By: Jean Johnson for Back1
It’s too late for Melvin Daniels of Longview, Washington. The debilitating back pain he experienced after a car accident led to a year’s misery during which time the weight he gained from lack of mobility finally culminated in a heart attack that took his life.
| Electromyograms or EMG measures muscle response to a nerve’s stimulation. The test aids in the detection of neuromuscular abnormalities.|
The procedure can be done in a physician’s office, although sometimes hospitalization is warranted.
Neurosurgeons insert a small needle or electrode into the muscle they want to study and via a connection between the needle and an oscilloscope or monitor, they can observe the electrical activity in the muscle. An audio amplifier is also used so that the activity can be heard as well.
“One cocky physician told Mel that he would just have to ‘cowboy up,’ as far as the pain went,” said wife Darla Daniels. “That was just a month before my husband died. They did do an MRI at one point, but I never heard a thing about an EMG.”
For Carolyn Koski of Michigan, the stars were aligned much differently. She suffered from years of weakness and numbness in her legs along with dizziness and fatigue. After her physicians determined she needed spinal surgery to treat the narrowing of the passages (stenosis) in the vertebrae, she volunteered for a University of Michigan Health System study that used an electromyogram or EMG to test for nerve damage in her muscles.
The decision was fortuitous. The university research team led by associate professor in the department of physical medicine and rehabilitation at the University of Michigan Health System, Andrew Haig, M.D., discovered that Koski had Charcot-Marie-Tooth. The inherited condition progressively worsens with age and causes degeneration of the muscles in the foot, lower leg, hand, and forearm.
“By having the EMG I was able to avoid surgery,” said Koski. “I was able to get answers for questions that weren’t answerable before.”
That is why Haig is studying the EMG technique. “The EMG is really going to help doctors to avoid unnecessary surgery and unnecessary injections because it’s going to prove to them that there is nerve damage in the people who clearly have it,” said Haig.
While EMG technology has been around for more than 50 years, magnetic resonance imaging or MRI is the favored method for diagnosing disease. Haig, though, thinks the medical community would serve patients well to remember that the EMG offers information the MRI cannot.
Koski’s condition “would never, ever show up on an MRI scan,” Haig said. He went on to explain that while an MRI produces a photographic image of an area, an EMG gives information about the function. Using a car as an analogy, Haig explained that while the MRI provides a photograph of the car, the EMR “is like putting a key in your car and seeing whether the engine works and seeing whether the radio plays.”
In Haig’s view rather than going directly to an expensive MRI, physicians would do well to use the EMR as the first test which along with a x-ray could either identify or eliminate problems arising from nerve-muscle dysfunction.
Haig’s current study on EMR has not been completed. Although in Koski’s case the outcome is already more than promising, further research will determine the success with which EMR technology can be used to isolate exact muscle locations from which back pain arises in particular patients.