X-Ray and MRI examinations are always complementary to EMG-NCV examinations, since they give separate windows into any particular patient’s problems. MRI, on the other hand, is taken in the supine or lying position, and shows soft tissues, like muscles, tendons, ligaments, and discs much better than X-Rays. After all, doctors should treat patients, not just their tests.ĮMG for back pain and leg pain, or for neck pain and arm pain, helps to get the last 15-20% of certainty about the location of nerve injury, and when coupled with appropriate imaging testing, like X-Ray and MRI studies, allows the doctor to find out the exact cause of pain and injury to the nervous system.įor instance, appropriate X-Rays in the lying and standing with bending positions allows the doctor to see whether spinal instability caused by congenital defects and trauma is contributing to a patient’s problems. This same approach, of correlation of imaging studies like X-Ray and MRI, with a patient’s history and exam is also crucial for patient care, but this is covered elsewhere. The examining physician must check reflexes and muscle strength in different areas of the body, to determine exactly which muscles and nerves or nerve roots need to be tested.
Since both the EMG and NCV tests can be a little uncomfortable, it is important that they be carried out by a specially certified physician, so that only the necessary nerves are stimulated and tested to get to the bottom of the problem.Īs in all cases, this testing must be carefully correlated with a patient’s clinical history and neurologic examination. The EMG is always coupled with nerve conduction testing (NCV) to test the electrical conduction of specific nerves. This test is called an EMG, which stands for Electromyogram.Īn EMG is done by inserting tiny pin electrodes into certain muscles whose exact electrical connections are known.
But to be as sure as we can be, and since nerves and nerve roots are “electrical” circuits by their very nature, an electrical test is usually done to test those circuits. In the exam room, a neurologist can be about 80% certain whether a particular nerve is injured, and oftentimes where that nerve or nerve root is injured.
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