Electromyography

[sneha1965]

Has anyone here every had it? Just looking to know what to expect.

[MatticusMania]

From wiki:

Procedure:
There are two kinds of EMG in widespread use: surface EMG and intramuscular (needle and fine-wire) EMG. To perform intramuscular EMG, a needle electrode or a needle containing two fine-wire electrodes is inserted through the skin into the muscle tissue. A trained professional (such as a neurologist, physiatrist, chiropractor, or physical therapist) observes the electrical activity while inserting the electrode. Certain states limit the performance of needle EMG by nonphysicians including a recent case in New Jersey stating it cannot be delegated to a physician's assistant.[5][6][7] The insertional activity provides valuable information about the state of the muscle and its innervating nerve. Normal muscles at rest make certain, normal electrical signals when the needle is inserted into them. Then the electrical activity when the muscle is at rest is studied. Abnormal spontaneous activity might indicate some nerve and/or muscle damage. Then the patient is asked to contract the muscle smoothly. The shape, size, and frequency of the resulting electrical signals are judged. Then the electrode is retracted a few millimetres, and again the activity is analyzed until at least 10–20 motor units have been collected. Each electrode track gives only a very local picture of the activity of the whole muscle. Because skeletal muscles differ in the inner structure, the electrode has to be placed at various locations to obtain an accurate study.

Intramuscular EMG may be considered too invasive or unnecessary in some cases. Instead, a surface electrode may be used to monitor the general picture of muscle activation, as opposed to the activity of only a few fibres as observed using an intramuscular EMG. This technique is used in a number of settings; for example, in the physiotherapy clinic, muscle activation is monitored using surface EMG and patients have an auditory or visual stimulus to help them know when they are activating the muscle (biofeedback).

A motor unit is defined as one motor neuron and all of the muscle fibers it innervates. When a motor unit fires, the impulse (called an action potential) is carried down the motor neuron to the muscle. The area where the nerve contacts the muscle is called the neuromuscular junction, or the motor end plate. After the action potential is transmitted across the neuromuscular junction, an action potential is elicited in all of the innervated muscle fibers of that particular motor unit. The sum of all this electrical activity is known as a motor unit action potential (MUAP). This electrophysiologic activity from multiple motor units is the signal typically evaluated during an EMG. The composition of the motor unit, the number of muscle fibres per motor unit, the metabolic type of muscle fibres and many other factors affect the shape of the motor unit potentials in the myogram.

Nerve conduction testing is also often done at the same time as an EMG to diagnose neurological diseases.

Some patients can find the procedure somewhat painful, whereas others experience only a small amount of discomfort when the needle is inserted. The muscle or muscles being tested may be slightly sore for a day or two after the procedure.

[sneha1965]

I have read that and it does not sound fun. Hopefully someone who has had this procedure will chime in. I'd be curious to know on the 1-10 scale of how uncomfortable this is.

[MatticusMania]

Originally Posted by sneha1965

I have read that and it does not sound fun. Hopefully someone who has had this procedure will chime in. I'd be curious to know on the 1-10 scale of how uncomfortable this is.

Yeah, sorry I couldnt give you more info. Having never had one I wouldnt know how uncomfortable it is. Good luck, sneha!

[sneha1965]

Thanks man, it's definitely not something I'm looking forward to.

[buzzbass]

what happened ? why do you need this ?

[sneha1965]

I injured my back. I have a herniated disc on the right side but all of the pain is on the left side of my body.

[1958Bassman]

Originally Posted by sneha1965

I injured my back. I have a herniated disc on the right side but all of the pain is on the left side of my body.

Subluxation? The disc may have moved to the damaged side and is pinching the nerves on the left.

Good luck- how bad is the damage?

[sneha1965]

I've been in PT for the past two months and have regained the ability to walk without limping and I am able to walk up stairs again. Nice to have that back since I have stairs where I live. However, I still have pain and need meds to get through the day. For the most part they help but it is not like being 100%. My goal is to have reduced the pain enough to travel for the holidays.

[buzzbass]

Originally Posted by sneha1965

I injured my back. I have a herniated disc on the right side but all of the pain is on the left side of my body.

I have 2 myself. sucks sometimes. Is this considered diagnostic, or treatment ? Let us know how you make out. I see the ortho tomorrow myself. I fear I may have torn a tricep in the gym this week. Good luck with your procedure.

