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MRI, Nerve Conduction Study, and EMG

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By Ardie

A year ago I began exhibiting numerous odd symptoms. My doctor and I both thought the symptoms to be neurological in nature. I underwent numerous tests to determine exactly what was going on with me physically. I had two MRI's, a nerve conduction study, and an EMG. I would like to share those experiences with you to help you better prepare for similar procedures.


http://www.flickr.com/photos/gaetanlee
http://www.flickr.com/photos/gaetanlee

The MRI

An MRI is performed to differentiate between pathological tissues and normal tissues within the body. It is also used to monitor the neurological, cardiovascular, and musculoskeletal systems of patients. I had an MRI (magnet resonance imaging) performed about a year ago. As a matter of fact, I had two of them. I had an MRI of my brain and an MRI of my cervical spine. Both times, I had to lay on my back on a very narrow table that slid into a thin tube. The MRI procedure is completely painless but may cause mental distress to those who are unable to be in small, tight spaces for an extended amount of time. If you are one of the many people who is unable to tolerate small, closed spaces you can ask your primary care physician to give you something to help with anxiety during the MRI. For the MRI of my brain a small plastic "cage" that looked like a miniature milk crate was placed over my head. It did not cause any discomfort and I did not even realize it was in place once I closed my eyes. (My technician told me to close my eyes before she slid me into the tube to reduce anxiety and told me to keep them closed for the entire time I was in the tube.) I was in the MRI machine for an hour and a half for the brain scan. The machine made all kinds of strange noises in surround sound. Some sounded like a xylophone, others sounded like chartoon-ish aliens arguing, and others sound like the soft, rhythmic beat of a distant drum. The repetitive sounds actually put me in a semi-conscious state of mind when I focused on them too intently. The radiologist told me to stay completely still so I would not blur or mess up any of the images. Sometimes the noises in the MRI were so strange it was difficult not to smile or laugh, which made it even more difficult not to move. Don't confuse the previous statement to sound like I enjoyed the experience. Rather, I am one of those people who needed anxiety medication due to the small, cramped tube. I am also fidgety and it was difficult to hold still for so long. My second MRI for my cervical spine only took about 30 minutes and the machine made the same odd noises and I had to hold still again. I did not require medication the second time because I knew it would be for a much shorter duration.

Note: I do not have experience with these types of MRI's, but there are open MRI's for those people who do not fit into a MRI tube or who cannot tolerate being in the MRI tube.


http://www.flickr.com/photos/27337026@N03
http://www.flickr.com/photos/27337026@N03

The Nerve Conduction Study

The nerve conduction study has an ominous sound to me, like an evil scientist's experiment. The test name also makes me think of human torture techniques that must have been used on criminals in the dark ages. However, getting shocks of electricity sent through your nerves is not nearly as painful as one may think. A nerve conduction study is often performed to help diagnose issues with the nervous system. Electrical currents are used to measure the electrical activity traveling between your brain and your nerves. The current used is much less than what powers your home and the study only produces mild discomfort in my opinion. The feeling is akin to hitting your "funny bone" again and again in different areas of your body, depending on where the technician is placing the device that transmits the current. While indeed an incredibly annoying feeling, I was not in any pain during the procedure.

I had the nerve conduction study performed a year ago for peripheral neuropathy and I was terrified before I got to the appointment. However, the test was not nearly as bad as I had feared. The technician gave me a gown to wear and I had to lay flat on an examination table. The room was dimly lit and very quiet to ease my nerves, please pardon the pun. The technician rolled a cart over to the table and showed me the device she would use to stimulate my nerves and to measure the activity taking place between each nerve and my brain. The test was performed on both sides of my body along my arms and legs. The first series of currents were a mild tingle. As the test went on, the technician increased the current until my extremities were twitching with each shock. As stated earlier, the shocks did not hurt, not even at their strongest point. The feeling was weird indeed, but not painful. While having the test performed, I envisioned someone plucking each of my nerves like one plucks the strings of a guitar. After the test I did not have any lasting effects and I spent the rest of the day as usual, playing with my kids.


http://www.flickr.com/photos/houseofsims
http://www.flickr.com/photos/houseofsims

The EMG

An EMG (electromyography) is used to measure the electrical activity of muscles. The test is used to diagnose maladies that affect the proper function and/or strength of muscles. A neurologist performs the test and inserts a fine, wire electrode through the skin and into the muscle using a long needle. If you have ever had a shot that hit the muscle, you know that it hurts like crazy. An EMG is no different.

I had an EMG a year ago, and before I went for the appointment I researched the topic on the Internet. I found medical information and procedures for the test all over the place. What I did not find, and what I was looking for, was a personal account of the test to help me prepare for it. After my test, I understood why I did not find a personal account. Surely all the neurologists spend their evenings finding such accounts and erasing them from the face of the Earth. Otherwise, nobody would ever have the test performed. Before I go further I want to say that if you are going to have the test and you are not prepared for the truth, do not continue reading this. An EMG does provide the neurologist with invaluable information if you do indeed have decreased muscle function and it can be an important part of your care.

