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uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 5/3/2009 11:00 AM (GMT -7)   
 
 
I went Friday and had my EMG done on both legs... I guess they wanted to make sure that I wasn't having Diabetic Neuropathy...Well, I'm not!! It is all related to my back.  My right leg is soooo much worse then my right.  The numbers were about half...if you know what that means...  So, she also mentioned an entrapped nerve?  Oh Hell!!  I have seen other people talk about that and having it burned?  What is that all about?
 
Me.

 I hate Boats!!!!
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night
                                                                    

 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13479
   Posted 5/3/2009 11:04 AM (GMT -7)   
It sounds like the dr is talking radiculopathy. At least you can have a little peace knowing its not from the diabetes. My husband has 3 months to get his act together on his sugar meds or he will be doing insulin.

Susie


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 5/3/2009 11:45 AM (GMT -7)   
It does sound like radiculopathy. Those aren't nerves that can be burned. Usually when they are talking about rhizotomies, they are talking about burning the nerves in the facet joints.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 5/3/2009 12:23 PM (GMT -7)   
Me,
If only it was easy to find the location of our pain or nerve problems! You've already been through so many surgeries - an entrapped nerve just means a nerve is being compressed somewhere. "Somewhere" can be a lot of places. But maybe you will get lucky. I'm not sure how much the EMG can pinpoint the precise location of the problem. You'll just have to keep following up and asking questions about your options and go from there.

Good luck!

PaLady

Pamela Neckpain
Veteran Member


Date Joined May 2008
Total Posts : 1821
   Posted 5/3/2009 1:18 PM (GMT -7)   
Rhonda,

One of my diagnoses is Radiculopathy. Mine, of course, is in my upper spine. (I guess) I don't really know what
it is. There is a world of stuff I do not know. I just keep chugging away trying to find out.

Actually, having a painful nerve burned away sounds good. (Serious)

That EMG is reallllllllllly something. It caused me say a bad word my pain doctor didn't have a clue that I even knew
the meaning of. "OH $&^#!" After that, each time I got zapped, I'd laugh real loud. It was kind of like crying but
it came out as laugh. Weird. Huh?

Pamela smhair

modelmaker
Regular Member


Date Joined Feb 2009
Total Posts : 168
   Posted 5/3/2009 2:05 PM (GMT -7)   
I have had some EMGs that hurt so bad I had to terminate the procedure. Some involved particularly sensitive areas of the body if you get my drift. That is a gruesome test that should be banned. I am not sure what they determine that can't be determined in other ways that are less painful. I asked my Dr. if the termination of my EMG would change his treatment. He said not at all. My next question was "then why do you do it? To pump up your billing?" There was silence to that.

Modelmaker

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 5/3/2009 2:07 PM (GMT -7)   
okay, I'm a bit confused. One of my dx's is radiculopathy (& radiculitis) of both arms & legs. I've had RF done on both my neck & low back. In both cases, it completely eliminated the pain in my limbs. Prior to the last procedure, I had pain in my low back starting at L3, radiating down my spine to the SI joint, spasms across my entire low back region, burning pain going around my right side (in a single line) to my iliac crest, then over to the inside of my thigh, plus burning pains & shooting pains going down the outside of my leg down to the bottom of my heel. My left leg often hurt too, but mostly it was due to muscle spasms -- the burning pain on my left side was from the SI joint around my side to the iliac crest, sometimes continuing to my inner thigh. The muscle in the back of my right thigh was almost constantly in deep spasms which were only alleviated by deep tissue massage & then only during the massage itself w/ no residual benefit. Because of that, my left leg had to work harder, so it would hurt a lot too & after 10 minutes of walking, would develop cripplingly painful shooting pains traveling all the way down to my foot.

After the RF procedure (10 lesions total: 4 at L5 & 6 at S1), the shooting pain went away after a few weeks, the burning pain went away after a month or so, the muscle spasms went away after another couple months of PT. My low back pain is significantly reduced. I can walk for up to 20 minutes straight without having any problems with my back or legs. After the prior RF at C2, my neck & shoulder pain were basically completely gone & the pain down my right arm was completely eliminated.

So, I'm not sure what the qualifiers are for getting an RF (Radio Frequency Nerve Ablation) procedure, but I don't think that a dx of radiculopathy would automatically rule it out -- at least, based on my personal experience.

best of luck,
frances

modelmaker
Regular Member


Date Joined Feb 2009
Total Posts : 168
   Posted 5/3/2009 2:09 PM (GMT -7)   
Radiculopathy is a general term relating to nerve root irritation by the discs and/or spinal structures. It is not any specific nerve nor is it a procedure.

