A.R.M. offers Electrodiagnostic testing at our state-of-the-art facilities for the diagnosis and treatment of illnesses of your nerves and muscles.

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome (CTS)?

CTS occurs when there is pressure on the median nerve at the wrist. This nerve passes through a canal or tunnel, created by the surrounding bones and ligaments of the wrist, known as the carpal tunnel. The median nerve is a major nerve of the arm and hand. When it is pinched, you can experience pain, numbness, tingling or weakness.

What are symptoms of Carpal Tunnel Syndrome?

• Numbness or tingling in the wrist or hand - at times the sensation extends into the forearm
• Cold hands
• Pain in the wrist, hand or arm
• Loss of motor skills - indicated by dropping things
• Loss of strength, weak grip, or weak fingers
• Loss of finger movement or coordination

What causes Carpal Tunnel Syndrome?

• Increased pressure on the median nerve at the wrist
• Health conditions such as diabetes, thyroid disease, rheumatoid arthritis, menopause or pregnancy
• Injury or repetitive use of hand(s)
• An unusually narrow carpal tunnel

How is Carpal Tunnel Syndrome diagnosed?

• NCS - to directly evaluate the electrical function of the median nerve as it passes through the carpal tunnel. If the nerve is being damaged, the conduction of electrical impulses across the pinched area is decreased. The NCS can also show the degree to which your nerve is damaged, which helps determine the most appropriate treatment. This is the most important test for CTS.
• EMG - to determine if the nerve compression is causing any loss of nerve supply to the muscle, resulting in muscle damage

Note: Carpal Tunnel Syndrome can be treated without surgery if diagnosed early. Talk to an A.R.M. physician about getting an EMG for proper diagnosis of Carpal Tunnel Syndrome.

Pinched nerve

What is a pinched nerve?

A pinched nerve occurs when there is an abnormal amount of pressure exerted on a nerve by surrounding tissue that disrupts the nerve’s normal function. This can lead to pain, weakness, numbness, tingling, cramping or loss of movement.

What are the symptoms of a pinched nerve?

• Numbness or tingling
• Sharp or burning pain - possibly radiating from one spot to another
• Weakness or muscle twitching
• The sensation of a foot or hand "falling asleep"

What causes a pinched nerve?

• Arthritis, Herniated disc, Bone spurs
• Spinal stenosis - narrowing of the space that spinal nerves pass through
• Carpal tunnel syndrome - narrowing of the carpal tunnel at the wrist
• Swelling caused by an injury or bruise
• Swelling caused by pregnancy
• Family history of a tendency towards this condition

How is Pinched nerve diagnosed?

• NCS - to directly evaluate nerve function. NCS are the most important and valuable test to diagnose a pinched nerve and other nerve disorders, because it is the only test that directly measures nerve function.
• EMG - to evaluate electrical activity in the muscles
• X-ray – to check for injury, arthritis, or structural problems
• CT Scan or MRI scan - to get information about discs and soft tissues not seen by an x-ray

Note: An EMG or NCS test is crucial for diagnosing Pinched Nerves (Radioculopathy). Talk to an A.R.M. physician about getting an EMG for proper diagnosis of Pinched Nerves.

Neuropathy

What is Neuropathy?

Neuropathy occurs when nerve damage is inflicted as a result of other medical conditions such as diabetes, thyroid disease, kidney disease, circulatory problems and metabolic disorders.

What are the symptoms of Neuropathy?

• Muscle weakness
• Cramps or spasms
• Loss of coordination
• Tingling, numbness, and pain
• Sensitivity to touch

What causes neuropathy?

• Pressure on the nerve or trauma
• Abnormal nerve metabolism
• Nerve inflammation
• Diabetes
• Alcoholism
• Autoimmune diseases - lupus, rheumatoid arthritis or Guillain-Barre syndrome
• Kidney disease
• Liver disease
• Hypothyroidism
• HIV/AIDS
• Genetics
• Poison exposure (typically to heavy metals or certain medications)

Diagnosing neuropathy

o NCS - to check for improper nerve function and degree of nerve damage from other underlying diseases.
o EMG - to measure poor muscle function and abnormalities in nerves that supply these muscles.
o Skin biopsy, Nerve biopsy, and Autonomic tests

Note: EMG tests are helpful in checking for nerve damage as a result of underlying diseases, and are crucial for finding the cause of Neuropathy. Talk to an A.R.M. physician about getting an EMG to check for nerve damage resulting from Neuropathy.

Myopathy

Sciatica

What is sciatica?

Sciatica is pain, numbness, tingling, or weakness that travels from the lower back or buttock, into the back of the thigh and leg

What are the symptoms of sciatica?

• Pain in the lower back or buttock that travels into the leg - pain usually worsens when sitting
• A burning or tingling sensation down the leg
• Difficulty moving the leg or foot
• Weakness or numbness in leg or foot
• Constant pain in one side of the buttock
• Difficulty standing due to pain shooting down into the leg

What causes sciatica?

