What Is A Nerve Conduction Study

Definition
A nerve conduction study is a test that measures the movement of an impulse through a nerve after the deliberate stimulation of the nerve.

Purpose
The ability of a nerve to swiftly and properly transmit an impulse down its length, and to pass on the impulse to the adjacent nerve or to a connection muscle in which it is embedded, is vital to the performance of many activities in the body.

When proper functioning of nerves does not occur, as can happen due to accidents, infections, or progressive and genetically based diseases, the proper treatment depends on an understanding of the nature of the problem. The nerve conduction study is one tool that a clinician can use to assess nerve function. Often, the nerve conduction study is performed in concert with a test called an electromyogram. Together, these tests, along with other procedures that comprise what is known as electrodiagnostic testing, provide vital information on the functioning of nerves and muscles.

Description

Nerve cells consist of a body, with branches at one end. The branches are called axons. The axons are positioned near an adjacent nerve or a muscle. Nerve impulses pass from the axons of one nerve to the next nerve or muscle. The impulse transmission speed can be reduced in damaged nerves.

Surrounding a nerve is a tough protective coat of a material called myelin. Nerve damage can involve damage or loss of myelin, damage to the nerve body, or damage to the axon region. The nerve conduction study, which was devised in the 1960s, can detect the loss of nerve function due to these injuries, and, from the nature of the nerve signal pattern that is produced, offer clues as to the nature of the problem.

Depending on the nature of the nerve damage, the pattern of signal transmission can be different. For example, in a normal nerve cell, sensors placed at either end of the cell will register the same signal pattern. But, in a nerve cell that is blocked somewhere along its length, these sensors will register different signal patterns. In another example, in a nerve cell in which transmission is not completely blocked, the signal pattern at the axon may be similar in shape, but reduced in intensity, to that of the originating signal, because not as much of the signal is completing the journey down the nerve cell.

Diseases of the nerve itself mainly affect the size of the responses (amplitudes); diseases of the myelin mainly affect the speed of the responses.

Nerve conduction studies are now routine, and can be done in virtually any hospital equipped with the appropriate machine and staffed with a qualified examiner. The nerve conduction study utilizes a computer, computer monitor, amplifier, loudspeaker, electrical stimulator, and filters. These filters are mathematical filters that can distinguish random, background electrical signals from the signal produced by an activated nerve. When the study is done, small electrodes are placed on the skin over the muscles being tested. Generally, these muscles are located in the arms or legs. Some of the electrodes are designed to record the electrical signal that passes by them. Other electrodes (reference electrodes) are designed to monitor the quality of the signals to make sure that the test is operating properly. If monitoring of the test is not done, then the results obtained are meaningless.

After the electrodes are in place, a small electrical current can be applied to the skin. The electrical stimulation is usually done at several points along the nerve, not just at a single point. This is done because conduction of an impulse through a nerve is not uniform. Some regions of a nerve conduct more slowly than other regions. By positioning the stimulating electrodes at several sites, a more accurate overall measurement of conduction velocity is obtained.

The electrical current activates nerves in the vicinity, including those associated with the particular muscle. The nerves are stimulated to produce a signal. This is known as the “firing” of the nerve. The nerve signal, which it also electric, can be detected by some of the electrodes and conveyed to the computer for analysis.

The analysis of the nerve signal involves the study of the movement of the signal through the nerve and from the nerve to the adjacent muscle. Using characteristics such as the speed of the impulse, and the shape, wavelength, and height of the signal wave, an examiner can assess whether the nerve is functional or defective.

Risks

A nerve conduction study can be done quite quickly. A person will experience some discomfort from the series of small electrical shocks that are felt. Otherwise, no damage or residual effects occur.

Conditions affecting the nerve conduction study

The nerve conduction study does not produce uniform results from person to person. Various factors affect the transmission of a nerve impulse and the detected signal.