Following is my personal account of having an EMG done. It is not nice, I am going to be brutally honest, and it may scare you away from the test if you are about to have one. Scaring people is not my intention at all. I simply want to provide information for people who truly want it. I was not prepared for my EMG because I could not find similar information. That said, even if I had found the information, I still would have gone for my test, because the information provided at the appointment was extremely important to my health.


http://www.flickr.com/photos/robertdx
http://www.flickr.com/photos/robertdx

The EMG I had was performed on the entire left side of my body from shoulder to foot, including my hand and arm. For the test, I had to change into a hospital gown and rest on my side, facing away from my neurologist. The first needle went into my calf. I could hear what sounded like an out of tune radio trying to come in clear. The neurologist turned the needle inside my muscle and it was very painful, but tolerable. The pain only lasted a moment before the neurologist pulled the needle out of my muscle. The second needle went into the outer arch of my foot and I barely felt it go in. I was later told the more muscle you have, the worse the EMG hurts. Evidently I don't have any muscle in that part of my foot. I don't remember where all the rest of the needles went, but I do remember getting one in my left hand and one in my lower back on my left side. If you are going because you think you may have carpal tunnel syndrome, don't worry too much about the EMG. The needle in my hand was placed into the meaty area between my pointer finger and thumb - and it didn't hurt much at all. While I do not have carpal tunnel syndrome, I have read that it causes the muscles in your hand to deteriorate. Keeping in mind the statement that the EMG needle hurts more when you have more muscle, it only makes sense that an EMG for carpal tunnel syndrome would not be overly painful. However, the needle that went into my lower back is a completely different story. The actual insertion of the needle into the skin is not what truly hurt; it was every turn of the needle the neurologist made while inside my muscle that threw me into a panic. After what seemed like hours, but was really only seconds, my body reacted instinctively to the intense pain and my fist shot out at my neurologist. Luckily, I only made contact with the cart because my neurologist saw me coming and had time to roll his seat back. At that time, I decided I was finished with the test and my neurologist agreed with me. The test results came back within normal range, so I feel as though I went through the test for no reason and I hope to never have to go through the test again because it was the most painful experience I have ever been through. On the other hand, I am glad I had the test to rule out what was originally suspected.

It is my hope that this information gets to patients who feel the need to prepare for similar tests. I often ease my anxiety of something by learning as much as possible about that thing. Since I was unable to find honest and accurate information about the above procedures, it is my desire to offer that information to others.

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Triplet Mom profile image

Triplet Mom  says:
12 months ago

Ardie, this is great information. I wish I had this information before my husband had his MRI, he is one of those that does not like enclosed places. Thanks for sharing!

Ardie profile image

Ardie  says:
12 months ago

Thank you for the nice comment. The only way I knew to ask my doctor for something was because my Mom mentioned it to me. I hate small spaces and the meds helped tremendously. They're probably why I heard aliens arguing ;)

Bardie  says:
12 months ago

Thank you so much for the information. You are absolutely correct when you say there is no information on how tests or procedures feel. Your hubs are concise and informative. Thank you!

Ardie profile image

Ardie  says:
12 months ago

Thank you for your nice comment, Bardie.

Elizabeth31 profile image

Elizabeth31  says:
12 months ago

Sorry you had to have so many tests. I have had a MRI for the neck. My experience was similar, except that they put your head and a neck in a brack like thing for that and you don't have to wear a cap. They had a button you could push if you needed to talk to the technician for some reason.

Ardie profile image

Ardie  says:
12 months ago

Hello Elizabeth, good to see you :) Im glad you mentioned the button you can push to talk to the technician. I forgot all about that. It was a nice comfort measure. I remember bsically holding on to mine for dear life my first MRI.

newcapo profile image

newcapo  says:
12 months ago

Great information--Great hub! I have had several MRIs on my lumbar spine. For the last few years, they have all been open MRI, but I remember the closed tube, I'm glad I'm not claustrophobic . Thanks for the info

Ardie profile image

Ardie  says:
12 months ago

Thank you for the comment. I have seen the open MRI's, but I've never had one. If I ever need another MRI thats the route Im going! But hopefully that wont be necessary since we never found a reason for the symptoms and they have gone away :)

Benson Yeung profile image

Benson Yeung  says:
11 months ago

Hi Ardie,

that's very interesting. I have to say you know much on these topics than I do (I'm a doctor). Good job.

Ardie profile image

Ardie  says:
11 months ago

Thank you Benson. Unfortunately I have first-hand knowledge of the tests. Being as you are a general surgeon, maybe you've heard of chiari, it is my curse. And also, since you are a doctor, have you ever almost been hit? I couldn't believe I did that :)

Lgali profile image

Lgali  says:
10 months ago

Great information--Great hub!

