. There also exists "needleless EMG"—an EMG performed using surface electrodes—though it gives much less accurate results with a higher level of disturbance from the surrounding environment.]
http://en.wikipedia.org/wiki/Electromyography

I've had 3 of them with nerve conduction studies at the same time. Mine consisted of one part where they zapped me over various sections of my arms and hands with electrical stimulation at the same time as they were measuring the nerve response. If you've ever had stim treatments at a chiropractor, it's a bit similar but at a higher zap level. Your muscles definitely jump, as can you. For me, that wasn't too horrendous other than the anticipation of getting zapped again.

The 2nd part that I was not fond of was the needle tests where they inserted the needles and sorta ground down to get a good connection for measurement. On me it didn't really hurt much through the arms but when it got to the ball of the thumb/palm and top of the hand near the thumb, that wasn't much fun. Point blank it hurt. You have to stay still though or it can hurt more by jerking the probe and then they'll have to stick you again to get a reading that's not distorted from your jerking (did that on the first test, made sure I didn't repeat that mistake on the rest). Good thing is it's fairly quick and if you experienced similar to what I had, you don't have much other than a localized ache where you got poked. My discomfort faded pretty quickly (10 mins max) and I have fibromyalgia on top of TOS so I tend to have the joys of pain a bit more than others do. There was only one aspect of my last EMG that I refuse to ever do again (unless I ABSOLUTELY HAVE TO) and while I'm glad I did it, I'm just not brave enough to do it again unless I'm able to be on Verset where I won't remember it. They had me on Verset when I got my discograms and I don't remember a thing even tho apparently I cussed them out royally (the report said I vehemently protested) when they found the disc that was giving problems.

One of my neurologist after my fusion wanted to thoroughly map up into my cervical area so he inserted the probe into my neck near my spine and I had to lean back into it. If there had been any state secrets I could have fessed up to, I probably would have. Finishing that part of the test had me in major streaming tears (there are times I think medical tests do a good job of mimicking medieval tortures). If you have to get it, grit your teeth and do it because it will give a very good idea of whether the nerve problems come from closer to the spine or farther along. But realize, it's not fun while it's happening. You probably won't remember the actual pain but I'd bet you'll remember the emotional distress of choosing to push up into the probe when every nerve is telling you to pull away. I did mine cold without anything in my system. Don't know if drugs would affect the results. Ask your doctor if there's anything that might help with making it not quite so memorable an occasion. As barbaric as it might seem, it is a pretty good test for measuring how the nerves are functioning and where the problems might lie. It was the only way I was able to convince the skeptical and extremely uninformed about TOS, docs that my problems weren't carpal. In my book, making sure I didn't get a totally unnecessary carpal surgery was well worth the brief discomforts.

Eastern,

Thank you so much for writing how your EMG's were. I'm terrified. I'm going to see a neurosurgeon regarding entrapment of nerves in the brachial plexus. I want to get this solved, but I'm not excited about this. I had acupuncture before and I was miserable. I stopped treatment because I couldn't handle the pain. My IM Doctor thinks I have RSD so that might highten the pain... I just haven't had good luck with this and I'm terrified that I'll need this test and probably surgery to fix the nerves...

Thanks again.

I have had several, and yes they do hurt, but only for a short time. Try this during the procedure count backwards and imagine that needles are realeasing the toxins from your bodyand allowing better movement in your muscles as they conduct the study.....I actually felt beeter for a few days after becasue he inserted the needles in my worst areas....He told me this would give him the best results..But everyone has different methods.

Ann

I have had a number of EMG's (probably close to a dozen) and the only thing I have found with them was they made me nauseous (sp?). The pain wasn't too bad I just felt 'off' the rest of the day...

ok I had several and I can say this, it did hurt but I had a really rude doctor do my second one. First they had me hold a hot towel on my arm they wanted to test, than when he did test me he kept leaving the room and left me there on the table laying with the needles for 15 min. I was in tears and he just comes in and says sorry I had other work. A jerk by all means of course he was a Workers Comp Doc.....enough said!!!!!!!!!!!!!!!!
I'm sure yours will not be so bad best wishes to you
flippnout

I have to agree, not fun. Not terribly painful, but the anticipation of all those jolts was awful. I also could not stomach the acupuncture. eeeeek.

Where are you located? www.nervemed.com is Dr Fillers website. He looks at nerve entrapment with a specialized MRI. There is a facility in LA and somewhere in eastern PA.

good luck.

Johanna

Someone has a post from Dr. Togut that explains why EMG / nerve testing really doesn't work for TOS - can someone find it?

I've had 5 EMG / nerve tests. There is a HUGE range of SKILL amongst the docs who say they can do these and whether they can "see" TOS.

It is important to consider getting to one of our Tops Docs' EMG specialists. My first EMG was crap. Waste. They guy did not test up "high" enough to relate to TOS. You want the C-8 nerve tested - which is if they put the needle behind your neck and back muscles. If they don't, per my knowledge this is a waste of EMG, because TOS can "hide" as a false positive on carpal tunnel, ulnar nerve, etc. AND, to make it even more confusing, you can have TOS and operable shoulder, elbow and hand (carpal tunnel included) issues.

My neuro lets me take two Xanax prior to testing. He says it has no effect on what he is testing. ALL of my EMGS hurt. But, I wanted to know what was going on, more than it hurt.

Always get and keep a copy of your test and report so that you can share it with any other docs, don't forget.

Good luck, and let us know how it goes, ok? God bless.

I have had over 4 emg 's and find that they are not really painful for that long....the worst is the needle going into the muscle but if the person doing it knows how to do it and is doing it a lot then your pain will be minimized. It is fast and quick and goes fast if they are good. I hope all goes well for you

best of luck
love and hugs,
Victoria