[sneha1965]

Originally Posted by buzzbass

I have 2 myself. sucks sometimes. Is this considered diagnostic, or treatment ? Let us know how you make out. I see the ortho tomorrow myself. I fear I may have torn a tricep in the gym this week. Good luck with your procedure.

Thank you and good luck with yours as well.

At this point they are still trying to diagnose.

[Rip Topaz]

Originally Posted by sneha1965

I have read that and it does not sound fun. Hopefully someone who has had this procedure will chime in. I'd be curious to know on the 1-10 scale of how uncomfortable this is.

I've had it done. It wasn't horrible but it did suck. Think happy thoughts. It's over pretty quick. Probably a 7 on the pain scale.

[sneha1965]

How deep did they put the needles in?

[Rip Topaz]

Originally Posted by sneha1965

How deep did they put the needles in?

About a half inch. It's a very thin needle.

[Marial]

Have they MRIed you yet? That was what allowed me to have surgery to repair a blown L4/L5 disc. I was bent over for a year with searing pain in my left leg from an impinged S1 nerve because the first MRI was inconclusive and the first surgeon I went to decided I should wait for twelve months to see if it would repair itself. PT, acupuncture, chiro, cupping, I did it all. After my second MRI a different neurologist took one look and asked me when I'd be available for surgery. I still get spasms and have to be careful, but it gave me a completely new lease on life.

Anyhow, the needles aren't pleasant but they're certainly not intolerable. Depending on your tolerance for pain it can vary from a 3 or 4 out of 10 or maaaaybe up to a 6.

[Rip Topaz]

Originally Posted by Marial

Have they MRIed you yet? That was what allowed me to have surgery to repair a blown L4/L5 disc. I was bent over for a year with searing pain in my left leg from an impinged S1 nerve because the first MRI was inconclusive and the first surgeon I went to decided I should wait for twelve months to see if it would repair itself. PT, acupuncture, chiro, cupping, I did it all. After my second MRI a different neurologist took one look and asked me when I'd be available for surgery. I still get spasms and have to be careful, but it gave me a completely new lease on life.

Anyhow, the needles aren't pleasant but they're certainly not intolerable. Depending on your tolerance for pain it can vary from a 3 or 4 out of 10 or maaaaybe up to a 6.

I'm done with MRIs. I've had a fusion done at L5/S1, and they botched it, leaving me in constant pain.

After the botched fusion, they did acupuncture, which now when the pain is at it's worst I can still feel every needle.

After acupuncture proved pointless, they implanted a Spinal Cord Stimulator. I've had nothing but problems with it since it was implanted. I'm having surgery on January 16th to remove it.

After the stim is removed, the plan is to look closer at the discs above the first fusion. The new surgeon I'm seeing (a total fiasco caused me to change doctors) thinks that I've blown out two more discs above the original fusion.

My daily diet consists of high levels of OxyContin and Gabapentin, along with some extra help from Mother Nature.

[Marial]

Wow, I'm so sorry to hear that. They didn't fuse me, they did a laparectomy (sp?) and essentially burned away the part of the disc that was impinging the nerve. I lost a bit of the disc and a tiny part of the vertebra but when I woke up my leg didn't hurt anymore.

[Rip Topaz]

Originally Posted by Marial

Wow, I'm so sorry to hear that. They didn't fuse me, they did a laparectomy (sp?) and essentially burned away the part of the disc that was impinging the nerve. I lost a bit of the disc and a tiny part of the vertebra but when I woke up my leg didn't hurt anymore.

I thought they had fixed the problem at first, but when I came off the pain meds from the surgery, the pain returned so bad that most days I can't even walk.
Hopefully this new group will find the real problem and fix it.

[sneha1965]

I'm sorry to hear that. I hope there is some way to get you back to we're yoy're not living in pain 24/7.

[Rip Topaz]

Originally Posted by sneha1965

I'm sorry to hear that. I hope there is some way to get you back to we're yoy're not living in pain 24/7.

Thanks. I've already been told to expect to always be on some form of pain med. the damage done by the first fusion caused some permanent nerve damage. They've already told me that any relief is success, but don't expect to ever be pain free.

Back on topic, the test is big deal. If they say discogram, however, frickin RUN!