Raise your hand if you’ve got a bad shoulder (badum ching!). Yup, me too. Although I had surgery to repair it a year ago, I’ve had some lingering problems.
Since physical therapy (PT) hasn’t resolved the functionality problems with that arm, my primary care manager (PCM) ordered some diagnostic medical procedures to try to determine what’s causing the problems. One of the procedures that was ordered was an electromyography.
“Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets…EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.”
In my case, they were trying to determine whether a pinched nerve in my neck was causing the problems with my arm.
Electromyography is an outpatient procedure that typically takes about an hour. EMG is often done in conjunction with a nerve conduction study (NCS), which I also had. NCS is the measurement of “the speed of conduction of an electrical impulse through a nerve. NCS can determine nerve damage and destruction” (Johns Hopkins).
According to WebMD,
“Nerve conduction studies are done before an EMG if both tests are being done. Nerve conduction tests may take from 15 minutes to 1 hour or more, depending on how many nerves and muscles are studied.”
Since they were going to need access to my arm and shoulder (and trapezius, as it turned out), I wore a track suit with a tank top underneath. They asked me to take off the track suit jacket and lie down on an examining table.
To prepare for the NCS, the person administering the
torture procedure asked me to move my fingers, hand, and arm in several different directions so she could determine her targets. These she marked on my arm with a marking pen. She fastened several electrodes to my hand and fingers with tape (see picture below), and proceeded to zap me with a machine that looked like a taser (but used less voltage, obviously).
This is not a pleasant sensation. It typically wasn’t too painful, except when she applied multiple shocks in the same location. The second or third consecutive shock in the same spot became more and more painful. For the most part, she told me what she was going to do before she did it, which helped me prepare. When she told me she needed to do 10 shocks in the same place, I knew two things: 1) It was going to hurt like hell, and 2) I’d better do the stress management/relaxation breathing techniques I learned at the base Wellness Center.
Breathing techniques, whether learned through biofeedback training or as part of yoga or meditation can be very helpful for managing pain or stress. I use them whenever I am having an uncomfortable/painful/stressful medical procedure. Of course, in this case, relaxing was a bit more challenging, since my body was also jerking from the shocks. For some of the shocks, only my hand/wrist twitched. But for some of them, my opposite leg jumped. Several times I got a cramp in my arm muscles, and toward the end, I got a cramp in the muscles in my lower back.
That was part one. Part two was the EMG. “During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle” (Mayo Clinic).
The needle is inserted into various muscles. It didn’t hurt most of the times it was inserted, since it is a very fine needle. It did hurt when it was inserted into the trapezius muscle. Once it is inserted, the doctor taps on the needle, and sometimes moves it around inside the muscle as she listens to the signal. As you can imagine, this doesn’t feel very good. Then she asks you to engage the muscle. You can hear an increase in signal noise while you are engaging the muscle. This also doesn’t feel very good, as the needle feels like it is stabbing you more.
These tests may be done only on one side of your body (one arm, one leg, etc.), or they may be done on both sides of your body in order to compare results. In this case, they only tested the problematic arm, not both, and the doctors were able to give me my results at the end of the procedures.
The good news is they didn’t see any evidence that I have a pinched nerve in my neck. The bad news is that these diagnostic procedures didn’t help determine the cause of the problems with my arm.
After the tests: I had one righteous bruise, and I was tired for the rest of the day.
“After the [EMG], you may be sore and have a tingling feeling in your muscles for up to 2 days. If your pain gets worse or you have swelling, tenderness, or pus at any of the needle sites, call your doctor.”
“If you still have pain after the [NCS]:
- Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
- Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.”