Modelmaker

modelmaker
Regular Member


Date Joined Feb 2009
Total Posts : 168
   Posted 5/3/2009 2:17 PM (GMT -7)   
Since radiculopathy relates to irritated spinal nerves, depending on the type of nerve a number of nerve-terminating procedures are possible: RFA (radio frequency ablation), CNL (chemical nerve lesioning) and actual dissection (cutting) of the affected nerve. These were explained to me some time ago. First I tried the RFA. I found the procedure to very painful. And the nerve pain returned after a year or so. Then I tried CNL. The nice thing about that is the nerve is first identified and the deadened before it is killed by phenol. That procedure has been very effective for me in the lower spinal facets (L3,L4,L5). Hope this helps.

Modelmaker

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 5/3/2009 3:08 PM (GMT -7)   
Modelmaker,

My PM identified the nerves that were the irritants before the procedure. We had multiple trial runs with local before the actual RF procedure to identify exactly which nerves were the culprits. I had tried it before with just one nerve & didn't get much relief, but by doing multiples I finally got to feel better.

The RF procedure itself was not painful at all. I was given a bit of local, so perhaps that made the difference. I wanted to try one lesion without anything & it was starting to hurt, so my PM made sure to use local for all the rest of them. Normally, he wouldn't even have tried that, but he knows how nervous I get when I can't see the needles going into me, so he agreed to try it & it did sting! I feel really, really bad for you if your PM didn't give you any local. Often the RF's are done under sedation & almost always the surgeons at least use a local anesthetic prior to burning the lesions. I'm glad they got it right for the chemical rhizotomy, but really it should have been done all along.

I've talked with a lot of people who had their nerves cut out. I'm not sure they even do that anymore b/c more often than not, the nerve grows back with one of more neuromas. Not fun!


Rhonda,

The RF procedure does last different periods of time for different people. It depends on how fast the nerve can heal itself. Average time, I'm told, is 18-36 months. Since I'm a slow healer, mine lasted for 7 years.
From what I've read, chemical rhizotomies achieve roughly the same results. So it may be a roll of the dice as to which is better for any given person. Also, not all doctors will do both procedures, so I would recommend that you talk to your PM about what would be best for you & whether she is qualified to do both types of procedures. In either case, they should be doing something ahead of time to identify which nerve(s) are the culprits. This is both to make sure to get the ones that cause pain & to make sure they don't zap a nerve that controls motor function. Often, the trials are mandated by insurance companies, but even if they aren't, I'd make sure to get some kind of testing to find the nerves causing your pain.

good luck!
frances

modelmaker
Regular Member


Date Joined Feb 2009
Total Posts : 168
   Posted 5/3/2009 4:54 PM (GMT -7)   
I do recall that with my RFA, they kept me awake to help identify nerve responses. They stimulated motor nerves with a low frequncy (maybe 5-20 hz.) to make the muscles jump or shake. This identifies the motor nerves they do not want to touch. Then they stimulate the sensor nerves with a much higher frequency.....wow did that hurt! Then they burned with the very high frequency (RF) and high current. I remember screaming and nearly passed out with that. Hopefully the newer techniques, like Frances said, are more comfortable.

Frances, your comment about neuromas reminded me of something else my PM doc said. Because of my multiple back surgeries, it is very possible that the nerves severed during surgery (the incision, not the facet joints) have tried to reconnect but can't do it properly. Those that do connect to the wrong nerve end are the ones that cause a great deal of confusion as to where the pain is coming from. Those that don't connect at all form a neuroma or cluster of nerves that is likened to a ball of spagetti. They just start firing randomly and cause their own brand of pain. Again, the pain may or may not appear to be at the incision site. Sometimes this neuroma pain can be misdiagnosed as scar tissue pain. This false wiring of the nervous system post-surgery can really complicate pain management. What fun!

Modelmaker.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13479
   Posted 5/3/2009 5:54 PM (GMT -7)   
The emg studies (needle type) measures the nerve conduction velocity of the electricty to the nerve. Slowing of the nerve impulses indicates a nerve problem. Have seen these done for both lumbar and cervical problems, as well as to rule out carpal tunnel syndrome. In the 80's and early 90's this test was done to identify what level was involved with the nerve such as say L5-S1 or or C-5-6. The accuracy of the test back then was about 75% so it is not the most reliable of testing. Kind of like when they did arthrograms on shoulders and knees back then, they were not all that reliable either. I read more EMG reports stating the test was normal rather than abnormal. Needless to say it was not the "gold standard testing" to rule out nerve involvment thank goodness. Between Ct's, EMG and myelogram & post myelogram Ct these were the tests done here to see if a person was a surgical candidate. Even after MRI's came out, in the beginning our drs here would not do surgery unless a myelogram was done.