Temperature affects the speed of impulse movement. Signals move more slowly at lower temperatures, due to the tighter packing of the molecules of the nerve. This variable can be minimized during the nerve conduction study by maintaining the skin temperature at 80–85° Fahrenheit (27–29° Celcius). Use of a controlled temperature also allows study runs done at different times to be more comparable, which can be very useful in evaluating whether muscle or nerve problems are worsening or getting better.

The speed of nerve impulse transmission changes as the body ages. In infants, the transmission speed is only about half that seen in adults. By age five, most people have attained the adult velocity. A gradual decline in conduction velocity begins as people reach their 20s, and continues for the remainder of life. Another factor that influences conduction velocity is the length of the nerve itself. An impulse that has to travel a longer distance will take longer. Some nerves are naturally longer than others. Measurement of nerve conduction takes into account the length of the target nerve.

Dr. Michael J. Spiccioli Now Offering Electromyogram (EMG) and Nerve Conduction Studies

Dr. Michael J. Spiccioli Now Offering Electromyogram (EMG) and Nerve Conduction Studies

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An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.

Nerves control the muscles in the body with electrical signals called impulses. These impulses make the muscles react in specific ways. Nerve and muscle problems cause the muscles to react in abnormal ways.

If you have leg pain or numbness, you may have these tests to find out how much your nerves are being affected. These tests check how well your spinal cord, nerve roots, and nerves and muscles that control your legs are working.

Why It Is Done

An EMG is done to:

  • Find diseases that damage muscle tissue, nerves, or the junctions between nerve and muscle. These problems may include a herniated disc, amyotrophic lateral sclerosis (ALS), or myasthenia gravis (MG).
  • Find the cause of weakness, paralysis, or muscle twitching. Problems in a muscle, the nerves supplying a muscle, the spinal cord, or the area of the brain that controls a muscle can cause these symptoms. The EMG does not show brain or spinal cord diseases.

A nerve conduction study is done to:

  • Find damage to the peripheral nervous system, which includes all the nerves that lead away from the brain and spinal cord and the smaller nerves that branch out from those nerves. This test is often used to help find nerve problems such as carpal tunnel syndrome or Guillain-Barré syndrome.

How To Prepare

Tell your doctor if you:

  • Are taking any medicines. Certain medicines that affect the nervous system can change electromyogram (EMG) results. You may need to stop taking these medicines 3 to 6 days before the test.
  • Have had bleeding problems or take blood thinners, such as warfarin or heparin. If you take blood thinners, your doctor will tell you when to stop taking them before the test.
  • Have a pacemaker.

Do not smoke for 3 hours before the test.

Do not eat or drink foods that contain caffeine (such as coffee, tea, cola, and chocolate) for 2 to 3 hours before the test.

Wear loose-fitting clothing so your muscles and nerves can be tested. You may be given a hospital gown to wear.

For an EMG, you may be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean.

To help you understand the importance of this test, fill out the medical test information form.

How It Is Done

An EMG is done in a hospital, clinic, or doctor’s office. It may be done in a room that stops any outside electrical interference. The test may be done by an EMG technologist or a doctor.

You will be asked to lie on a table or bed or sit in a reclining chair so your muscles are relaxed.

Electromyogram

The skin over the areas to be tested is cleaned. A needle electrode that is attached by wires to a recording machine is inserted into a muscle.

When the electrodes are in place, the electrical activity in that muscle is recorded while the muscle is at rest. Then the technologist or doctor asks you to tighten (contract) the muscle slowly and steadily. This electrical activity is recorded.

The electrode may be moved a number of times to record the activity in different areas of the muscle or in different muscles.

The electrical activity in the muscle is shown as wavy and spiky lines on a video monitor and may also be heard on a loudspeaker as machine gun-like popping sounds when you contract the muscle. The activity may also be recorded on video.

An EMG may take 30 to 60 minutes. When the test is done, the electrodes are removed and those areas of the skin where a needle was inserted are cleaned. You may be given pain medicine if any of the test areas are sore.

