this age of advanced technology, we have many instruments and devices that measure and monitor everything from brain activity to heart rhythm changes. All this available technology is beneficial to help diagnose health issues and injuries. Medical personnel can use this information to help individuals live better lives. In the following article, we will discuss a few devices and tests that help determine the extent of muscle and nerve damage. This is especially beneficial after an auto accident or work-related injury.
No one wants to be involved in an accident, whether its in a car or at work. But if you are injured in an auto accident or experience a workers’ compensation trauma, you want to be accurately diagnosed. This information is crucial in helping your doctor determine the correct treatment you will need for recovery. We will be discussing some Electrodiagnostic testing methods which involve the EMG and NCV tests.
EMG is an abbreviation that stands for Electromyography. This is a test that determines the health of muscles and the nerves that help control them.
An EMG test measures the response a muscle has to stimulation from a nerve.
An NCV test can and usually is done at the same time as the EMG test. NCV is an abbreviation for Nerve Conduction Velocity, also known as a nerve conduction study. This test measures the health of the nerves that control the muscles.
EMG tests are done when someone shows signs and symptoms of muscle or nerve damage. Muscle and nerve damage can occur from many different causes.
The main three causes can be grouped into genetic, chemical, or physical. Some genetic causes are conditions like diabetes and thyroid disease. Chemical causes involve medications such as cholesterol-lowering medicines, antibiotics, and excessive alcohol consumption. Out of the causes mentioned, the most common cause is physical damage. These physical causes include trauma and injury which commonly occur from auto accidents and work-related injuries.
Muscle and nerve damage is considered a serious injury because they both serve important roles in the body. Muscle damage can have many signs and symptoms. One of the major symptoms is experiencing pain. The pain can range from mild to severe. Difficulty moving the muscle or increased pain with movement is another common symptom. Weakness, soreness, and bruising are also common. Nerve damage has a wide range of symptoms similar to muscle damage. Sensations in the limbs or skin that feel like prickling or tingling may occur. Muscle weakness, numbness, or paralysis is also a possibility. Uncontrollable muscle movements or twitching has been experienced as well. If you suffer from any of the symptoms listed you should discuss them with your doctor. He or she will develop a plan of action to diagnose the cause and treatment options. One of the common testing methods is the use of EMG and NCV tests.
In order to get an accurate test and, most importantly, an accurate test reading, a Neurologist that is certified by AANEM (American Association of Neuromuscular & Electrodiagnostic Medicine) should perform the testing.
Some states require doctors to have specific qualifications to perform EMG testing, and some do not. In these states that do not, any doctor can purchase an EMG machine and perform testing. This is extremely important in situations where an injury has occurred on the job or in a motor vehicle accident.
Before having the test done, review all the medications you are taking with the doctor. Some routine medications need to be stopped for a short time before the test is performed. Also, review all your medical conditions with the doctor, such as an internal medical device you may have, if you are taking any blood thinners or if you have a bleeding or clotting disorder.
Take a shower or bath prior to the test to remove any dirt and/or oils from your skin. Do not apply any lotions or creams to the skin before the test. Once you are at the testing facility they will have you change into a hospital gown and lie down on a table.
Just before the test, the doctor or technician will place electrodes on various locations on your
skin, depending on where you are having the symptoms. The electrodes will vary from surface electrodes to needle electrodes, depending on your symptoms. The surface electrodes stick to the surface of the skin and do not cause pain. This type of electrode is used to do the NCV portion of the test. The needle electrodes are small needles that are inserted into the muscle, similar to an injection. This type of electrode is used to do the EMG test.
With the needle electrodes, you will have some soreness after the test. Both types of electrodes are used as microphones. They can detect the electrical activity within the muscles and nerves. This activity is then transmitted to a monitor where it is displayed as waveforms.
The waveforms can be read and measured by trained medical professionals. When the test is underway, the surface electrodes will transmit small electrical currents that may feel like a twitch or spasm. The needle electrodes may cause slight discomfort until they are removed. They are used to determine if there is any muscle activity when the muscle is at rest. They will also determine how much activity the muscle has when slightly contracted.
During this process, the examiner may ask you to contract or relax specific muscles. They may also ask you to change your position, depending on which muscles are injured. The test itself usually lasts anywhere from 30-90 minutes.
Our body controls our muscles with nerves. The nerves send electrical signals to the muscles
during movement and at rest. The EMG test measures the electrical activity within the muscle
while it’s moving and while it is at rest. The NCV test measures the speed and effectiveness of
the electrical signal that the nerves are sending to the muscles. These measurements help the neurologist determine the damage and the extent of the damage to the muscles and nerves. These
tests can help determine if the damage was preexisting or caused by an accident or injury.
The EMG technician or doctor that is conducting the test will have a good idea of what the results are as soon as the test is finished. However, in order to get a complete and accurate result, additional measurements and calculations must be done with the information that was collected during the test. With that being said, your test results will not be ready for at least a couple of days.
Once the test results are completed they are not released directly to the patient. Normally, the results are explained at a later office visit with the testing doctor. If the testing doctor is not the doctor that requested the test to be done then the results are sent to the requesting doctor.
Once your doctor receives the results, he or she will compare the results to your symptoms and discuss the findings with you. Your doctor will take all this information and develop a plan of care for getting you back on your feet.
Once the test is completed, and the results are obtained it will show a normal or abnormal test.
Normal results mean that the muscle or muscles that were tested did not show electrical activity while at rest, also normal activity when the muscle was contracted. If the test was abnormal it will show up in two ways:
An abnormal EMG test could mean that there are muscle injuries and damage. An NCV will also show a normal or abnormal result.
A normal result means the speed and strength of the nerve signals are in a normal healthy range.
An abnormal result means the speed and strength of the nerve signals are slow and weak.
An abnormal test is an indication of nerve damage. It is also possible to have a normal NCV test and still have nerve damage. If this is the case, further testing will be needed to determine the problem with the nerve.
An EMG test is a valuable tool used by trained medical providers to diagnose problems accurately. On its own, the EMG test is not an absolutely accurate way to diagnose a problem, but when the results of the EMG test are incorporated with other relevant health information, then an accurate neuromuscular diagnosis can be determined.
If you are injured in a car accident or suffer from a work-related injury then having EMG and
NCV testing is essential. EMG and NCV tests are referred to as objective medical testing. Objective medical testing is considered the most reliable medical tests that can be performed. Having an NCV, along with the EMG test, improves the accuracy of both tests. This is very important mainly if your injuries occurred at no fault of your own.
As mentioned above, the EMG and NCV tests not only help diagnose injury but help determine the extent of the injury as well. An EMG test is not an accurate way to diagnose a problem on its own. When the results of the EMG test are incorporated with other important health information then an accurate neuromuscular diagnosis can be determined.
If you are involved in a lawsuit the EMG and NCV tests are invaluable. Having an attorney that is not only familiar with the tests but understands the language used in the results provided by the doctor. Having a competent attorney that understands how to present the EMG and NCV results to a jury or insurance agency could mean the difference in ensuring you are properly compensated
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