EMG Testing
EMG Testing
Electromyography (EMG) is a method of testing the electrical activity of muscles while they are relaxed and when they are contracting. Electrical charges are generated by muscles when they contract. When there is a problem with a muscle or the nerve that controls that muscle, changes occur in the physiology or the way they function and the electrical discharges generated by the muscles, at rest or contraction, are altered.
The EMG test provides important information about how muscles are functioning that otherwise could not be detected. Information from the EMG and other tests such as nerve conduction studies and manual muscle testing, assist in identifying reasons for symptoms such as weakness or numbness. EMG is used in various parts of the body and is often helpful in muscle diseases such as muscular dystrophy and a wide range of nervous system disorders such as carpal tunnel syndrome, ruptured discs, and more widespread neuropathic disorders. EMG requires the insertion of a thin pin to “record” the muscle’s electrical activity.
Nerve Conduction Test
The nerve conduction test is often referred to as a Nerve Conduction Velocity Study (NCV) or Nerve Conduction Study (NCS). Nerves serve many functions in our bodies. Two of the major functions are the control or activation of muscles and for your ability to feel sensations. The brain sends signals through nerves to make muscles work and the nerves carry impulses to the brain so that we can feel hot, cold, textures, pain, etc.
When nerves are healthy, they carry their impulses quickly and efficiently. Pressure, damage or diseases of the nerve cause the signals to travel differently from normal such as slower or with less power.
The nerve conduction test determines how well a nerve’s signal travels to help determine where the problem may be located and how severe it may be. Nerve conduction is most often used with other testing such as electromyography and manual muscle testing. It is used for a wide variety of nervous system disorders.
The test requires an electrical stimulus to trigger the nerve to generate its own impulse. It is that generated nerve impulse that is studied.
Carpal Tunnel Syndrome and Other Causes of Tingling
One of the greatest causes of tingling, numbness and pain in the hands is caused by Carpal Tunnel Syndrome.
Carpal Tunnel Syndrome is a very common cause of tingling and numbness in the hands. Carpal Tunnel may also cause pain in the hands. Physical Therapists who are trained in hand therapy for Hand and Nerve problems often evaluate people with these types of problems. All tingling, numbness and pain in the hands is not caused by carpal tunnel syndrome. Tingling and numbness in the hands should not be ignored. Carpal Tunnel Syndrome and other sources of tingling and numbness can be or become serious. Take a look at the list of symptoms on this page and link to more information about the different causes of tingling and numbness in the hands as well as Carpal Tunnel Syndrome. Read the signs and symptoms of Stroke and Heart Attacks by clicking on the links to the American Stroke Association and the American Heart Association because not all tingling and numbness in the hands is caused by Carpal Tunnel Syndrome.
Take a look at these symptoms and click on the one that best describes you.
If you have tingling, numbness or pain:
1. In your thumb, index (pointer) finger and middle finger, click here for carpal tunnel.
2. In the top side (nail side) of your thumb and index (pointer) finger, click here for radial nerve.
3. In your ring and little fingers, click here for ulnar nerve.
4. That starts at the side of your neck or shoulder, click here cervical disk.
5. If you're wondering who gets carpal tunnel syndrome (CTS), why CTS happens, and will it get worse if it's ignored, then look here for the answers.
6. What tests are done for CTS? Learn about EMG and nerve conduction tests.
Diabetes - Diabetic Neuropathy
If you have diabetes you are at risk for a condition called peripheral neuropathy which can cause the following symptoms: numbness, burning, tingling or decreased feeling in the hands and, very often, feet. Many times the symptoms in the hands act much like Carpal Tunnel Syndrome. Most of the time, but not always, the symptoms feel more generalized than specific fingers.
The best way to find out if it's Carpal Tunnel Syndrome or Diabetic Neuropathy is to be evaluated by a health care specialist. Your family physician or diabetes care doctor need to examine your condition. The most objective way is to have, electromyography and nerve conduction studies. These testing procedures help tell if the problem you are having is localized to the carpal tunnel or more widespread as with neuropathy. It is possible to have both neuropathy and carpal tunnel at the same time.
Diabetic Neuropathies can be serious and you should always seek medical help by your your family and/or diabetes specialist doctor. At even greater risk than a neuropathy in the hands is the neuropathy in the feet. Often the symptoms come on so slow that you don't notice the loss of feeling in the feet. This places you at great risk for serious foot and leg problems.
Electromyography (EMG) is a method of testing the electrical activity of muscles while they are relaxed and when they are contracting. Electrical charges are generated by muscles when they contract. When there is a problem with a muscle or the nerve that controls that muscle, changes occur in the physiology or the way they function and the electrical discharges generated by the muscles, at rest or contraction, are altered.
