Wednesday, June 22, 2022

How Painful Is A Nerve Conduction Test

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Preparing For An Ncv Test

What is a Nerve Conduction Study?

Generally speaking, there is a very low risk associated with the electrical pulses used during an NCV test due to their low voltage. However, certain medical conditions can interfere with the results, including severe pain or spinal cord damage. Your provider should discuss alternatives with you if you meet these criteria or If you have permanent devices like a pacemaker installed.

If your provider clears you for an NCV test, you will not need to fast or undergo any procedures before the exam, though you may have a temperature check. You should arrive for the test in loose-fitting clothes and with as little metal on your body as possible. You may also be asked to avoid lotions or oils on the skin in advance of the test.

Any questions or concerns should be discussed with your neurologist beforehand. If you think an NCV test might be needed or you have the symptoms discussed, contact AICA Orthopedics today to meet with a neurologist. They will help to determine if an NCV test is the right form of diagnostic imaging for you and make use of our in-house test centers to begin your path towards recovery.

What Affects The Test

You may not be able to have the test, or the results may not be helpful, if:

  • You take medicines, such as muscle relaxants or anticholinergics.
  • You have bleeding, swelling, or too much fat under the skin where the nerves or muscles are being tested.
  • You aren’t able to do what is asked during the test.

What Is Emg Testing

Electromyography is a form of electrodiagnostic testing that is used to study nerve and muscle function. It is commonly performed by a physiatrist or neurologist with special training for this procedure. An EMG nerve test can provide your doctor with specific information about the extent of nerve and/or muscle injury and can also determine the exact location of injury and give some indication whether the damage is reversible.

There are actually two parts to EMG:

  • Nerve conduction study The nerves are stimulated at different points with small electric shocks, artificially activating them so their function can be measured.
  • Needle exam for muscle testing Very fine needles are inserted into several muscles. Each needle has a microscopic electrode that picks up both the normal and abnormal electrical signals given off by a muscle.
  • In most cases, your doctor will perform both elements, but in some situations, only one or the other may be done.

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    What Are The Risks Of Ncv Tests

    The voltage of the electrical pulses used during an NCV is considered verylow.

    Risks depend on your specific medical condition. Be sure to discuss anyconcerns with your healthcare provider before the procedure.

    Certain factors or conditions may interfere with the results of NCV tests.This includes damage to the spinal cord, severe pain before the test, andbody temperature.

    Tell your healthcare provider if you have a cardiac defibrillator orpacemaker, as precautions may need to be taken.

    What Should My Doctor Know About Me To Determine If I Should Have An Edx

    EMG &  Nerve Conduction Studies » Traumacare

    The doctor performing the electrodiagnostic test will ask questions about the nature of your pain, tingling and weakness. This will help them determine which nerves and muscles to test. The physician may also ask questions about other conditions which may affect the nerves and muscles, such as diabetes and thyroid problems. Your doctor should know if you have ever had a neck or back surgery.

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    Questions To Ask Your Doctor

    Making a list of questions can help you remember everything you want to ask your doctor before nerve conduction testing. Questions you may want to ask include:

    • Why do I need a nerve conduction test?

    • What information will you get from a nerve conduction test?

    • How many nerves do you need to test?

    • How long will the testing take?

    • Will you also do an EMG?

    • How and when will I get the results?

    • What other testing or procedures might I need?

    How Do I Prepare For A Nerve Conduction Test

    Nerve conduction testing does not require much preparation. Do not use oils, lotions, moisturizers, sunscreen or colognes or perfumes the day of your test. Your doctor may ask you to avoid these products for a few days before your test.

    Be sure to tell your doctor about all your medications. This includes prescriptions, over-the-counter drugs, herbal products, and supplements.

    Also, its important to know you must stay at a normal body temperature during the test. Being cold can slow nerve conduction. If you feel chilled, let your doctor know.

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    Why Do I Need An Emg Or Ncs Test

    While an MRI or X-ray of the spine can provide clues about its structure, EMG and NCS tests provide data about how the muscles and nerves function. The tests add valuable information to what your doctor already knows from your history, physical exam, and imaging scans.

    For example, during the physical exam the doctor looks for clues as to the underlying spinal problem . This structural exam is expanded by imaging tests that look inside the body at the skeleton, muscles and nerves .

    A good analogy is shopping for a used car. You first look at the cars structure: Is there any body damage or leaking oil? No matter how good it looks, you do not make an offer to buy without driving the car to test its function: How does it steer or brake? How does the engine sound?

    In a similar manner, X-ray, MRI or CT myelogram all take a look at spinal structure â the bones, discs and nerves. X-rays tell us about bony alignment or bony spurs . MRI scans show us details about disc herniation, or narrowing of the nerve canals.

    An MRI may show nerve entrapment, but it has limitations. It only shows narrowing when the MRI was taken, at one point in time. It cannot tell if the nerve was more severely pinched three weeks ago or how tightly the nerve is being pinched right now. The nerve could have been damaged with swelling, but now the swelling is less.

