What Is Electrodiagnostic Medicine?

Testing of the median motor nerve for Carpal Tunnel Syndrome

Electrodiagnostic Medicine is a special diagnostic skill that is performed most commonly by Physical Medicine physicians (like Dr. Faubel) and Neurologists.  These skills include performing tests such as nerve conduction studies (NCS) and electromyography (EMG).  At MOI Spine, we use the state-of-the-art Cadwell Sierra Wave machine.

Nerve Conduction Studies (NCS)

  • Electrical stimulation is applied with a probe at a particular point along a nerve.  This sends an impulse up or down a nerve and an electrode picks up that signal at another site.  The speed at which the signal travels tells us if the nerve is being entrapped (pinched) somewhere between the stimulation site and the pickup site.
  • This is used to diagnose (just a few examples):
    • Carpal Tunnel Syndrome
    • Cubital Tunnel Syndrome
    • Tarsal Tunnel Syndrome
    • Peripheral Neuropathy

Electromyography (EMG)

  • A tiny needle is inserted into various muscles to “look at” different parts of those muscles.  This checks to see if the nerve going to those muscles is normal, or if it is damaged (and where along the nerve path it is injured).
  • This is used mostly to diagnose:
    • Cervical and lumbar radiculopathy
    • If a nerve injury is new or if it is old and recovering

Important Patient Information

  • What to do the day of the test
    • Do not apply lotions or oils to your arms or legs
  • Potential adverse effects
    • Bruising: Taking anticoagulants (Plavix, Coumadin, etc) can increase your chance of bruising from the EMG testing
    • Discomfort: The small electrical shocks from NCS feels like a “funny bone” sensation.  The tiny needle can cause the muscles to cramp while they are in there, but resolves quite soon after removal.
  • How long will it take?
    • The testing can take from 30-60 minutes.
    • It may take longer if your hands/feet need to be warmed up before the testing; cold extremities can incorrectly show abnormal findings.
  • Will I have to get the needle part of the test?
    • Absolutely not.  Many times, especially when a clear diagnosis of Carpal Tunnel Syndrome, Ulnar Neuropathy, or Peripheral Neuropathy is made, EMG needle testing is rarely needed.
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