EMG/Nerve Conduction test

[brneyedgirl40]

Hurt back-I also have pain lying down.I have constant pain that never goes away.Its just the numbness,weakness and tingling in my leg seems to be worse during walking and sitting too long.My pain seems to actually be worse at night lying down due to I cant find a comfortable positon and lucky if I get 4 hours of sleep a night.If your doctor orders a nerve study test for you be prepared.With the electrical impulses shocking me and the needles they put in my back it was not pleasant.I am a big baby though so most people dont think its really that bad.Well hope everything is going well and curious to see how your meeting goes with the case manager.Take care.

(07-08-2012 12:36 AM)hurt back Wrote:  quote]


I have lower back,hip, and left leg pain,muscle spasms,numbness,weakness and tingling in my left leg.They pain is constant and the other symptoms come and go usually when walking or sitting for long periods.

brneye - I have the exact same problem, except for sometimes even lying down in bed hurts as well. Its weird how 1 minute you are fine and the BAM, instant pain......

My current dr ( the one giving the steriod injections ) said he was going to recommend me getting a nerve study done, so we will see how that goes as well.

Well I hope all is well..

[/quote]

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Thanks!That definitely makes sense.I decided instead of stressing out about it and jumping to conclusions I need to just wait until I get the results from the doctor.I appreciate your help!

(07-08-2012 12:23 AM)AQA Wrote:  It sounds like the disc is pressing on the nerves while you are not laying down. That would be why the emg shows normal. While you are active is when the disc presses against the nerve.

Kwhite48, If memory serves me. Walmart is self insured. That can add a very serious twist to a workercompensation claim.

[heynow]

(07-06-2012 06:42 PM)brneyedgirl40 Wrote:  Its me again from Tx.I just had an EMG test done yesterday due to the doctor thought I may have nerve damage from a herniated disc.When the test was over the technician stated it doesnt look like you have an abnormal test so you probably just had a back sprain.Does this mean that even though the mri showed a herniated disc that its now just a sprain?I asked my doctor after the test and he stated he would have to wait for the report before discussing anything further.Has anyone had a normal emg and still had disc problems?Any help would be appreciated.Thanks!

You can have a herniated disc with a normal EMG. The MRI does not lie. Typically when you herniate a disc it bulges out and if it bulges out far enough it can compress the spinal nerves and spinal cord causing sciatica. Sciatica is the pain in the buttocks that runs down either one or both legs to your calves. You also have pain in your hips as well. I have two herniated discs but they are not bulged out far enough to compress any nerves. Let the doctor determine the results of the EMG.

I do have a question for you. There are two types of EMG tests in use. I had a surface EMG done which came back normal. I later had the intramuscular (needle and fine-wire) EMG which showed that I had nerve damage. Which type of EMG did you have??

[brneyedgirl40]

Heynow Thank you for responding to my post.I did have the intramuscular EMG done.I will get the results next week from my doctor.I do have the symptoms of sciatica.It states on my mri I do have a disc that bulges out 4mm which may effect the exiting of the left L4 and L5 nerve root.What treatment did you receive for your injury?

(07-10-2012 10:58 PM)heynow Wrote:  

(07-06-2012 06:42 PM)brneyedgirl40 Wrote:  Its me again from Tx.I just had an EMG test done yesterday due to the doctor thought I may have nerve damage from a herniated disc.When the test was over the technician stated it doesnt look like you have an abnormal test so you probably just had a back sprain.Does this mean that even though the mri showed a herniated disc that its now just a sprain?I asked my doctor after the test and he stated he would have to wait for the report before discussing anything further.Has anyone had a normal emg and still had disc problems?Any help would be appreciated.Thanks!

You can have a herniated disc with a normal EMG. The MRI does not lie. Typically when you herniate a disc it bulges out and if it bulges out far enough it can compress the spinal nerves and spinal cord causing sciatica. Sciatica is the pain in the buttocks that runs down either one or both legs to your calves. You also have pain in your hips as well. I have two herniated discs but they are not bulged out far enough to compress any nerves. Let the doctor determine the results of the EMG.

I do have a question for you. There are two types of EMG tests in use. I had a surface EMG done which came back normal. I later had the intramuscular (needle and fine-wire) EMG which showed that I had nerve damage. Which type of EMG did you have??

[heynow]

My back injury was from playing sports for many years. I go to a chiropractor twice a month and I do a lot of stretching that really helps for my back injury My WC injury is unrelated to my back injury and this is the injury I had the EMG done on.

