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EMG test - was it done correctly?

TWHladyinLVTTWHladyinLV Posts: 47
I had a EMG test done last week. I didn't really know what to expect so I wasn't nervous.
The tech did the surface part of the test with electric shock on different areas of my legs. Several spots I didn't feel much and others I felt quite a bit more.
Fine. So then the MD comes in and does the other part of the test. First just a pinprick test on the top of my feet, then the straight leg lift asking me to push/pull my foot against his hand. No more in-depth questioning than that. Then the needle stick part of the EMG test on my legs-thighs, calves and lower back. He stuck the needle in, looked at the computer screen, removed the needle and went on to the next spot. He did not ask me to flex my muscles or anything like I read most people have done with them.
When he stuck the needle in I was looking at the screen and the noise was very loud and static sounding along with the waves on the screen extremely erratic.
My question is did I get short changed or did the MD see what he needed to see that fast and didn't need to go further?
Also he did not give me any feedback on what he saw so I am at a loss till I see my own MD again


  • Done correctly or not? Hard one to answer as it all depends on "what" specifically they were looking for. Mine was similar to yours except the Neurologist did the whole exam.

    From what I was told during the test (my doctor was a talker), when he had my thigh for instance at rest, there was suppose to be minimal 'noise' shortly after the needle went in - some areas were, some were not. When he did my calf, I was instructed to flex my toes up and towards me, then push my foot against his hand. When he worked in a couple of areas of my thigh, I was told to point my toes and tighten my thigh. Other times he moved my leg around to test whatever he was wanting to test. Most of mine was the foot, ankle, upper calf, front of thighs and abeam my lumbar spine. He also gave me a 'short' discussion on what he found.

    I hope this helps.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi Aviatrix!
    They are trying to access nerve damage because I am having foot drop and leg weakness on the left side
  • TWH, Howdy! :)

    Looks like we share the L2/3! Me L2/3/4 but the roots affected are L2&3. Did they tell you when your report will be ready? You said you were also stuck in the back - that would be checking the paraspinal nerves in those muscles. I'm not sure how those translate into the whole picture, but mine along the L3 were bad, the rest where either "unremarkable" or (and I think this is not good) reduced recruitment. <-- Had a lot of that reduced stuff.

    I hope they get the report to your doctor soon. If it doesn't match, then give your doctor your concerns, as the test is only as good as the person tech/doctor conducting it. Please let us know how it goes. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • When my test was done the girl doing my test (the shock part) was having trouble around my ankle, foot, area and had to call the older woman in to help in placement. I questioned her in how much schooling in took to be a tech to do her job and she informed me that "No, I didn't need any college or tech school for this training, I was hired off the street and they train you as you go." She finished with me and sent in the MD who started with my right leg with the needle part then stopped and told me he was done and I could get dressed. I asked about my left leg as that was the side that I was having the problems with. He got a weird look on his face, looked at the paperwork, and told me "It's your lucky day, you get a 2 for 1 ". I was upset needless to say. I did not have much faith in the test and was not surprised when the test came back with no problems. Right, that is why I am in constant burning pain with numb spots and have lost some leg.
  • Based on what you said about the "probe" portion, part of me isn't surprised. The lady (mid 20's??)in my former Neurologists office didn't seem to be the sharpest pencil in the box as they say! I've since switched to an office where the Neuro does the test. :) I hope you went to another facility for a full test?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • >:D<

    Hi Ladys!

