Needle electromyogram (EMG), a relatively low-tech and inexpensive test in use since World War II, may be making a comeback. The old test may be more effective than magnetic resonance imaging (MRI) at detecting an increasingly common cause of back pain known as spinal stenosis, according to a new study led by Andrew Haig, MD, an associate professor in the department of physical medicine and rehabilitation at the University of Michigan Medical School in Ann Arbor.
Marked by a narrowing of spaces in the spine, spinal stenosis results in pressure on the spinal cord and nerves. As a result, people with spinal stenosis experience debilitating back pain or even paralysis, if it’s left untreated. Close to 400,000 Americans have this condition, and the number is expected to increase as more baby boomers hit their 50s and 60s.
An EMG can help doctors better differentiate spinal stenosis from other conditions, like arthritis, herniated discs or peripheral nerve disease, and stave off unnecessary exploratory back surgery, explains Dr. Haig. MRIs tend to show arthritis, because most people older than 50 have some degeneration of their vertebrae, when the pain might really be due to spinal stenosis.
The new study followed 150 people who had low back pain but no MRI evidence of spinal stenosis, varying severity of spinal stenosis or symptoms of either condition. Each patient was examined by a doctor and had an MRI. Then physiatrists, neurosurgeons and neuroradiologists came to a unanimous diagnosis about each patient’s condition. Following the diagnosis, the people had EMG testing and results were compared against the initial diagnosis. EMG clearly determined spinal stenosis diagnosis from other causes of low back pain.
Diagnosing Spinal Stenosis
Electromyogram is better than MRI for spinal stenosis diagnosis
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JESSIE
01 Sep 2010, 12:00
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| Thanks to Hanna for her comment above. |
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Linda V
28 Aug 2010, 06:43
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| I have many types of arthritis and just recently I have developed severe right side pain just below my bra line.The pain is very sharp and stabbing, It cause considerable amount of pain on movement such as bending forward, turning sideways, raising my arm,taking a deep breath and just about any movement causes I very, very sharp pain. I was hopitalized twice for this, but no one is able to help me find what the problem is. I have been diagnosed with gout, RA, OA, degenerative Arthritis, alkolosing spondilitis,and so on I am on many pain meds due to my other conditions but this dosent seem to help this pain. Is this possibly a part of the other conditions that I currently have or should I look at other avenues. I do not have a kidney on that side nor due I have a gallbladder so that cancels out anything of that order. I have in the past had elevated live enzymes, but when the did an ultrasound that looked good no problems there. I really would like to find out what is going on its been over 2 months since the unset of this new problem. The pain is extremely debilitating. If you have any sugestions it would be extremely helpfull. Thus far I have had chest xrays, as well as catscan which were both negative. Is there any other test that might be more helpful in solving this medical problem. Any suggestions or advice would greatly be apreciated. What type of doctor should I go to, to help solve this medical issue? Thanks in advance for your help. |
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Hanna
11 Aug 2010, 09:03
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| Here is one more option for pain relief due to stenosis. I am talking about
a disc removal surgery I had nearly 2 years ago. It was done as a last
resort after a busted? disc between L4-L5. MRI showed a herniated
(broken?) disc and another bulging disc in the L3-L4. I had visited an orthopedic surgeon who refused to fuse my back bones due to my young age (35) and because the herniated discs were in joints right next to each other. He could not fuse the L4 into 2 directions as it would give me 3 immobile bones. I lead a relatively active life and a stiff spine would be more detrimental to my health in the long run. The doctor referred me to a pain clinic. I went for a second opinion. Pain pills for the rest of my life did not seem an option. How long would the narcotics hold me? Decades? I went and saw a neurosurgeon. I had heard of disc removal from couple of different acquaintances. They both said to see a neurosurgeon, NOT an orthopedic surgeon. The neurosurgeon told me about the OA he was able to see in the MRI. He also saw the busted and bulging discs and was able to explain to me that they were 2 different problems. He could remove the discs but the OA I would have to live with for the rest of my life. The disc removal was done scopicly as an outpatient. I had severe postsurgery pain, which didn't come even close to the pain I had suffered before the surgery. I had been taking Vicodin, muscle relaxants, Mobic, Motrin... anything and everything under the sun. I even had had a shot of morphine once or twice. After the surgery I took Vicodin for 10 days and Motrin for few weeks after that. 2 months later I was completely medicine free. It took several months to get over the stiffness from the surgery, but it was still a miracle to me. The