One thing I learned about test results...you can have five qualified people look at the same exact test/report and still get five different opinions. I would not put much stock into what the technician thinks.

[Bayan1905]

When I first got hurt in my arm which has now turned out to be a very severe case of tennis elbow (lateral epidondelectomy) and RSD was first diagnosed and treated as a sprain. I had two MRI's, the first one showed some damage, not alot and then I had my EMG which showed carpal tunnel. I had the carpal tunnel surgery because three separate doctors said I had it, guess what it didn't help at all except it made some of the nerve damage worse. When I had my workers comp hearing to fight for the carpal tunnel surgery the head of my employers self insurance department said smugly "This is just a sprain" to which I sharply corrected her. Well, from then on they finally got the message. What I would tell you is don't let them or a single doctor tell you what your injury is. Sometimes what you think you have or what even the docs say is wrong, get another opinion, hell get two more if you can to make sure because your employer will go with whatever injury costs them the least amount of money.

[brneyedgirl40]

Bayan thank you for responding to my post.I am sorry you had such a hard time.I am sure it is frustrating to finally have the surgery approved and done only for it to make your injury worse.My goal was to have surgery and feel better but now I am not even sure if that is the solution.After reading your story and many others about surgery making injuries even worse maybe thats not the path I need to take. I will definitely follow your advice about not letting others tell me what my injury is or let them downplay the severity of it.They are not the ones feeling the pain and suffering I go through on a daily basis.Is it even an option to get 2nd and 3rd opinions on a WC injury?I had to fight forever just to get them to approve this treating doctor.Well thanks for your help.It is much appreciated!

(07-11-2012 01:52 AM)Bayan1905 Wrote:  When I first got hurt in my arm which has now turned out to be a very severe case of tennis elbow (lateral epidondelectomy) and RSD was first diagnosed and treated as a sprain. I had two MRI's, the first one showed some damage, not alot and then I had my EMG which showed carpal tunnel. I had the carpal tunnel surgery because three separate doctors said I had it, guess what it didn't help at all except it made some of the nerve damage worse. When I had my workers comp hearing to fight for the carpal tunnel surgery the head of my employers self insurance department said smugly "This is just a sprain" to which I sharply corrected her. Well, from then on they finally got the message. What I would tell you is don't let them or a single doctor tell you what your injury is. Sometimes what you think you have or what even the docs say is wrong, get another opinion, hell get two more if you can to make sure because your employer will go with whatever injury costs them the least amount of money.

[heynow]

I know a lot of people who have had back surgery to correct disc problems and are worse off because of it. I would exhaust all other avenues before deciding to go the surgery route. Back surgery is a different animal it's not like fixing an ACL tear in a knee. The insurance company can't force you to have surgery so take your time on deciding. I live in Pennsylvania and I can get as many different opinions as I want after 90 days of treatment from their doctor which I did. See if that is an option for you. I am not sure if you have a lawyer or not but it might be wise to think about it, especially when it comes to your treatment. It can't be taken lightly. A lawyer will make sure you get the care you need.

[UndercovrAngel]

Brneyedgirl,

Most technicians that do EMG/NCS testing have specialized schooling in order to do the job they do. In some cases, it is even licensed Dr's that do the testing as was my case recently with my left arm and having severe ulnar nerve damage ending in an ulnar nerve transposition on June 14th. By comparing tests I had done June 13, 2011 for the same thing, he knew right away that there was definitely a problem. When the orthopedic Dr who was to do the surgery saw the results, he apologized to me, as the damage was worse than even he suspected. He then apologized to me on the 25th of June when taking out the stitches after surgery, saying the damage was even worse then the tests showed. He has given me a 5% chance of the surgery being a success after a 6 to 12 month healing period. So don't assume the tech or who ever did your testing doesn't know what they are talking about.

And not all EMG/NCS tests have the correct results, there can be false positives as well as the opposite. It's not a perfect science. I would suggest having an MRI done with contrast to see exactly what is going on. This will show more than a regular MRI and whether there is any pressure being put on the nerves. I had one done earlier this year and it showed problems at the c4-c5-c6 that weren't clear on a regular MRI. All I need to do is quit smoking so that I can have surgery on my neck, as well as at my T7-T8 at the same time. Hard to do when you are 48 and been smoking since you were 11.