Ardie profile image

Ardie  says:
10 months ago

Thank you, Lgali :)

Raju  says:
4 months ago

Its Very information. thanks for sharing your experiences.

Michelle  says:
2 months ago

I'm really glad I kept reading your post about the EMG nerve test because you said the carpal tunnel test would probably not be as painful. I was totally freaking out because I am deathly afraid of needles. I went in for my EMG today to test the nerves in my arm to see how bad my carpal tunnel syndrome is. I just wanted to share my experience in case someone else is going in for this type of EMG test. I must tell you--it was not as bad as I thought it would be. The guy on the phone told me it would take 30 min-1 hour (which FREAKED me out!), but the test didn't last even 10 minutes. First, he connected electrodes to my hand and sent shocks through my arm--weird, but not extremely painful. Then, he took the needle (I didn't look at it) and inserted it into about 5 different spots on my arm and hand and then once in my neck. He didn't hold the needle in there or anything. It just felt like a really thin tiny needle poking me about 5 times (it's obvious it didn't hurt very much because I don't even know how many times he inserted the needle). He then had me lay with my head on the other side of the table and did the same thing to my other arm. And BAM! I was done. Less than 10 minutes total. So, don't worry about this test if you are getting a similar test for carpal tunnel. That small amount of discomfort is totally worth what the test results will tell my doctor.

paul  says:
2 months ago

hi, thanks for information i've had similar tests done never liked the enclosed space whilst in machine, on the other hand it was totally painless. Had SEP test Somastosensory Evoked Potential test, this i never liked, as the electric current was at its max i felt it very uncomfortable on my wrists the doctor then stopped test for about 1min told me to relax then started back up again, on doing this he started with the same amount of current as when he had stopped the test (ouch) is all i can say, dont let me put anyone off everybody is different. I am waiting to go for EMG so sitting here with my fingers crossed lol. I was electrocuted with 33,000 volts in an accident at work so you would have thought the SEP should have been easy lol.

Ardie profile image

Ardie  says:
2 months ago

Hello Michelle

Im glad you kept reading too. I dont mean to scare anyone...if the tests are necessary then they are necessary. I am wondering if I should pull this article so I dont scare anyone out of getting a test they absolutely need. Im glad your testing went as easily as possible for you.

Hi Paul

WOW! 33,000 volts?! Now thats impressive and crazy. Im glad to know you lived through it. For the EMG, I've heard that the more you can relax your muscle - the less it hurts! So stay calm and collected :)

Randy   says:
2 months ago

I'm going for and EMG next week to hopefully determine what's going on from L4-L5 down my right leg. For two years now my right shin, from knee to ankle and two inches on either side has been numb. I'm also experiencing weakness in the muscle groups around my outside thigh and buttocks. The numbness came the day after I'd had a chiropractic adjustment for the lumbar spinal area. Thanks to your posting I'll be ready for the pain. Sadly, I've experienced electrical shock pain down my right leg that lasted six days and prevented me from standing. The pain was an 11 on a scale of 1-10 and that was while I was on Vicodin! I'm prepared now thanks to your information.

erin  says:
3 weeks ago

I recently went for a EMG for my upper cervical area and both arms they thought it was Carpel Tunnel well the original test done my arms was not bad but my neck was a totally different story he insert a needle in 2 diffenet spots on my neck he chenged needles and inserted that needle 4 to 6 times in my neck alone. He then continued down my back and shoulder blades which wasn't bad either all and all its worth it I have severe nerve damage stemming from neck next trip is MRI.. your info is very correct good job

maria little  says:
2 weeks ago

Thank you all. My main question is what will the results of the tests produce in terms of treatments? Can bad nerves be operated on? or is it just to determine what medications one needs?

Carol  says:
9 days ago

Thank goodness I ran across your honest report regarding the EMG! My doc ordered a Nerve Conduction Study and didn't bother to mention that an EMG with needles would be included. I am scared to death of needles, and after having muscle pain and inflammation from head to toe for over a year now, I certainly am not going to allow them to give me even more pain, not to mention that doesn't even make sense when doc thinks I have fibromyalgia. So after reading your story I called both doc and neurologists office and told them I refuse to allow the EMG. I told them I will agree to the electrode pads for the first part of the test, but no needles. So we compromised that we will start with a consult, and if I still don't want the EMG then they will do only the first part of the test. Something told me there was a reason they schedule the testing on 2 separate days for upper and lower, so I went searching on the internet for answers today. Thanks a million for your valuable info!

Dave  says:
6 days ago

Ardie, you're the man!!! I am scheduled for MRI and then both of the others,(NCS and EMG). I wish I had found this hub last year! You are very thoughtful to have taken the time to write all this down for others. Thank You!

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