The EMG test provides important information about how muscles are functioning that otherwise could not be detected. Information from the EMG and other tests such as nerve conduction studies and manual muscle testing, assist in identifying reasons for symptoms such as weakness or numbness. EMG is used in various parts of the body and is often helpful in muscle diseases such as muscular dystrophy and a wide range of nervous system disorders such as carpal tunnel syndrome, ruptured discs, and more widespread neuropathic disorders. EMG requires the insertion of a thin pin to “record” the muscle’s electrical activity.
Nerve Conduction Test
The nerve conduction test is often referred to as a Nerve Conduction Velocity Study (NCV) or Nerve Conduction Study (NCS). Nerves serve many functions in our bodies. Two of the major functions are the control or activation of muscles and for your ability to feel sensations. The brain sends signals through nerves to make muscles work and the nerves carry impulses to the brain so that we can feel hot, cold, textures, pain, etc.
When nerves are healthy, they carry their impulses quickly and efficiently. Pressure, damage or diseases of the nerve cause the signals to travel differently from normal such as slower or with less power.
The nerve conduction test determines how well a nerve’s signal travels to help determine where the problem may be located and how severe it may be. Nerve conduction is most often used with other testing such as electromyography and manual muscle testing. It is used for a wide variety of nervous system disorders.
The test requires an electrical stimulus to trigger the nerve to generate its own impulse. It is that generated nerve impulse that is studied.
Carpal Tunnel Syndrome and Other Causes of Tingling
One of the greatest causes of tingling, numbness and pain in the hands is caused by Carpal Tunnel Syndrome.
Carpal Tunnel Syndrome is a very common cause of tingling and numbness in the hands. Carpal Tunnel may also cause pain in the hands. Physical Therapists who are trained in hand therapy for Hand and Nerve problems often evaluate people with these types of problems. All tingling, numbness and pain in the hands is not caused by carpal tunnel syndrome. Tingling and numbness in the hands should not be ignored. Carpal Tunnel Syndrome and other sources of tingling and numbness can be or become serious. Take a look at the list of symptoms on this page and link to more information about the different causes of tingling and numbness in the hands as well as Carpal Tunnel Syndrome. Read the signs and symptoms of Stroke and Heart Attacks by clicking on the links to the American Stroke Association and the American Heart Association because not all tingling and numbness in the hands is caused by Carpal Tunnel Syndrome.
Take a look at these symptoms and click on the one that best describes you.
If you have tingling, numbness or pain:
1. In your thumb, index (pointer) finger and middle finger, click here for carpal tunnel.
2. In the top side (nail side) of your thumb and index (pointer) finger, click here for radial nerve.
3. In your ring and little fingers, click here for ulnar nerve.
4. That starts at the side of your neck or shoulder, click here cervical disk.
5. If you're wondering who gets carpal tunnel syndrome (CTS), why CTS happens, and will it get worse if it's ignored, then look here for the answers.
6. What tests are done for CTS? Learn about EMG and nerve conduction tests.
Diabetes - Diabetic Neuropathy
If you have diabetes you are at risk for a condition called peripheral neuropathy which can cause the following symptoms: numbness, burning, tingling or decreased feeling in the hands and, very often, feet. Many times the symptoms in the hands act much like Carpal Tunnel Syndrome. Most of the time, but not always, the symptoms feel more generalized than specific fingers.
The best way to find out if it's Carpal Tunnel Syndrome or Diabetic Neuropathy is to be evaluated by a health care specialist. Your family physician or diabetes care doctor need to examine your condition. The most objective way is to have, electromyography and nerve conduction studies. These testing procedures help tell if the problem you are having is localized to the carpal tunnel or more widespread as with neuropathy. It is possible to have both neuropathy and carpal tunnel at the same time.
Diabetic Neuropathies can be serious and you should always seek medical help by your your family and/or diabetes specialist doctor. At even greater risk than a neuropathy in the hands is the neuropathy in the feet. Often the symptoms come on so slow that you don't notice the loss of feeling in the feet. This places you at great risk for serious foot and leg problems.
1. What does EMG/NCS stand for?
2. Why is my doctor sending me for this test?
3. Is this test painful?
4. Do I need to do anything special to prepare for this test?
5. Who is qualified to perform this exam?
6. Can you make a diagnosis based solely on this exam?
What does EMG/NCS stand for?
NCS is the abbreviation for nerve conduction study. NCS entails using a small electrical stimulus to record nerve activity. EMG is the abbreviation for needle electromyography. Needle electromyography is the study of electrical activity of the muscles and is done by inserting a small needle directly into the muscle to record the electrical activity. Surface electromyography uses electrodes placed on the surface of the skin and records non-specific electrical activity of the muscles beneath. Surface EMG is not allowed to be used in place of needle EMG in the EMG/NCS study.
Why is my doctor sending me for this test?
EMG/NCS is the "gold standard" test for evaluating nerve and muscle disease. This test can help to determine nerve damage, where it is, how bad it is and if it is old or new. Whereas an MRI creates a picture of anatomical structures, the EMG/NCS can evaluate the actual physiology and function of the nerves and muscles.