• Lumbar herniated disc – when the interior substance of the disc between the spinal vertebrae leaks into the spinal canal inflammation and sometimes nerve compression can occur.
• Lumbar spinal stenosis - a narrowing of the spinal canal, which can cause nerve compression
• Degenerative disc disease - disc degeneration, or drying out of discs, can lead to stenosis and nerve compression
• Spondylolisthesis – when one vertebrae slips over another causing a combination of inflammation or nerve compression
• Piriformis syndrome –when a nerve is pinched or irritated by the Piriformis (buttocks/pelvis) muscle.

How is a Sciatica diagnosed?

• EMG - to measure the electrical activity in muscles and the nerves that control them
• NCS - to measure electrical activity of nerves, which helps determine if nerve compression or inflammation is present at the level of the spine, pelvis, or anywhere along the path of the nerve.
• X-ray of the spine and pelvis, - to check for bone related conditions
• MRI - to detect damage to the discs, ligaments, soft tissues, or to check for tumors
• CT Scan - to detect bone-related structural problems in the spine

Note: EMG and NCS tests are used to determine improper muscle or nerve function due to nerve compression resulting from Sciatica. They can determine if damage is present, whether the pain is a result of nerve damage and to which degree damage has occurred. Talk to an A.R.M. physician about getting an EMG for proper diagnosis of Sciatica.

Herniated / Slipped disc

What is a herniated / slipped disc?

A herniated / slipped disc results from a tear in the fibrous tissue covering the disc that causes the interior substance in the disc to leak into the spinal canal. When this happens, inflammation, spasms or nerve compression can occur

What are the symptoms of herniated / slipped disc?

• Pain - can be either dull or sharp
• Cramping, spasms, tingling or weakness at the site. Pain can also move into the leg and/or foot (lumbar region) or the arm or hand (cervical region)
• Loss of bowel control

What causes herniated / slipped disc?

• Injury or trauma to the spine resulting from a fall or accident
• Degeneration of the disc
• Improper lifting, or sudden twisting
• Obesity

How is a herniated disc / slipped disc diagnosed?

• MRI - disc herniation is most commonly diagnosed with this test
• EMG - to determine if leg pain is being caused by nerve damage
• X-ray and CT Scan - to show how much spinal deterioration is present
• Discogram - to identify the cause of pain when surgery is being considered

Note: EMG tests are helpful to check for nerve compression as a result of herniated / slipped discs, and are crucial for finding the cause of leg pain. Talk to an A.R.M. physician about getting an EMG to check for nerve damage caused by a herniated / slipped disc.

Spinal Stenosis

What is Spinal stenosis?

Spinal stenosis occurs when one or more areas in your spine (usually the lumbar region) narrow and apply pressure to the spinal cord or nerves. This typically results in pain, cramping, tingling, numbness, weakness and loss of function.

What are the symptoms of spinal stenosis?

• Leg pain or cramping
• Radiating pain in the back or hips
• Neck and shoulder pain
• Loss of balance
• Loss of bowel control

What causes spinal stenosis?

• Degeneration of the spine
• Osteoarthritis – arthritis where the cartilage is worn down until it is rough, or there is nothing left but bone on bone
• Disc herniation or spinal tumors
• Shortening of the spine caused by ligament changes
• Injury or trauma to the spine
• Paget disease - when your body is producing new bone at an abnormally fast rate, new bone grows before old bone is removed

Diagnosing Spinal Stenosis

• EMG or NCS - to check if nerve compression is a result of stenosis, and whether these nerves are functioning abnormally. This determines the degree of nerve compression, and helps determine how aggressive the treatment to relieve nerve compression should be.
• X-ray and Myelogram - to check for causes like tumors, injury, arthritis and genetic abnormalities
• CT Scan and MRI - to evaluate what could be putting pressure on the spine
• Bone scan - to check for abnormal bone activity, stress fractures, and other conditions affiliated with spinal stenosis

Note: EMG tests are helpful in checking for nerve compression resulting from Spinal Stenosis and are crucial in determining the type of treatment necessary for full recovery. Talk to an A.R.M. physician about getting an EMG to check for nerve damage caused by Spinal Stenosis.

Nerve Conduction Studies (NCS)

A Nerve Conduction Studies (NCS) test is used to assess the function of nerves and identifies nerves that may not be working properly.

Nerves are stimulated by small electric impulses passing over the nerve while recording the nerve’s response at a different location.

Patients may experience:

• A mild sensation like a static shock often felt in the wintertime
• A brief tingling sensation that may last for a few minutes once the testing is completed
• The muscles will jump like they do when you have your reflexes checked

Electromyography (EMG)

An Electromyography (EMG) test is used to test the function of nerves and muscles.

A.R.M. physicians insert a tiny, sterile, disposable needle beneath the surface of the skin, into the muscle to record signals that are generated. Our Physicians then analyze these signals and determines if the muscle or nerves (supplying this muscle), are working properly.

Patients may experience:

• A mild pinching, stinging, or cramping sensation when the needle is inserted into the muscle
• Mild discomfort

Evoked Potentials (EP)

An Evoked Potential (EP) test is used to see how different neurologic pathways in the brain or spinal cord are working.

Visual, sound, or sensory stimulations are given and the electrical responses from the brain or spinal cord (central nervous system) are measured by recorders attached to the scalp or skin.