Me when you see your dr again ask her what level of involvement showed up on the test...Susie


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 5/3/2009 6:12 PM (GMT -7)   
Thanks everybody...I was kinda freaked, but now I feel better. When I go for my regular appt. I will be sure to ask about it..Another good thing is I got a copy of my latest MRI report...When I feel better I will write it and ask for opinions...

Me.
 I hate Boats!!!!
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night
                                                                    

 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13479
   Posted 5/3/2009 6:20 PM (GMT -7)   
Frances, I had RFL of the medial branvh nerves done on my neck and back and mine were done pretty much the same as yours. My pm dr also did the trial prior to the RF as you stated to locate the correct area. Mine were done under light sedation because you do have to be able to answer his questions during the procedure. I did relatively well until he hit one spot in my low back and at that time I thought I would jump off the table. The pain he recreated made me sick at my stomach. After having the RF done on my neck, the pain under my shoulder blades completely disappeared, it was like a miracle. I could not believe a simple procedure such as an RF could alleviate that pain, everything else tried, failed miserably. I had more massage therapy than the law ought to allow and still could not get rid of the pain. I can't remember how many massage therapist worked on me either. My neck pain is pretty much gone, oh I get some pain here & there with my neck, but nothing like before. It only gave me almost a yr of relief with my back and then I was back to square one. The dr told me some RF's have lasted as long as a year, depends on the person. He did tell me it was a temporary treatment not permanent. I do know if that kind of pain returned, I would not hesitate to do it again. Susie


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 5/3/2009 7:37 PM (GMT -7)   
Hi Rhonda,

Yuck! Those EMG's sound horrific! I've never had one. I've narrowly avoided having to get one & I hope it stays that way! Everything that I have heard is how horrible and painful they are. But you survived it! It's over! It is good that you don't have diabetic neuropathy, as it's just one more thing that you don't need - but not great news about the entrapped nerve. Boy does that sound painful! Hopefully your doc will be able to explain it & your options in more detail next time you see him!
Hope you're not in too much pain tonight!

Skeye

cshelp
Regular Member


Date Joined Mar 2009
Total Posts : 96
   Posted 5/3/2009 8:29 PM (GMT -7)   
How expensive is an EMG and I heard that you cant take any meds prior to the EMG, is this true?

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 5/3/2009 10:49 PM (GMT -7)   
CShelp,
My insurance always picked up the cost of the EMG, but it may depend on your plan. I always took my meds, although I didn't take a dose close to the EMG, but waited until after - especially meds that affect nerves like my neurontin.

If there's no problem with the nerves, I didn't find the test painful. But when I had severe carpal tunnel syndrome, you could have pulled me off the ceiling! Course that was the first one I ever had, and didn't have any idea how bad it could be. The EMG I had for neuropathy in my legs was basically negative, and I didn't find it significantly painful.

PaLady

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 5/3/2009 10:51 PM (GMT -7)   
My spots were identified during the trials. In the trials, it did hurt for a second or two when my PM would torture my angry little nerves. Yes, it hurt like the dickens for a couple seconds, but no more than my normal spikes in pain.

For the actual RF itself my PM operated mostly off the saved images from the trials. He did need to use that buzzing machine, but kept it low. I could also feel the needle with the local going into the nerves, so that gave us some additional information reaffirming that he had the right spots on the nerves identified. My previous PM moved it to a much buzzing thing to a higher level, but somehow it didn't bother me as much in my neck (maybe b/c the muscles back there had atrophied?).

In any case, I wouldn't say it's something to fear. Definitely not any more painful than an epidural. And if any part of your EMG came back clean, then I would say that those parts of the EMG test would be quite a bit more painful than RF. The EMG is a horribly painful test unless you have the kind of nerve damage that it tests for. If you made it through that, you can probably make it through anything. :)

uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 5/5/2009 5:54 AM (GMT -7)   
They never said NOT to take my meds..so I did. The only thing that she said during the test was that I had so much scar tissue that my muscles were always spasming...that really explained alot to me..always in pain from that...The only part of the test that hurt was when she put the needle in the front of my leg, on my shin...Yowsa!!!!

Me.
 I hate Boats!!!!
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night
                                                                    

 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13479
   Posted 5/5/2009 12:48 PM (GMT -7)   
Me, I asked a dr here that does EMG's only and he said that taking our meds had no bearing on the tests. He explained since its an electricity type testing meds would not intefere one way or the other. Susie


cshelp
Regular Member


Date Joined Mar 2009
Total Posts : 96
   Posted 5/6/2009 11:41 AM (GMT -7)   
thanks for the advice cshelp
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