    What Is A Nerve Conduction Study

    Real Question: What’s a Nerve Conduction Test?

    A nerve conduction study, or NCS, is a test your doctor may use to diagnose damaged and destroyed nerves and come up with a pain relief plan. An NCS tests how fast your nerves send signals to your muscles.

    The NCS is usually done with an electromyogram , or EMG, which measures the electrical activity of your muscles. Using the information from the NCS, your doctor or another pain management specialist can help find relief for your pain symptoms.

    Both the nerve conduction study and EMG test use patches to send electricity through parts of your body. Doctors can measure the speed and strength of this electrical signal to test your nerves and muscles. They can diagnose problems you may have from the test results and recommend solutions and treatments for pain.

    Your doctor will start the nerve conduction test by putting patches on your skin. Some of these patches create a small electrical current that stimulates your nerves. Other patches measure the reaction of the nerve.

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    Undergoing A Nerve Conduction Test Is Helpful To Determine Damaged Or Dysfunctional Nerves

    The nerve conduction test is a highly valuable tool used in the medical industry. It is the nerve conduction test results interpretation that helps the neurologists determine the reason behind the disease affecting the peripheral nerves and muscles. The test is considered to be a medical boon as several nerve dysfunction, and damage related issues can be diagnosed on time and given treatment.

    Is An Emg Or Nerve Conduction Test Painful

    Your technician or doctor will make every effort to minimize any discomfort you may experience. Most patients do not experience significant discomfort or side effects.

    • Nerve conduction study: These feel like static electricity or like a rubber band slapping against your skin. You may feel your muscles twitch.
    • EMG study: You may feel some discomfort or pain when the doctor inserts the needle into the muscle.
    • Potential side effects: There may be bruising and/or soreness of the muscle for one or two days after the test.

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    Electrodiagnostic Studies Are An Extension Of Clinical Examination

    Very early on in just about every textbook or article on NCS/EMG the following two observations are made:

    • The tests do not replace a careful history and examination of the patient

    • NCS/EMG are an extension of the clinical assessment.

    These observations may seem implausible to those who do not perform these tests and view electrodiagnostic tests as a black box from which answers magically appear. However, neurophysiology is very definitely used in the same way as clinical examination to solve clinical problems, and complements the clinical evaluation rather than replacing it. In clinical examination you determine the site of the lesion by assessing the distribution of weakness, reflex changes, and sensory loss. Neurophysiologically you not only examine the distribution but also the type of abnormalities detected in the nerve conduction studies and EMG. Neurophysiology can be thought of as the clinical examination with the ability to probe nerves and muscles in a different manner.

    There are a few obvious parallels with clinical examination:

    NCS/EMG is particularly helpful in localising a peripheral nervous system deficit found on clinical examination. Thus:

    • If you cannot frame your question in anatomical terms, which is how the neurophysiologist will try to answer it, then wonder why you are ordering the test at all.

    • If you can localise the lesion with confidence on clinical examination alone, will you gain additional useful information from requesting NCS/EMG?

    What Are The Risks And Potential Complications Of A Nerve Conduction Test

    How Does EMG Testing Evaluate Nerve Damage?

    A nerve conduction test is a very low-risk procedure. There are generally no complications from the testing, aside from discomfort during the test.

    Theoretically, nerve conduction testing impulses could possibly interfere with cardiac pacemakers and implantable cardiac defibrillators. However, there is no evidence it actually causes problems in people with these devices. To be safe, make sure your doctor knows if you have one of these devices.

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    What To Expect On The Day Of Your Nerve Conduction Study

    During the nerve conduction study, the doctor will place electrode stickers on the outside of your skin to record electrical activity. This is repeated for each nerve that is tested. You might experience some discomfort for a few seconds as your nerve is stimulated. Depending on how many nerves are being tested, this procedure usually lasts between 15 minutes and an hour long.

    Electrodiagnostic Assessment Of Pregnant Women

    No known contraindications exist for performing NCS and needle EMG in pregnant patients. In addition, no complications from these procedures have been reported in the recent neurophysiology literature. Evoked response testing, likewise, has not been reported to cause any problems when performed during pregnancy .

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    What To Expect The Day Of Your Nerve Conduction Test

    In general, this is what happens the day of your nerve conduction test:

    • You will need to remove all metal accessories, such as jewelry and eyeglasses, which could interfere with the test. Clothing with metal can also interfere. You can change into a patient gown if you need to remove clothing.

    • You will be sitting or lying down for the test.

    • The will locate the nerve needing testing.

    • The doctor will place two electrodes on your skin at a specific distance apart over the nerve. One electrode sends out the signal and another one receives and records it. Using the distance, the doctor can know how fast the signal travels.

    • Activating the stimulating electrode will send a mild electrical impulse to the nerve. It can produce brief pain, and twitching. It may feel like the shock you get from static electricity. While the test can be uncomfortable, each impulse is very brief, lasting less than a millisecond.

