Diagnosing Nerve and Muscle Problems - Isaac Cohen, MD
My name is Isaac Cohen, MD and I’m a spine and musculoskeletal physiatrist at the Orthopaedic and Sports Medicine Center. One of the most effective tools to diagnose nerve and muscle problems is Electrodiagnosis. Electrodiagnosis utilizes electrical technology to analyze the impulses between nerve and muscles. The information that we obtain enable us to localize the problem in the nervous system and to establish the severity. Electrodiagnosis is typically performed by physicians that are specially trained such as neurologists and physiatrists. Patients are typically referred for Electrodiagnostic testing who have symptoms of tingling, numbness, weakness, pain, or muscle cramping. These tests typically run between 20 to 90 minutes depending on the nature of the problem. When a patient presents with a problem, we usually perform two different tests. Nerve conduction studies and needle electromyography or EMG for short. Like wires, your nerves conduct electrical impulses from the brain to the muscles and from the skin back to the brain. And so, nerve conduction studies assess how well these electrical impulses are being transmitted along the nerves. Artificial electrical impulses are applied to the nerve and the response to the nerve are then recorded. What that feels like is a mild static shock. And it is harmless to the nervous system. The second test, EMG, records the electrical activities in the muscles. Like an EKG, that records electrical signals in the heart, EMG records electrical signals in the muscles. And so, very thin acupuncture type needle is inserted just beneath the skin into the muscles and we record the activity both at rest and with muscle contraction. And what that feels like is a pinch. Once the test is complete – ah – patients are free to resume their normal desired activities. They also follow up with their referring physicians who then discuss the results of the tests with them and the decide the next step in the treatment plan.