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What is an EMG/NCV test?
EMG, or electromyogram is a test used to record the electrical activity
of muscles. Active muscles produce an electrical current that is usually
proportional to the level of muscle activity. Another name for an EMG is
a myogram.
There are two types of EMG -- the intramuscular EMG and the surface EMG.
The intramuscular EMG is the test most commonly ordered and involves
inserting a needle electrode through the skin into the muscle in
question. Surface EMG (SEMG) involves placing the electrodes on top of
the skin overlying the muscle to detect the electrical activity of the
muscle.
EMGs can detect abnormal muscle electrical activity in many diseases and
conditions, including inflammation of muscles, pinched nerves, damage to
nerves in the arms and legs, disc herniation, and degenerative diseases
such as muscular dystrophy, Lou Gehrig’s disease, Myesthenia gravis,
among others. The EMG helps to distinguish between muscle conditions in
which the problem begins in the muscle and muscle weakness due to nerve
disorders.
We typically order EMGs when we want to find out if a patient’s pain is
related to a pinched nerve or disc herniation most commonly. Most pain
conditions that we see at Caring Medical are related to soft tissue
injuries such as injuries to the ligaments, tendons, or muscles which do
not require EMG testing. These injuries may refer pain down the arm or
leg or to other sites. Almost all pain, in our experience, responds well
to Prolotherapy (at least 85% of all cases seen here). If a patient has
a pinched nerve, this person can be experiencing 10/10 level of pain, 24
hours per day, 7 days per week. The patient may experience true
numbness, weakness, and decreased grip strength, for example. An EMG in
this case helps determine cases of
radiculopathy
or pinched nerves.
In the nerve conduction velocity (NCV) test, the nerve is electrically
stimulated by one electrode while other electrodes detect the electrical
impulse "down stream" from the first electrode. The distance between
electrodes and the time it takes for electrical impulses to travel
between electrodes are used to calculate the speed of impulse
transmission (the nerve conduction velocity, or NCV). A decreased speed
of nerve conduction indicates nerve disease.
The NCV test is often done at the same time as the EMG in order to
exclude or detect both nerve and muscle conditions. The interpretation
of an abnormal NCV test depends on why the test was done in the first
place. It may indicate damage to a nerve from trauma, diabetic or
peripheral neuropathy, herniated
discs, polyneuropathy, or myasthenia gravis or Guillain-Barre Syndrome,
among other things.
We take a very thorough history on each and every patient, as this is
the key to determining the root cause of a patient’s pain. EMG/NCV tests
are not something that we frequently order considering the number of
pain patients who come through our doors, because we find that most
conditions respond very well to Prolotherapy. Degenerative disc disease,
arthritis, bulging discs, sphondylolisthesis, and many other conditions
are most typically due to an underlying soft tissue weakness/injury – to
the ligaments, tendons, or muscles. These types of conditions respond
very well to Prolotherapy. The history from the patient is one of the
key factors to determining the need for these types of studies. The
experience of the physician and clinical team at asking the right
questions, can be the difference between getting an expensive test that
you may or may not need. If a nerve injury is suspected as being the
cause of the patient’s pain, then an EMG/NCV study may be ordered.
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