Nerve conduction studies

In this test, several flat metal disc electrodes are attached to your skin with tape or a paste. A shock-emitting electrode is placed directly over the nerve, and a recording electrode is placed over the muscles controlled by that nerve. Several quick electrical pulses are given to the nerve, and the time it takes for the muscle to contract in response to the electrical pulse is recorded. The speed of the response is called the conduction velocity.

The same nerves on the other side of the body may be studied for comparison. When the test is done, the electrodes are removed.

Nerve conduction studies are done before an EMG if both tests are being done. Nerve conduction tests may take from 15 minutes to 1 hour or more, depending on how many nerves and muscles are studied.

How It Feels

During an EMG test, you may feel a quick, sharp pain when the needle electrode is put into a muscle. After the test, you may be sore and have a tingling feeling in your muscles for 1 to 2 hours. If your pain gets worse or you have swelling, tenderness, or pus at any of the needle sites, call your doctor.

With the nerve conduction studies, you may feel a quick, burning pain, a tingling feeling, and a twitching of the muscle each time the electrical pulse is given. It feels like the kind of tingling you feel when you rub your feet on the carpet and then touch a metal object. The tests make some people anxious. Keep in mind that only a very low-voltage electrical current is used, and each electrical pulse is very quick (less than a split-second).

Risks

An EMG is very safe. You may get some small bruises or swelling at some of the needle sites. The needles are sterile, so there is very little chance of getting an infection.

There is no chance of problems with nerve conduction studies. Nothing is put into your skin, so there is no chance of infection. The voltage of electrical pulses is not high enough to cause an injury.

Results

Your doctor may be able to tell you about some of the results of your nerve studies right after the tests. A full report may take 2 to 3 days.

Electromyogram (EMG) and nerve conduction studies
Normal: The EMG recording shows no electrical activity when the muscle is at rest. There is a smooth, wavy line on the recording with each muscle contraction.
The nerve conduction studies show that the nerves send electrical impulses to the muscles or along the sensory nerves at normal speeds, or conduction velocities. Sensory nerves allow the brain to feel pain, touch, temperature, and vibration. Different nerves have different normal conduction velocities. Nerve conduction velocities generally get slower as a person gets older.
Abnormal: Electrical activity in a muscle at rest shows that there may be a problem with the nerve supply to the muscle. Abnormal wave lines when a muscle contracts may mean a muscle or nerve problem, such as amyotrophic lateral sclerosis (ALS), post-polio syndrome, inflammation, or other muscle problems.
In nerve conduction studies, the speed of nerve impulses is slower than what is normal for that nerve. Slower speeds may be caused by injury to a nerve or group of nerves. Nerve conduction velocities generally get slower as a person gets older.

The results from EMG and nerve conduction studies are used along with your medical history, symptoms, physical and neurological exams, and the results of other tests to help your doctor find out what the problem is or see how a disease is changing.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Taking medicines, such as muscle relaxants and anticholinergics.
  • Having bleeding, swelling, or too much fat under the skin at the site of the nerves or muscles being tested.
  • Not being able to do what is asked during the test.

What To Think About

  • The levels of some enzymes in the blood, such as aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and creatine phosphokinase (CPK), may rise when muscle tissue is damaged. An electromyogram can cause higher levels of these enzymes for up to 10 days after the EMG, so blood tests for these enzymes should not be done for 5 to 10 days after an EMG.
  • Special types of electromyograms (EMG) may also be done. For example:
    • Single-fiber EMG is a special type of EMG test. For this test, very small needles are inserted into a muscle to see how a single muscle fiber contracts. It is a useful test for myasthenia gravis, a disease that affects the nerve-muscle (neuromuscular) junctions.
    • Repetitive nerve stimulation is a useful test for myasthenia gravis and Lambert-Eaton syndrome. In this test, small, repeated shocks are given to measure how the muscle reacts to repeated nerve stimulation.
    • External sphincter electromyogram measures the electrical activity of the external urinary sphincter to help find urination problems. The urinary sphincter is a ring-shaped band of muscles around the urethra that helps control urination. The electrical activity can be measured by skin electrodes, by needle electrodes inserted through the skin, or by electrodes in an anal plug.