    Well, the Neuro did the part with the needle, a guy tech did the other part. When the doc placed the needle I made sure I had my muscle relaxed. I'm not needle shy from working around them all my career in the Medical field. The research I have done so far says that after needle placement the muscle should calm and the screen should show a flatline. Then as the MD asks the pt to move the muscle the line on the screen jumps to whatever the electrical impulse indicates is happening in the muscle. The report went on to say that a highly erratic line indicates nerve damage a low line indicates more muscle damage?
    Is that what you guys have heard?
    When he did my needle tests the line was all over the place, and he said, "Well!" or "Hummm!", each time before going onto the other sites. He placed the needles in my thigh just above the knee, calf (not sure what side), down around the ankle, and lower back.
    Aviatrix, what did you mean when you said the MD was checking out an area on my lower back for? Can you say it again in Layman's terms? :} Thanks Bunches! Hugs!
    I'll know at my appointment on Thursday what he reported. Probably like everyone else it will be "normal" and I'm still in horrible pain. The worst part has been pain and numbness in my left hip, knee and ankle. I feel like my joints are all wobbly and I have fallen down several times. I haven't lost complete control of my bladder yet, but leak all the time and can't feel it either. Then the foot drop issue is being addressed by a special brace for that ankle (getting it fitted omorrow).
    I have terrible problems taking any medication in the anti-inflammatory family, and Lortab and Soma aren't cutting it. I'm going to ask if I can increase my Lyrica and Tramadol to help with the pain so I might avoid having to increase the Lortab dose.
    My atty wants me to try to get my neck injury case opened, so I have to bring that up on Thursday too.
    If I am having muscle spasms up in the high thorasic area, does that mean I'm having issues there too? My MD tried to get the insurance Co to approve an MRI of the thorasic spine too, to compare it with the last one, but they would not. I;ve been having a marked increase in difficulty breathing lately too. (Another problem)! I need to know if I should petition to have the claim modified. I only have till October 14 to do it. Going to bed, night! night! I)
  • I'm not sure what you mean by reduced recruitment? Please enlighten me!
    I will certainly tell them ALL if the MD looks like he was lame, and didn't do his job.
  • Here is an excerpt of a flyer I was given with my report. My final was chronic moderate Neuropathy in both legs, severe Ulnar Neuropathy through my right arm. Additional to it, it found (and I haven't seen these on a scan!) Upper Motor Neuron Lesions affecting the C5-8 levels. Basically in a nutshell reduced recruitment = nerve problems (disorders). I just re-looked at my EMG report, and found another area labeled "diminished" recruitment - I'm gonna go look that up (not on my flyer) to see if that is different, or just a difference in how the same issue is labeled! (G) I hope this helps. :) See quote of my flyer below....I marked in bold the reduced recruitment assessment.

    "There should be some brief EMG activity during needle insertion. This activity may be increased in diseases of the nerve and decreased in long-standing muscle disorders where muscle tissue is replaced by fibrous tissue or fat. Muscle tissue normally shows no EMG activity when at rest or when moved passively by the examiner. When the patient actively contracts the muscle, spikes (motor unit action potentials) should appear on the recording screen, reflecting the electrical activity within. As the muscle is contracted more forcefully, more groups of muscle fibers are recruited or activated, causing more EMG activity.

    Electrical activity at rest is abnormal; the particular pattern of firing may indicate denervation (for example, a nerve lesion, radiculopathy, or lower motor neuron degeneration), myotonia, or inflammatory myopathy.

    Decreases in the amplitude and duration of spikes are associated with muscle diseases, which also show faster recruitment of other muscle fibers to compensate for weakness. Recruitment is reduced in nerve disorders."

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • TWH,

    There is a moderator on here (Dave) who knows this stuff tons better than I, but here is my layman's understanding of the tests on the back.

    Paraspinal muscles are on each side of your spine, and nerves of course run through them. They support the spine and are the motor for movement of the spine. If nerve information is not getting to them, or not properly, you can have issues with spine support. Depending on the readings in those muscles, it can also rule in or out stenosis (taken from my report). Personally I am not fully sold on EMG's, as they are only as good at the person conducting the test, plus not all of us are 'wired' the same way. Hope this helps. :)