Is this test painful?
Each patient will have a different experience during this test and each test is specifically designed to address the particular problems that the patient is experiencing. Typically patients report that the test can be uncomfortable, but very tolerable. While there can be some nerves and muscles that are more sensitive than others, most patients report that the test was not as bad as they had previously assumed.
Do I need to do anything special to prepare for this test?
Patients should continue to eat and take their medications as normal. Taking pain medications will not change or "mask" the physiologic abnormalities of a damaged nerve even if they make the pain go away. Patients should avoid applying any creams, lotions or oils on the day of the exam prior to being tested. It is often helpful to wear shorts, tank tops or loose clothing to the visit to allow for easy access to the extremities. Depending on the nerves and muscles being tested, patients may need to remove additional clothing.
Who is qualified to perform this exam?
Three groups of providers typically perform this exam: Physical Therapists, Neurologists and Physiatrists (Physical Medicine and Rehabilitation). These providers are qualified to perform both the nerve conduction and needle EMG portions of the exam. Some physicians will use a technician to perform the nerve conduction portion of the exam, but the needle EMG must be performed by either a physical therapist or a physician.
Can you make a diagnosis based solely on this exam?
The medical literature is clear that a diagnosis cannot and should not be made based solely on the EMG/NCS exam. A diagnosis is made only after incorporating the patient’s history, physical examination, lab work, imaging studies, other tests, etc. Making a diagnosis based only on the findings of an EMG/NCS is inappropriate and at best poor healthcare practice.
How Our Physical Therapists Can Help
Our physical therapists are the ideal providers of nerve conduction studies and needle electromyography (NCS/EMG) because of our unique education and training. Physical therapists are considered to be the experts in evaluating musculoskeletal and neuromuscular conditions that interfere with movement and function. We can then make recommendations on your plan of care, including if you should seek specialty care from another provider. Here are some highlighted facts:
History
Physical therapists have performed NCS/EMG since the 1960's. In 1985, the American Board of Physical Therapy Specialties was the first national organization to offer voluntary board certification in NCS/EMG. Currently, there are 135 board-certified clinical electrophysiologic physical therapists in the country.
Education and Training
Graduating with at least a bachelor's degree is required to enter a physical therapy school. Most physical therapy schools are three-year graduate programs offering a Doctor of Physical Therapy degree. The basic knowledge, skills, and abilities required to perform NCS/EMG are taught in physical therapy school. Physical therapists who go onto performing NCS/EMG receive additional training under supervision from a qualified provider. It takes at least 10 years of higher education, professional school, licensure, and training to be eligible for board certification.
Patient Safety
Physical therapists who perform NCS/EMG have no malpractice claims or licensing board complaints filed in the past 50 years. Also, there are no criminal indictments or convictions of physical therapists providing NCS/EMG insurance fraud. Other providers of NCS/EMG services can't make these statements.
Regulations
Most state licensing boards allow physical therapists to perform NCS/EMG. Most insurance companies including Medicare recognize and pay physical therapists for performing NCS/EMG tests.
Quality
Physical therapists have higher rates for following the recommended NCS/EMG clinical practice guidelines as compared to physician groups.
Our physical therapists are the ideal providers of nerve conduction studies and needle electromyography (NCS/EMG) because of our unique education and training. Physical therapists are considered to be the experts in evaluating musculoskeletal and neuromuscular conditions that interfere with movement and function. We can then make recommendations on your plan of care, including if you should seek specialty care from another provider. Here are some highlighted facts:
History
Physical therapists have performed NCS/EMG since the 1960's. In 1985, the American Board of Physical Therapy Specialties was the first national organization to offer voluntary board certification in NCS/EMG. Currently, there are 135 board-certified clinical electrophysiologic physical therapists in the country.
Education and Training
Graduating with at least a bachelor's degree is required to enter a physical therapy school. Most physical therapy schools are three-year graduate programs offering a Doctor of Physical Therapy degree. The basic knowledge, skills, and abilities required to perform NCS/EMG are taught in physical therapy school. Physical therapists who go onto performing NCS/EMG receive additional training under supervision from a qualified provider. It takes at least 10 years of higher education, professional school, licensure, and training to be eligible for board certification.
Patient Safety
Physical therapists who perform NCS/EMG have no malpractice claims or licensing board complaints filed in the past 50 years. Also, there are no criminal indictments or convictions of physical therapists providing NCS/EMG insurance fraud. Other providers of NCS/EMG services can't make these statements.
Regulations
Most state licensing boards allow physical therapists to perform NCS/EMG. Most insurance companies including Medicare recognize and pay physical therapists for performing NCS/EMG tests.
Quality
Physical therapists have higher rates for following the recommended NCS/EMG clinical practice guidelines as compared to physician groups.
Telephone:
610.432.7733
610.432.7951 (fax)
610.432.7733
610.432.7951 (fax)