Chiropractor In Kingston PA

Chiropractor Kingston PA,  Riverside Chiropractic & Rehabilitation.

Across the street from Kirby park in a state of the art facility.  Directions

We treat a wide variety of ailments from:

Neck and Low Back Pain,
Disc Herniations,
Carpal Tunnel,
Headaches,
Tendonitis/Bursitis
Decompression Therapy,
Massage Therapy,
Worker’s Comp Injury
as well as maintenance care.

We are providers with most insurance companies and do all the insurance filling for you.  You may be new to chiropractic and have questions about what we do or you may be familiar with chiropractic and looking for a new approach to better health.  Either way, feel free to browse this site and if you have any further questions, consultations are always free.  We offer the full gamut of care from Chiropractic adjustments, ultrasound, muscle stem/tense, massage therapy, to active and passive exercises in our full service gym.

We also offer cold laser therapy to help treat carpal tunnel as well as tendonitis/bursitis and spinal decompression therapy which is very effective for disc ailments from herniations to arthritis.

We also offer Biofreeze Cold Therapy Pain Relieving products, the most widely-used and confidently-recommended topical analgesic by hands-on health professionals for over 15 years.

It is the topical pain reliever of choice for chiropractors, podiatrists, physical therapists, occupational therapists, massage therapists and athletic trainers.

Biofreeze Pain Reliever offers temporary relief of minor aches and pains related to:

  • Back, Shoulder, and Neck strains
  • Ankle, Knee, Hip, Elbow joint discomfort
  • Muscle sprains and strains

Feel free to browse this site and if you have any questions, you may e-mail us or for more personalized attention, give our friendly staff a call!

Chiropractor Michael Spiccioli Kingston PA, Dedicated to improving your quality of life, Contact Us today!

Chiropractor In Kingston PA, Offers Decompression Therapy, Back Pain Relief

Non-Surgical Spinal Decompression Therapy produces the forces and positions required to cause decompression of the intervertebral discs.  Decompression is the unloading due to distraction and positioning of the spine.  This therapy produces negative pressure within the disc to allow the particular injury to heal naturally.  Conditions that may be treated include:  back pain, neck pain, herniated disc, protruding disc, degenerative disc disease/arthritis, posterior facet syndrome and sciatica.

Patients are treated fully clothed and are fitted with a pelvic harness that fits around their pelvis as well as a thoracic harness as they lie face down, or face up on a computer controlled table.  The doctor operates the table from a computerize console, where the customized treatment protocol is entered into the computer.  Each treatment takes about 20-30 minutes.  The average treatment protocol is approximately 20-28 treatments within a five to seven week period, depending on the individual’s case.

The therapy may also include electrical stimulation, ultrasound, cold laser therapy, heat/ice before, during and/or after the treatment.  Your doctor will use these therapies when appropriate.  All of the above aid to accelerate the healing process.

Although there is no procedure that is 100% successful, non-surgical spinal decompression therapy has a high success rate with full compliance from the patient.  Your doctor will recommend that you refrain from certain activities and that you engage in a certain rehabilitation program either during or after your therapy.  If you adhere to your prescribed therapy, you will enhance your chance for success.  Drinking at least a half gallon of water per day will enhance the re-hydration process within the discs.  There are also nutritional supplements that may be recommended to you as well to help in the recovery and repair process.

 

Decompression therapy is extreamly effective in treating and managing the pain and discomfort assocaited with disc herniations

For more information, Please visit our Decompression Therapy Page.

Cold Laser Therapy: Why Dr. Michael J. Spiccioli incorporates this into his practice and what is it?

Cold Laser Therapy is a form of medical treatment which involves the use of a low intensity laser to address pain and inflammation.  Studies have shown that light of certain wavelengths can reduce pain and inflammation.