findings from the surgeon included severe stenosis, disc herniation (L4-5), bruised, red, and flattened spinal cord (which healed within weeks if not days). The horrendous pain in my back/leg was caused by the disc and the bones rubbing against my spinal cord. He also removed part of the lamina in both L4&5. Now, 2 years later I still have stiffness, but no pain. My OA is not intolerable, I am still free of medication. I am not allowed to dead lift more than 30 lbs or carry more than 50 lbs. I have to follow an excercise routine given to me from rehab. I am able to walk, swim, ride a bike. I cannot ride horses, jet ski, or do anything that involves bouncing or high impact, or even possibility of banging my back. No running as the continuous impact would eventually compress the spine. Sometimes it is very challenging trying to find variety in cardio excercise that raises my heart rate high enough. Fortunately I am a swimmer, and there is no better excercise for people with back/joint problems. My advice is: make sure you consult the right doctor. He will give you all the details of your diagnosis. He will explain and explain and explain. He will answer all of your questions. He will not refer you to a psychiatrist. AND he will let you make decisions knowing that they are not easy to make when you are in severe pain. Granted my doctor couldn't help me much regarding the OA, but he also admitted that. AND he told me where to find information about OA. Why the orthopedic surgeon didn't tell me about that seems odd, doesn't it? Oh, and then there is the MONEY: an outpatient surgery done using a scope vs. a fusion or an artificial joint. Needless to say my insurance company did not refuse coverage even out of network. Good luck folks, I hope my story helps someone. |
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mary slade
22 Jul 2010, 17:10
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| i'm a 61 year old female africa america i have back pain in the lower part of my back, every once in awhile the upper part of my back hurt.ago,i fell and hurt my back and broke my vertbre bone(seperate my tail bone) from my spine.i am also overwieght.my stomach just hang down(flopion tube came down after i had my children.i might need a operation.please send detail to my e-mail. |
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maggie serrano
24 May 2010, 15:28
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| I have been diagnosed with diabetes.. also i have Rhuematoid Arthritis..i
have problems with my sugar levels, blood blessure,eye sight. Ive have had
this now for five years. i am blessed that i dont have to take insulin for
my diabetes but the arthritis really gets me..
brusitis,fibromyalgia...especially in the back and neck are. it is so
fraustrating that when i am at work it makes it hard for me to do my job as
well as i should..but doing stretches and keeping a balanced diet helps
me.. the pain is still there but i have learned to deal with it the best i
can. i dont like taking pain meds..i would rather take a Ibuprofen..and relax..get excersize.. enjoy life .. |
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sally parrish
06 May 2010, 20:48
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| I have stenosis and degenerative disc disease. I work retail sales as management. I use a pallet jack and pull over 300lbs, when unloading most trucks. I also have to lift over 50lbs at times, by myself. I had a hip replacement two years ago which is ok now, doctor says, but i have bersitis on left side in back. Very painful, i had a shot in my back last week. Didn't work but two days and not real well. what should i do. |
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Marilyn Sweatt
21 Apr 2010, 00:04
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| When my ski accident=AC repair in my right knee in 1976, the PT hurt so
much I found that water aerobics was great. FMS has been a problem since
then & in 2006 had a knee replacement,again the pool was the answer. Since 2008 spine/hip problems=stenosis in L4/4&5, again pool helps along with 3 injections every 4 months, so please try it! A EMG & deep tissue massage helps I also use a small 10's unit that I'm using right now! Life is not for chickens, I'm, 73, so don't give up...try what might work for U!! ac |
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Mary
06 Apr 2010, 10:20
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| I too have spinal stenosis and had a lamenectomy. I would tell everyone please give careful consideration to this. I've heard if there is stenosis that the surgery is a must and I did have relief for about a year. Now I'm back in the same boat and can hardly walk. My latest xray shows severe degenerative changes, severe scoliosis, and a lamenectomy defect. I've been on strong drugs for 5 years now and worry about the damage they are doing. I really wish there was something that would help. I've done the EMG too. |
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SONJA FLORES
03 Apr 2010, 15:53
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| I HAVE SEVERE STENOSIS 3 PLACES IN LOWER BACK. I AM GOING TO TRY THE INJECTIONS.I JUST WANT MY LIFE BACK AND BE ABLE TO FUNCTION,I AM VERY SCARED OF SURGERY KNOW TO MANY PEOPLE WHO GOT WORSE AND HAD TO KEEP HAVING MORE SURGERY. DOES ANYONE KNOW ABOUT LASER SURGERY? |
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Jennifer Stell
16 Mar 2010, 20:58
