EMG & Nerve Conduction Studies
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What they are
EMG (electromyography) and NCS (nerve conduction studies) are diagnostic tests that evaluate how your nerves and muscles are functioning. They're the most direct way to determine if a nerve is being compressed, damaged, or not working properly, and to tell you exactly where and how severely.
I perform these studies myself, which matters because the information I get from doing the test directly informs how I treat you. It's not a separate diagnostic step that gets sent away for interpretation. It's part of the clinical encounter.
When we use them
Carpal tunnel syndrome and other nerve entrapments. Cervical and lumbar radiculopathy (pinched nerve in the neck or back). Peripheral neuropathy (nerve damage in the hands and feet). Unexplained weakness, numbness, or tingling. Differentiating between nerve and muscle problems. Monitoring nerve recovery after injury.
The nerve conduction study (NCS)
This is done first. Small adhesive electrodes are placed on the skin over the nerves being tested. A brief electrical stimulus is delivered, and the response is recorded. The speed and strength of the electrical signal tell me whether the nerve is functioning normally, where along its path it's being compressed, and how severely.
It feels like a quick, sharp tap or buzz. It's startling at first but tolerable. Each nerve takes about a minute to test.
The EMG
A very thin needle electrode is inserted into specific muscles. I listen to and analyze the electrical activity of the muscle at rest and during contraction. The patterns tell me whether the muscle is receiving normal nerve input, whether there's been nerve damage (and how old it is), and whether the nerve is recovering.
The needle is thin (much thinner than an injection needle) and the discomfort is usually described as a mild ache or cramp. I test as few muscles as needed to get the information I'm looking for.
How long does it take?
A focused study (like evaluating one arm for carpal tunnel) takes about 20 to 30 minutes. A comprehensive study (like evaluating for peripheral neuropathy) may take 45 minutes to an hour.
Getting results
I interpret the results in real time and discuss them with you immediately after the study. No waiting for a separate report. We'll talk about what the findings mean, how severe the issue is, and what the treatment plan looks like going forward.
How to prepare
Wear loose, comfortable clothing that allows access to the arms and legs. Avoid applying lotion or oil to your skin on the day of the test (it interferes with the electrodes). Keep your hands and feet warm, as cold extremities can slow nerve conduction and make the results harder to interpret. If your hands or feet tend to run cold, warm them up before your appointment.
Continue taking all of your medications as prescribed. There's nothing you need to stop before the test.