    Forgot to mention, for me only the Neurologist is allowed to stick me! One of my first NVC/EMG's a tech did the whole thing, waaaayyyy off the beaten path of what was going on! My NS didn't buy the results, sent me to another Neurologist (who conducted the test), and though not as bad as my NS thought, it at least matched the areas suspected! Since then, ONLY the Neuro does the needle part with me. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I will definetly do some homework and find who has the good rep of doing good reports and findings. That has a well established staff with best technology and equipment available. They are not the most pleasant test to go through and I understand that they are not super accurate account anyway. I am one of those people that needs a reason as to why I have all my pain and problems. Not a generalization, but a diagnosis for my peace of mind. I know I have 3 bulging disc, even after a discetemony for a herniated one and another he shaved at the same time. So 3 more bulges, Epidural Fibrosis, Some Stenonsis, Some Arthritis. The way I hurt feels more like I have that Adhesive Arandoditis. I have a lot of little things that paint the bigger picture. I already am being treated the same medically as if I had it but I don't have the diagnosis. Right now people look at you and say "Oh yeah, you have some back problems, So and So had them and went bact to work in 6 wks and plays golf and yada yada yada" If I could say I have SSSSSYYYYYY and this is the only treatment or cure and it is likened to having XXXXCCCCC. I do the best I can with it and I try to stay ahead of it when I can for as long as I can. Then maybe mentally a diagnosis would help me some, something I could wrap my mind around and understand. Sorry so long.
  • Well,
    My MD says I'm normal?? I asked him about why the Neuro did the test that way, he said,"I don't know anything about doing the test, I just look at the report". :
    He says he thinks my issues are caused by MS which is very prevalent in my immediate family.
    I had an MRI done of my brain about 2 years ago that did not show any lesions.
    Then he says I can't have any more pain pills . He knows I have a rough time with anti inflamatory drugs as they make me swell up and I get jaundice. Without pain meds I'm SOL.
    I'll go see my PCP about getting a referral to another Neuro MD for MS tests but that will take a while. In the meantime I will see a PT for the back issues.
    It wouldn't be so bad except for the problems walking, balance, hand-drop, finger-drop, etc. I can't sleep more than 2 hours at a time, even with all the meds. The doc is sympathetic but says he can't do anything because the MRI's just don't show the damage to fit the pain I am having.
    I told him I could not go back to my present job full-duty. Plus I'm still looking at foot surgery that is unrelated to the back thing. The foot MD says that surgery will take at least 2-3 months to heal properly. I'm already past my FMLA, so there goes my job I have had for 33 years.
  • On top of it all I just got diagnosed as Hypothyroid and Narcolepsy! Other than that I'm the picture of health! 
  • You are certainly going through alot right now and my heart goes out to you. I do not understand with the issues you have how he can all of a sudden cut your pain meds. Even and I don't say that lightly if it turns out to be MS isn't that a very painful disease? In addition, it is going to take such a long time for you to be tested. Just because an EMG did not show what the dr. thinks it should have it seems by looking at your history that you would be in pain. And then having your job on the line at the same time. Not only are you fighting physical issues but very emotional ones at the same time. I would seek 2nd and 3rd opinions if necessary. No one should have to go through this. You will most certainly be in my thoughts and prayers.
  • It means a lot to me to be able to communicate to people who know what I am going through.
    I sent a fax to the Atty who is supposed to be representing me and I never heard back from her either! I told her the issues with the MD and that I wanted a different opinion. I'll be calling her back on Monday as well.
    I guess I'll go to the quick care today and see if it is an infection or not.
  • hey guys I had a 360 spinal fusion about 2 months ago and have been having double leg pain from the back to hips down I went to a neurologist and everything went fine in my legs but when they stuck the needles in my back they said that something wasn't right so they referred me back to my back doctor who's telling me since my blood pressure isn't high enough that I shouldn't be having pain cuz there's no explanation for it I know what I'm feeling and it is pain constant standing makes it worse sitting in a chair position makes it worse I don't get a good night's sleep and I don't want to be on pain meds the rest of my life but I want to know what's going on what could be affecting both of my legs after a spinal surgery that was done for sciatica and spondyletheosis (sorry about spelling) anybody have any clue what this could be or anyone going thru the samething...i feel like my doctor doesnt believe
  • itsautonomicitsautonomic LouisianaPosts: 1,806
    EMG can be very subjective , I was told by my neuromuscular specialist that just the difference in warming the hands arms or not can impact the test and each dr does it a bit different. Ive had 6-7 last 3 years and each was different and some said one thing that the other did not.
    They thought I had MS to early on, was damage to spinal cord turning into neurological condition. Address the hypothyroid as it has its own set of issues. Another thing a B6 toxicity can cause MS like symptoms, don't know if take supplements.
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
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