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| I have a form of muscular dystrophy called Charat Marie Tooth Disease. This
affects the the pereferal nerves especially in my back and legs. I started having surgery when I was 13 yrs. old. I have 3 hip surgeries, 1 double foot surgery, 1 spinal fusion surgery (due to very bad scolilois.This all happened by the time I was 17 yrs. old. I have had a couple more surgeries but not as big as when I was I young. I just found out I have to 2 bulging disks in my lower back. I am in so much pain and I only have a pain patch to cover my pain. I used to be on pain pills but the doctor took me off them because i refilled them to soon. But that month, I was having problems with stomach,and this medicine I was on it was actully working to cover my pain adequelly. And it was for a month, but now I have nothing but the pain patches, the occassional shots for trigger points, and my arthritis medicine. And I am only 29 years old. |
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CAROL
16 Mar 2010, 14:30
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| What STATE coulD bring relief to those that need help? If help is out there for those with spinal arthritis or need surgical relief? Why is it only a state mandated allowance? This is a major problem nationally!!!!!!! We all have control to take charge with in our government and ask them to help with the decisions on this, go to your government for this!!!! I urge you all!!! Missouri-California=Florida=Texas Our UNITED STATES AND UNITED WE CAN STAND AGAIN! |
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Marci
24 Feb 2010, 09:14
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| Diagnosis of degenerative disc disease, arthritis affecting facet joints, foraminal bilateral narrowing, Fibromyalgia. With all that said, my pain is 90% in my legs. Just had a medial nerve branch block consisting of six shots that only made everything worse. I have already been checked for PAD and all is well with my circulation. I am on pain medication that makes my life bearable, but would rather just fix what is wrong than have to count on medication. I am afraid of the long term effects on my liver. The pain usually is not the sharp sciatica type of pain but rather a bad toothache type of pain that never ever goes away. When the medicine wears off I am miserable. I am looking for ideas from those of you who have similar symptoms of what has helped you. What have the doctors tried? Thanks. |
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leonard earl roberts
18 Feb 2010, 13:09
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| i was diagnosed with spinal stenosis and had surgery that did not help much. later i was told that i had arthritis in my spine and there is no surgery for that. i was sent to a pain management doctor and i get a little relief from some pain medicine. i am on several other medications for other conditions, so i have to be careful as to what kinds of medicine i take. if any one knows of any treatment that has been sussesful for my problem please let me know. thanks |
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Mary
25 Jan 2010, 13:07
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| I was diagnosed with spinal stenosis and spondylolisthesis. They prescribed physical therapy and it worked wonders. As long as I do my exercises daily and I don't lift anything over 20lbs, I do fine. Lat week, I lifted a box that was about 25lbs and now I am in pain again. They prescribed predisone which is kind of helping. I am still doing my exercises. They would not prescribe pain medicine so I hoping with rest and the steroid I will be back to feeling good again. |
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Mariann
14 Jan 2010, 18:32
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| Stenosis seems to require ongoing management - a wholistic approach works for me - relaxation training (meditation, and yoga stretches that allow muscles that are trying to protect the spine to relax. Also, frequent moving around - don't stay in one position for too long, such as sitting. Walking is excellent, as it takes the weight off the spine (when sitting) and allows all the muscles to work together. Glucosamine/chondroitin can help restore cartilage loss, and drinking plenty of fluids and taking low doses of anti-inflammatories - such as 200 mg Ibuprofen when pain begins to flair up. Don't wait until the pain gets bad. Try to stay aware of body signals. And be aware of how you react to pain - do you tense up more or get fearful, which aggravates the muscles and nerves further. |
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Robin
15 Dec 2009, 20:00
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| Hi everyone; I have been having some really bad back aches lately.. my lower back as well as between my shoulder blades.. I have been seeing my pcp.. but know that I probably need to see a speciaalist as by the end of the day..I am hurting some days so bad ..I just want to sry.. I am on pains meds.. but they don't take the pain away , so I will take 2 or 3 just so I can fall asleep ..but then with in about 4 hours ,I'm awake again and hurting.. any suggestions on what kind of specialist I should see.. I do have Ra in my arms and hands, so I figure thats what going on with my back too. let me know please.. could use all the help and suggestions.. Thanks and Happy Holidays everyone. |