As for second opinions, in most cases, they are allowed, however you are given a short list of Dr's that work with your IC and both you and the IC must agree to the same Dr. Any opinions after that will generally have to come out of your pocket and if you win your case, you can try to get the IC to reimburse you.

Hopefully, your Dr will have more answers for you, once he has had a chance to have a good look see at the results of the testing. I noticed where you said your Dr is in the Ft Worth area. If you need another good Dr, I have a neurologist that I see in Keller that also has offices in Ft. Worth and I believe that he also accepts wc. I would be happy to send you his information. Maybe you could at least call and see if he does accept wc and get your IC to accept him for a 2nd opinion if the will allow for one.

I have been through wc here in TX and would be happy also to answer any questions that you have. If needed, and you can find another Dr willing to treat you, you are allowed a 1 time change of Dr's if you find that you don't like/agree with the treatment/answers you are getting from your current Dr. I live in Wichita Falls, but a in the Keller/DFW area 2 to 3 times a month. My next trip down will be Aug. 6 to see my ortho in Decatur and my dermatologist in DFW.

You can go to my profile to get my email addy if you want to talk in private, or look me up on facebook if you have it under Rebecca Reinwalt.

Angel ^j^

[Cycler]

PLease be aware that EMG/NCV's detect certain types of nerve damage or inflammation but not ALL types of nerve pain and so may be reported as a "negative" test. In other words the presence of significant abnormalities on EMG/NCV is positive but the absence of findings does not mean there is no injury.

The same goes for MRI and "herniations"; most abnormalities on spine MRIs are in patients who have no complaints so the mere presence of an "abnormal" disc finding is not enough to make a determination of a pain generating structure or pathology. It's is simply why people get shorter as they get older. It takes a skilled clinician to put together a;; the pieces of data and treat the patient, not the test.

(07-11-2012 11:39 PM)UndercovrAngel Wrote:  Brneyedgirl,

Most technicians that do EMG/NCS testing have specialized schooling in order to do the job they do. In some cases, it is even licensed Dr's that do the testing as was my case recently with my left arm and having severe ulnar nerve damage ending in an ulnar nerve transposition on June 14th. By comparing tests I had done June 13, 2011 for the same thing, he knew right away that there was definitely a problem. When the orthopedic Dr who was to do the surgery saw the results, he apologized to me, as the damage was worse than even he suspected. He then apologized to me on the 25th of June when taking out the stitches after surgery, saying the damage was even worse then the tests showed. He has given me a 5% chance of the surgery being a success after a 6 to 12 month healing period. So don't assume the tech or who ever did your testing doesn't know what they are talking about.

And not all EMG/NCS tests have the correct results, there can be false positives as well as the opposite. It's not a perfect science. I would suggest having an MRI done with contrast to see exactly what is going on. This will show more than a regular MRI and whether there is any pressure being put on the nerves. I had one done earlier this year and it showed problems at the c4-c5-c6 that weren't clear on a regular MRI. All I need to do is quit smoking so that I can have surgery on my neck, as well as at my T7-T8 at the same time. Hard to do when you are 48 and been smoking since you were 11.

As for second opinions, in most cases, they are allowed, however you are given a short list of Dr's that work with your IC and both you and the IC must agree to the same Dr. Any opinions after that will generally have to come out of your pocket and if you win your case, you can try to get the IC to reimburse you.

Hopefully, your Dr will have more answers for you, once he has had a chance to have a good look see at the results of the testing. I noticed where you said your Dr is in the Ft Worth area. If you need another good Dr, I have a neurologist that I see in Keller that also has offices in Ft. Worth and I believe that he also accepts wc. I would be happy to send you his information. Maybe you could at least call and see if he does accept wc and get your IC to accept him for a 2nd opinion if the will allow for one.

I have been through wc here in TX and would be happy also to answer any questions that you have. If needed, and you can find another Dr willing to treat you, you are allowed a 1 time change of Dr's if you find that you don't like/agree with the treatment/answers you are getting from your current Dr. I live in Wichita Falls, but a in the Keller/DFW area 2 to 3 times a month. My next trip down will be Aug. 6 to see my ortho in Decatur and my dermatologist in DFW.

You can go to my profile to get my email addy if you want to talk in private, or look me up on facebook if you have it under Rebecca Reinwalt.

Angel ^j^

[1171]

welcome back cycler--it's been a while.
there's been a few medical posts. we can always use your informed input.