A number of terms are used to refer to cold laser therapy, including low level laser therapy and biostimulation.  In all cases, the technique involves exposing the skin to targeted laser beams for set periods of time and at set intervals.  The light in the laser stimulates damaged cells to promote healing and a reduction in inflammation and pain.  The “cold” refers not to the temperature of the laser, but to the fact that the laser is of low intensity, rather than high intensity lasers, which can burn the skin.

Doctors generally recommend cold laser therapy as part of an overall pain management program.  For people dealing with chronic pain, cold laser therapy is an option which can be used to reduce pain, while people with persistent inflammations may also benefit.  This therapy is also very effective in the treatment and management of carpal tunnel syndrome and disc herniations, as well as strain/sprains.  This therapy can be used in conjunction with ultrasound.


Decompression Therapy: Why Dr. Michael J. Spiccioli incorporates this into his practice.

Non-Surgical Spinal Decompression Therapy produces the forces and positions required to cause decompression of the intervertebral discs.  Decompression is the unloading due to distraction and positioning of the spine.  This therapy produces negative pressure within the disc to allow the particular injury to heal naturally.  Conditions that may be treated include:  back pain, neck pain, herniated disc, protruding disc, degenerative disc disease/arthritis, posterior facet syndrome and sciatica.

Patients are treated fully clothed and are fitted with a pelvic harness that fits around their pelvis as well as a thoracic harness as they lie face down, or face up on a computer controlled table.  The doctor operates the table from a computerize console, where the customized treatment protocol is entered into the computer.  Each treatment takes about 20-30 minutes.  The average treatment protocol is approximately 20-28 treatments within a five to seven week period, depending on the individual’s case.

The therapy may also include electrical stimulation, ultrasound, cold laser therapy, heat/ice before, during and/or after the treatment.  Your doctor will use these therapies when appropriate.  All of the above aid to accelerate the healing process.

Although there is no procedure that is 100% successful, non-surgical spinal decompression therapy has a high success rate with full compliance from the patient.  Your doctor will recommend that you refrain from certain activities and that you engage in a certain rehabilitation program either during or after your therapy.  If you adhere to your prescribed therapy, you will enhance your chance for success.  Drinking at least a half gallon of water per day will enhance the re-hydration process within the discs.  There are also nutritional supplements that may be recommended to you as well to help in the recovery and repair process.

Decompression therapy is extreamly effective in treating and managing the pain and discomfort assocaited with disc herniations

For more information, Please visit our Decompression Therapy Page.

Chiropractor in Kingston PA, Dr. Michael J. Spiccioli

Dr. Michael J. Spiccioli
Riverside Chiropractic & Rehabilitation Center
183 Market St.
Kingston Pa, 18704
570-714-7070
info@riversidechirorehab.com

Dr. Michael J. Spiccioli Welcomes You To His New Website

Dr. Michael J. Spiccioli Welcomes You To His New Website

Michael J. Spiccioli would like announce the opening of the new Riverside Chiropractic & Rehabilitation website. Michael J. Spiccioli and staff would like you to look around our site and read all the wonderful information that we have provided to you about our services. If you have any questions feel free to contact us by phone or email today. We look forward to hearing from you. Have a wonderful day.

Michael J. Spiccioli
Riverside Chiropractic & Rehabilitation Center
400 Third Ave. Suite 208
Kingston Pa, 18704
570-714-7070
info@riversidechirorehab.com

Welcome to Riverside Chiropractic & Rehabilitation

Welcome to The New Riverside Chiropractic & Rehabilitation Center

Michael J. Spiccioli would like announce the opening of the new Riverside Chiropractic & Rehabilitation website. Michael J. Spiccioli and staff would like you to look around our site and read all the wonderful information that we have provided to you about our services. If you have any questions feel free to contact us by phone or email today. We look forward to hearing from you. Have a wonderful day.

Michael J. Spiccioli
Riverside Chiropractic & Rehabilitation Center
183 Market St.
Kingston Pa, 18704
570-714-7070
info@riversidechirorehab.com