emg normal but still have pain

• 8 September 2023

This article discusses why EMG and nerve conduction studies are done and what they can reveal about your neuromuscular function and health. I am angry! That was my experience. Both procedures help to detect the presence, location, and extent of diseases that damage the nerves and muscles. Combined with the understanding that EMG can be time-consuming, costly, and painful, it is important to first consider whether patients have pain alone or pain in addition to other symptoms. Think of it that way, as temporary because it is, and you will get through it. Electromyography-related pain: muscle selection is the key modifiable study characteristic. Getting a second opinion doesn't mean you don't trust your healthcare provider and it may help you feel reassured to hear another medical professional's take on your situation. University of Massachusetts L5s1 disc hern chronic back&sciatic pain. NEUROLOGICAL CONDITIONS MIMICKING CERVICAL RADICULOPATHY Entrapment/Compression neuropathies Median, Radial, and Ulnar Peroneal motor studies low normal CMAP EMG of right FDI (in hand) was + for fibs Radial sensory was low in amplitude and slightly prolonged in latency. EMG tests came back normal: Hi. Long story as - Pain If the muscles in your chest are being tested with EMG, there's a tiny risk that air could get into the space between your chest wall and your lungs and cause pneumothorax (lung collapse). The electrical activity from your working muscle will be measured and displayed on the oscilloscope. For lumbosacral radiculopathy there is a similarly low sensitivity; as few as 42% people with lumbosacral radiculopathy have abnormal EMGs compared to using MRI and clinical suspicion together as gold standard.23 The patients for whom to consider EMG for radiculopathy may be those with symptoms not correlating with imaging due to the high false-positive rate in imaging or when multilevel disease is present and the question is which level is affecting the patient most. EMG is normally performed immediately following the NCS. I have not had any real electrical shocks lately but the pain is still there. You never know the impact you may have: Meet @karukgirl. All Rights Reserved. Figure 1: Algorithm for considering whether to send a patient who has pain for EMG. In this case, you'll remain where you are while the neurologist finds the muscle(s) he or she wants to test. EMG is not a test used for MS. EMG tests for peripheral nerve disfuntion. You/re going there for a reason, that's what you should keep in mind.Tell them you have anxiety for this procedure and they may prescribe one anxiety pill for you for that appointment as long as you bring a driver with you. I have had 3 Nerve conduction tests over the last three years since I was Floxed. Yes it can. Scheduled for July 10th with a 2nd neurologist opinion the 14th. Call your doctor or 911 if you think you may have a medical emergency. If there is a sensory deficit with vibration or proprioception indicative of a large-fiber neuropathy, then the EMG may indeed be important to pursue. Not terrible, but a touch painful. By Peter Pressman, MD How is one "Expected" to BE STILL during this phase???? Nerve conduction and EMG studies are an important procedure for evaluating possible peripheral nervous system (PNS) disorders. Had another one about 2 years ago and I barely felt it. Verywell Health's content is for informational and educational purposes only. Together, you can navigate the potentially scary road of a new diagnosis armed with information and reassurance. Copy and paste it, adding a note of your own, into your blog, a Web page, forums, a blog comment, An audio-amplifier is used so the activity can be heard. Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. C'mon @wisfloj .we got this. Unfortunately, it seems that sEMG is not likely to be able to differentiate well between different causes of muscle pain. It is also important to remember that pain is not the only risk of the study. Electromyogram (EMG) and nerve conduction studies: about these tests. The NCS is performed by a neurologist (a doctor who specializes in brain and nerve disorders), although a specially trained technician may also perform some portions of the test. Lori. Be open with your healthcare provider and ask questions about what results he or she expects from these tests and what they might mean for you, and be sure to voice any concerns you have. Symptoms of ulnar nerve entrapment and damage include: Curving Posts : 7. If MRI doesn't show cause of foot drop (l5s1 protusion)and emg doesn't show nerve issue and you have back and sciatica pain, could MS be a possibility. Myopathy or myositis, like radiculopathy, remains a difficult diagnosis on EMG. Assessing altered motor unit recruitment patterns in paretic muscles of stroke survivors using surface electromyography. They also suggest whether the axon or myelin sheath, which is the exterior layer of nerves that helpselectrical impulses travel faster, is more damaged by a neuropathy. Position statement: overview of electrodiagnostic medicine. doi:10.1001/jamainternmed.2016.0162. In: Winn HR, ed. John Hopkins Medicine. In this video, Dr. Eric Sorenson discusses the EMG (Electromyography) test. I am worried in that a few weeks back I could only complete about half of the EMG test as the electric impulses were getting stronger and stronger and I have pins and needles in my left hand and fingers. Muscle Nerve. Electromyography: This is more involved than NCS. 2012;46:287-293. Cartwright M, Hobson-Webb L, Boon A, et al. AANEM Web site. I have had pain for a year now since I herniated my L5-S1 disc into my sciatic nerve. As your muscle is contracted, nerve fibers signal more and more bits of muscle (called motor units) to join in and help. Susan Sindall. Thank you Joshua, Re tender point/redness. Ulnar nerve entrapment can occur at your elbow or wrist. In median neuropathy, when compared to the clinical criteria of carpal tunnel, 25% of patients in a study did not have findings of median neuropathy at the wrist by EMG.19 Therefore, it is useful to consider what a test will add to management of an individual patient. It's a valuable tool for your Dr. to be able to proceed with your treatment. Proper performance and interpretation of electrodiagnostic studies. See: Magnesium for Tendonitis 3. I have had the classic carpal tunnel symptoms of numbness and tingling in both hands, with a bonus of very painful tendonitis in my left, dominant hand. I feel like I am walking on pepples, my legs tingle constantly. Remember that while EMG and NCS are helpful diagnostic tools, they are only one piece of the puzzle. Can pain in back and leg along with foot drop be caused by a small disc protusion l5s1 if conductive nerve study and emg are normal? Richardson JK, Evans JE, Warner JH. