ELECTROMYOGRAPHY (EMG) AND NERVE CONDUCTION STUDIES
Electromyogram, commonly referred to as an EMG, is an electrical study of muscle. It is a type of electrodiagnostic testing used to help determine if there is evidence of nerve or muscle injury contributing to your symptoms. The spinal cord is a thick bundle of nerves and other tissue that extends from the brain through the spinal column. As the spinal cord descends, there are spinal nerves that branch off and go to various parts of the body. It is very important to be able to evaluate the nerves when dealing with spinal problems or other musculoskeletal issues. Specialized nerve tests called Electromyography and Nerve Conduction Studies are designed to diagnose abnormalities in the functioning of nerves.
The EMG test helps to clarify the cause of symptoms by confirming any nerve or muscle damage. This is especially helpful when exam findings or other diagnostic tests are not clear. Electrodiagnostic testing cannot tell you the cause of nerve or muscle damage, it only confirms details of the damage.
HOW DOES THE NERVOUS SYSTEM FUNCTION?
The nervous system includes the brain, the spinal cord, and all the connections from the spinal cord to the muscles. It works like an electric circuit. The brain thinks and plans an action, such as lifting your foot to walk. Planning this move generates an electric signal that travels to the spinal cord. The spinal cord works like a switchboard, and its job is to direct this signal to the muscles needed to lift your foot.
The signal travels out of the spinal cord through the nerve roots, which then bundle together to form plexuses before emerging in the arms and legs as smaller nerves. In this example, the nerves in the leg directly pass the electric signal to the muscles that lift your foot, and the process planned in your brain finally happens. While it seems like a long way for a signal to travel, the time between thinking about lifting your foot and seeing your foot leave the ground is almost none—unless there is a problem somewhere in the nervous system.
WHY DO I NEED AN EMG? WHAT IS AN EMG TEST USED TO DIAGNOSE?
Let’s say that you cannot lift your foot off the ground regardless of how much you think it. Is this weakness due to a problem with the brain? Is it the spinal cord? Nerve root? Plexus? Nerve in your leg? Muscles in your leg? An EMG can help us answer those questions.
WHICH CONDITIONS DOES AN EMG HELP TO DIAGNOSE:
• Cervical radiculopathy
• Lumbar radiculopathy
• Peripheral neuropathy
• Carpal tunnel syndrome
• Cubital tunnel syndrome
• Myasthenia gravis
• Myopathy/myositis
HOW IS AN EMG PERFORMED?
An EMG is a two-part procedure:
• The first part, the nerve conduction studies, tells us about the health of the nerves in the extremities. We mimic the electric signal from your spinal cord with a small stimulus at one part of the nerve and record that impulse at another part of the nerve or at a muscle supplied by that nerve. This part tells us if the individual nerve is conducting that electric signal properly. What you will feel when we stimulate is a small sensation that goes down the arm or leg.
• The second part, electromyography (EMG), involves placing a small needle with a microphone into several of your muscles. We listen to the muscles while they are resting and while they are active. This part tells us if the muscles are injured, and the pattern of injured muscles can determine if the problem is in the nerve in the extremity, the nerve root, the nerve plexus, or the muscles. You may feel discomfort with the needle in your muscles. This sensation tends to be similar to acupuncture or dry needling.
Taken together, these tests can tell us where in the nervous system the signal is interrupted on the way from the brain to the muscles in your hand or foot.
HOW LONG DOES AN EMG TAKE?
An EMG can last anywhere from 30-90 minutes, depending on what question we are trying to answer. Based on what we are finding, sometimes we may have to add a couple extra nerves or muscles, which may make the test last longer.
HOW DO I PREPARE FOR AN EMG?
On the day of your test you may still wash your skin with soap and water, but do not rub any topical lotions or oils on the arms or legs that are being tested. We will be placing sticky electrodes on your skin, and lotion may cause them to slip off rather than stick. Also, if you are prone to having cold hands or feet, try to wear warm gloves or socks on the day of your test.
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Wesleyan University, University of Kansas School of Medicine, University of Florida, Dartmouth Institute
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Lewis J. Dorrance's life journey took him from the vibrant landscapes of Nairobi, Kenya, to an overseas upbringing until his teenage years, when the United States became his new home.
His academic pursuits led him to the University of North Carolina Chapel Hill, where he immersed himself in English and art before delving into the world of healthcare at Duke University.
Dr. Schapiro utilizes advanced cartilage and joint preserving techniques and minimally invasive procedures to get men and women back to the active lifestyle hat they enjoy.
He has extensive training in orthopaedic traumatology and management of extremity trauma and fractures as well as additional training in cartilage preserving procedures such as platelet rich plasma gel techniques and harvesting of adult autologous stem cells to treat a multitude of orthopaedic conditions.
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Dr. Valenzuela is committed to outstanding clinical care and strives to provide the most advanced operative and non-operative treatment of injury related orthopedic and sports medicine conditions with an emphasis on elimination of pain, joint preservation, and restoration of function to safely allow patients to return to daily activities as soon as possible.
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Throughout his career, Caracciolo has been an active member of prestigious professional organizations, including the American Academy of Physician Assistants and the Florida Academy of Physician Assistants.
Dr. Alberto de Arrigoitia is an established Chiropractor with over 25 years of experience. Dr. Al began his college career at the University of South, graduating with a B.S. in Microbiology. The following year he embarked on an internship at Florida Hospital in Clinical Laboratory. After several years of practicing as a Medical Technologist in Central Florida he entered Logan College of Chiropractic; graduating the class of 1997. Since graduating he has practiced at several different locations throughout the state of Florida.
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Dr. Dale Hanson has been providing chiropractic care in Tampa, Florida, for over 17 years, serving local residents, athletes, and injury victims seeking a natural approach to pain relief without harmful medications. He specializes in treating auto accident and personal injury victims through a multidisciplinary approach, including Physical Therapy, Chiropractic Adjustments, diagnostic imaging, and collaboration with Orthopedic and Neurosurgeons to restore health and vitality.
Dr. Ralph E. Joyner is a Chiropractor in Winter Haven, FL with special training and skill in applying chiropractic healing methods to provide relief for dysfunctions of the neck, spine, musculoskeletal, and nervous system. As a Chiropractor, Ralph E. Joyner, DC, MS performs spine manipulation (also called chiropractic adjustment) to improve your overall physical health. Chiropractic is a medical specialty dedicated to practicing non-surgical healing techniques to reduce patient pain while improving mobility.
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