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joe murray
09 Dec 2009, 14:15
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| i have arthrits in my spine and when i on my feet standingup i have blackouts and it feels like my spinel cord is getting cut my nevers are so bad i cant control my self all the shakeing and headaches and diarrhea and pain i am sick all the time but you know what i cant get medical help for this if you ask a m.d. arthrits is jest joint pain i live in kansas city missouri in this state if you get sick jest kill your self and get it over with |
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Kathy Copeland
01 Dec 2009, 10:18
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| I have spinal stenosis in three places in my lower back. The shots directly into the spine have helped with the leg pain and with my legs giving out on me. However, if I stand for longer then 10-15 minutes, my back where the stenosis is becomes very painful. |
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vickie
23 Nov 2009, 01:16
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| hey joe mittner, My aunt had that device put it and no good she still has
severe back pain. she has had surgery and has a rod in her back now and
still awfull pain. Good Luck..... Also my mother has spinal stenosis and is now having siatic nerve problems I had her at the hospital today as a matter of fact and they told her the only thing that is going to help her is a awfull surger to get it straightened out.... I myself have arthritis in my lower back and crappy disc I am on medication and muscle relaxers 3 and 4 times a day and tired all the time it is no fun.....I also bought a inversion table to deconpress my spind a lot of money wasted it does not work either it just makes me sick when i come back up from hanging..... good luck to everyone. |
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Bobbye Adams
20 Nov 2009, 17:05
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| After several tests and MRI, I have finally been diagnosed with Spinal Stenosis. According to the Pain Clinic Doctor and informatin found on Mayo Health Clinic website, I do not have the nornal pattern for spinal stenosis as my pain occurs more when I sit and lie in bed. It is often necessary for me to get up and walk around to relieve the pain. The first epide1:1/8rmal injection I had helped the pain in my buttocks and thighs, but the second one has not helped much in my hip and lower leg which appear to be muscle spasms. Does anyone else disagnosed with spinal stenosis have pain in these areas and has the injections helped them? |
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Barb
18 Nov 2009, 19:26
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| I have servere spinal stenosis and have had 6 injections and they haven't dome anything for me. I wear pain patches and they help a bit. I am on pain medication and am very tired. Now I am trying spinal decompassion. Does anyone know about this? |
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joe mittner
03 Nov 2009, 15:44
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| i have had spinal stenosis for quite a while i didnt know what was bothering my back so i went to a chiropracter and he made it much worse i could hardly walk when he got done he sent me for an mri and he told me i had spinal stenosis i went to a pain management dr and he gave me a shot in the back and that helped it so i could walk ok he gave me about 9 shots in the spinal area and still no relief i work out at the ymca and i can only walk about 5 laps before i have to sit and let the pain subside the dr and i talked it over and i am going have a trial period for a pacemaker for pain the process to get it done is a long dreawn out process i started in july and still waiting to have it done its not 100% but if releives any of the pain i will be greatful |
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Walter
31 Oct 2009, 23:53
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| All of my data (MRI, EMG) indicate that I have Stenosis C5-C7 and a possible nerve damage happening in my left tricept. I have not pain/tingling anymore after 6 weeks. Before PT I was at 10% of tricept power and now I am at 70% when compared to my right. I have made progress and feel good. Although my neurologist still tells me that I should have surgery and fuse those two sections. Do I continue to workout for months and re-take the EMG? If I have loss some nerves already what is the point of surgery? Can I regrow some of the damaged nerves through other means? I see that surgery is only about 16% successful and actually might create other problems? |
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Rita Chergi
11 Sep 2009, 14:46
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| My doctor told me that I have stenosis and wants to give me an injection in my back for the pain. Is there some exercises that would work before I have that done? |
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Dolores Adolf
06 May 2009, 09:28
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| An EMG did detect nerve damage from my spinal stenosis. However, further MRI tests showed arthritic changes, stenosis at C3/C4 AND a grade 1 spondylolythesthesis at L4/L5. I have been doing core exercises for 1 year. Now I am finally able to walk around the block without leg pain. Can you advise me how I might avoid further spinal damage? Thanks. |