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Muscle Nerve. Mondelli M, Aretini A, Arriqucci U, et a.. Clinical findings and electrodiagnostic testing in 108 consecutive cases of lumbosacral radiculopathy due to herniated disc. And it may be because it takes time for the test result to change. I had it done, it's not so bad (I had no anxiety pill). If the algorithm does not clearly lead to the EMG, carefully weigh the costs and potential pain for patient against the likely diagnostic benefit of EMG. Their EMG may be normal, but yet they actually have pain. Generally, fasting is not required before the test. Created for people with ongoing healthcare needs but benefits everyone. Has anyone else had this? Dr. James Natalie answered. It's a valuable tool". You will feel various pains for a while as this Guyons canal syndrome, which affects the nerve in your wrist, is a rare peripheral neuropathy. Muscle Nerve. Pain is MS is usually either nerve pain or spasticity pain (overy tight muscles from dysfunctional nerve messages). Phys Med Rehabil Clin N Am. 1, they don't know that it will definitely fix a trapped or nerve impingement, but this is a Consultant in Pain Medicine and Anaesthesia in a Pain Clinic. Electromyogram (EMG) Test & Nerve Conduction Study (NCS) It was done by a student. Your healthcare provider will let you know how to proceed. Depending on your situation, your physician may give you additional or alternate instructions after the procedure. A nerve conduction study measures how fast electrical signals move through your nerves to determine the extensiveness of the issue. Clin Neurophysiol Pract. Arch Phys Med Rehabil. The EMG part was the worse for me because I feared pain and the needles that cause the pain. EMG can be considered an extension of the clinical neurologic examination, rather than simply a test, and is ordered by many healthcare providers from all specialties. I agree with Rachel that it is unpleasant. If you have damaged nerves, you might feel less pain in those areas. Confused about EMGs- weakness, atrophy but normal emg Electromyography (EMG). EMG is nearly always performed during the same visit as nerve conduction studies (NCS). 2018;41:147-153. 2014;49(4):570-574. Alport AR, Sander HW. All Rights Reserved. I have no health ins. Yesterday I had the fourth EMG in my life and the doctor stuck the needle in my neck too far. This activity shows a smooth action potential in a normal EMG. That means that you have objective weakness related to, (usually before 7-10 days of weakness) can be falsely normal. When to Refer Patients With Pain for EMG Your ulnar nerve is a single nerve in a network known as the peripheral nervous system, which carries information to and from your brain by route of your spinal cord. Khoshbin S, Hallett M, Lunbeck R. Predictors of patients' experience of pain in EMG. Had an appointment with a Neurologist today, but think I was abducted by aliens on my way to the hospital because I ended up in a torture chamber. It depends: Nerve injury will typically show up on emg. 10. In the likely event that you have both tests, plan for the whole thing to take anywhere from one to three hours. University of Massachusetts The tech will guide you through it. Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.ncbi.nlm.nih.gov/books/NBK431063/). 2004;29(4):515-522. In other words, even though you may have some nerve damage, your NCS result may still be normal. I said, bring on the pain! I found the NOISE of my EMG very annoying but not painful. When patients with neck pain have had deep cervical flexor muscle activation through sEMG it was found that analysis could determine less activation in these muscles when flexed and more activation in the superficial muscles, suggesting patients with pain alter their muscle activation, which may be another way to consider the physiology of pain.15 Variation of activation and inactivation may be explained by pain adaptation theories that suggest agonist muscles have reduced activity during pain whereas opposing muscle group activities increase.16,17. Other causes of ulnar nerve entrapment and damage include: Ulnar nerve entrapment affects more men than women. Is an EMG (electromyography) painful Any alternatives to surgery? Connect with a U.S. board-certified doctor by text or video anytime, anywhere. If you had an NCS or EMG to monitor a condition you already have, the test will likely show your healthcare provider how much nerve damage or change in muscle activity there has been since your last test, which can help him or her adjust your treatment plan accordingly, if needed. I had an EMG several years ago. NO clinical weakness. 2011;40(9):693-697. An audio amplifier may also be used so that both the appearance and sound of the electrical potentials can be evaluated. A stimulating electrode is then pasted onto the skin overlying the nerve of interest, while a recording electrode is pasted over the muscle that the nerve controls. There may be a technician to help attach the surface electrodes as well. http://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/nerve_conduction_velocity_ncv_92,p07657/. You must tell your examiner if the test is painfulbecause this can interfere with the results. These tests are performed on an outpatient basis at an office, lab, or clinic, or you may have them while you're already in the hospital. These cysts cause up to 40% of Guyons canal syndrome. Dear God, it's awful :(. London ZN, Burke JF, Hazan R, Hastings MM, Callaghan BC. Nerve entrapment is a type of nerve compression syndrome. A neurologist, a healthcare provider who specializes in conditions that affect the nervous system, will likely perform most or all of your tests. Good luck with your tests. Both procedures help to detect the presence, location, and extent of diseases that damage the nerves and muscles. Radiculopathy is a commonly missed diagnosis with EMG and also commonly associated with pain.21-23 The missed diagnoses may occur because unless the radiculopathy affects the muscle, and therefore causes areas of denervation, the needle EMG may be normal even though the nerve is compressed leading to pain. My symptoms (FYI) are constant (24/7) bilateral calf twitching, cramps, pain, foot numbness and "perceived" weakness in both legs. Procedures may vary depending on your condition and your doctor's practices.

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