    • Once the test is over, you should not feel any pain or discomfort.

    The total time it takes to complete the testing depends on how many nerves the doctor needs to test. It can take anywhere from 15 minutes to over an hour. If you will also have an EMG, nerve conduction testing usually occurs first.

    Discomfort During The Procedure

    electromyography nerve conduction study

    While there is little or no sensation involved with the detecting of electrical activity, the insertion of the needle itself into the muscle may cause discomfort but generally not more so than if you were receiving a shot or giving blood. The neurologist only performs one insertion at a time, and you receive advance warning and guidance for minimizing the discomfort while its happening. Depending on the muscle and extent of testing, the neurologist may need to perform several insertions over a period of time.

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    How Is It Done Or Administered

    Different doctors may perform the tests in different ways, but in general, this is how nerve conduction and EMG tests are done:

    Nerve conduction test

  • Two patches are placed on your skin. These patches will record the electrical activity of your nerves. One patch is placed near the muscle that is being studied, and another patch is placed farther away.
  • A paste or gel will be placed on your skin between the two patches. This gel helps the electricity pass between the two patches.
  • A small amount of electricity will be applied to the patch, and a machine will measure how long it takes for your nerves to respond.
  • When the nerve conduction test is finished, the gel and patches will be removed.
  • EMG test

  • You may be given a medicine to numb the area that is being tested.
  • A very thin needle with an electrode will be inserted into your muscle. A patch will be placed on your skin.
  • Your doctor will send a small amount of electricity between the electrodes. This will help measure electrical activity in your muscle.
  • You may be asked to relax your muscles for one test, and then flex them for a second test.
  • When the EMG test is finished, the needle and patch will be removed.
  • How Does The Nerve Conduction Test Results Interpretation Work

    Also referred as the NCV test or examination is used for the understanding and determining of the nerve damage. The test examines the pace of the electrical signal movement through the peripheral nerves of the human body. The nerve conduction test results interpretation can determine any damaged peripheral nerve situated outside the brain and along the spinal cord.

    It is the peripheral nerves that have control over your muscles and also aids you to experience the sense. When the nerves are healthy, they will send electrical signals more quickly and rapidly with excellent strength as compared to dysfunction or damaged nerves. The nerve conduction test results interpretation has proved to help to the doctors to distinguish between a nerve disorder and a nerve injury affecting the muscles. Making out the difference is vital because the doctor can diagnose and render the proper treatment course.

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    Pneumothorax Peritonitis And Local Nerve Injury

    Several reports document that it is possible to cause pneumothorax, the most potentially serious iatrogenic complication of needle EMG, when attempting to examine certain high risk muscles such as the diaphragm, serratus anterior, supraspinatus, rhomboids, cervical or thoracic paraspinal muscles . In the most recent paper Kassardjian et al. retrospectively found over an 18 year period a symptomatic pneumothorax caused by EMG examination in 7 patients out of 64,490 patients, who had undergone EMG evaluation of 71,782 high risk muscles. Pneumothorax became apparent within 1 h in 6/7 patients and in 1 patient after 24 h. Overall the complication frequency is therefore rare but dependent up on the target muscle. The highest risk was for the serratus anterior muscle with about 1/200 examinations and less than 1/500 for the diaphragm . These figures are in agreement with previous assessments of fewer patients .

    A potentially hazardous penetration of the peritoneum during chest wall or abdominal musculature by needle EMG examination might theoretically lead to peritonitis, although we are not aware of any reported cases.

    Electromyography And Nerve Conduction Study

    Nerve Conduction Velocity Screening available at ...

    Electromyography and nerve conduction studies can diagnose muscle and nerve issues that may be otherwise difficult to diagnose.

    Electromyography and nerve conduction studies can diagnose muscle and nerve issues that may be otherwise difficult to diagnose.

    Electromyography and nerve conduction studies can diagnose muscle and nerve issues that may be otherwise difficult to diagnose.

    Nerves and muscles naturally produce electricity. An electromyography and nerve conduction study measures the electrical activity created by your muscles and nerves to determine if they are healthy.

    Some nerve and muscle issues may be difficult to diagnose. Often, a physical exam and/or blood tests alone cannot provide a diagnosis. An EMG and nerve conduction study can help.

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    Why Is An Emg Test Done

      An EMG is often performed when patients have unexplained muscle weakness. The EMG helps to distinguish between muscle conditions in which the problem begins in the muscle and muscle weakness due to nerve disorders. The EMG can also be used to detect true weakness, as opposed to weakness from reduced use because of pain or lack of motivation. EMGs can also be used to isolate the level of nerve irritation or injury.

      How To Prepare For The Test

      You must stay at a normal body temperature. Being too cold alters nerve conduction and can give false results.

      Tell your doctor if you have a cardiac defibrillator or pacemaker, or other implanted device such as a deep brain stimulator. Special steps may need to be taken before the test if you have one of these devices.

      Do not wear any lotions, sunscreen, perfume, or moisturizer on your body on the day of the test.

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