Electrodiagnostic Medicine

Please bring these completed forms with you on your first visit. Download the PDF files and print:

• Loudoun Spine New Patient Information Packet
• Loudoun Spine Pre-Procedure Instructions for Spinal Injections
• Loudoun Spine Patient Follow Up Questionnaire

Low back and neck pain related to arthritis, disc herniations, and spinal stenosis. Knee, hip, and shoulder joint pain related to arthritis, bursitis, or tendonitis. Numbness/tingling related to carpal tunnel syndrome, radiculopathy, or peripheral neuropathy. Muscle pain due to muscle strains and myofascial pain.

Please contact us if you have a fever or infection prior to the day of the procedure as we may need to postpone your procedure. There are no food or drink restrictions. You do not have to have a driver, but feel free to bring one if you feel more comfortable.

Please read the Loudoun Spine Pre-Procedure Instructions for Spinal Injections (located under FORMS TO DOWNLOAD…) as there are certain blood thinning medications that should be stopped prior to the procedure.

If your injection does not involve the spine, you do not need to stop blood thinning medications.

Patients with numbness, tingling, pain, weakness, or muscle cramping are frequently assessed with EMG/NCS. Disorders most commonly assessed include: carpal tunnel syndrome, ulnar neuropathy, peripheral neuropathy, radiculopathy (“pinched” nerves in the neck or low back), sciatica, numbness/tingling or weakness in upper or lower limbs.

Depending on the areas of the body being evaluated, the patient may be asked to change into a gown. Before the test, a focused patient history and examination is performed and imaging reviewed if appropriate. This evaluation helps determine which specific nerves and muscles should be assessed with the EMG/NCS test. The findings for the initial nerves and muscles assessed will determine which additional nerves and muscles should be tested.

Patients are advised not to apply any creams, lotions, or oils to their skin the day of the test because the small electrodes are attached to the skin with an adhesive.

The NCS component of the test evaluates electrical signals along the nerves to the skin or muscle. Electrodes are attached to the skin and a small electrical stimulus is applied to a nerve and the electrical signal is detected at the electrodes. An electrical waveform is produced on a computer screen. The speed, size, and shape of the waveform are analyzed. The number of nerves tested will depend on the clinical situation and the findings for the initial nerves tested.

This stimulus is very brief (less than one thousandths of a second). It feels like a small electrical shock and the muscles may “twitch.” NCS is usually well-tolerated by most patients.

The EMG component of the test evaluates the electrical signals from the muscles. A small, thin, and sterile needle electrode is inserted into different muscles. The electrical activity is assessed when the patient contracts the muscle and when the patient has the muscle relaxed. The electrical activity is displayed on a computer screen and the noise produced from this electrical activity is heard from a small speaker. Visualizing and hearing the electrical activity are both important in determining what is normal versus abnormal. The number of muscles tested will depend on the clinical situation and the findings for the initial muscles tested.

There may be some discomfort during testing; however the needle can be easily moved slightly to a different area which will not cause discomfort. It is very rare that a patient will not be able to tolerate this part of the test.

The complete testing process usually takes 30-60 minutes. Afterwards, there are no patient restrictions. At Loudoun Spine and Rehabilitation, EMG/NCS tests are performed and interpreted by a physician board-certified in Electrodiagnostic Medicine. The test results are discussed with the patient immediately after the test is completed. The EMG/NCS report is typically ready within 24 hours and will be sent or faxed to the patient’s referring physician (and other physicians if requested).