Do I Have a Pinched Nerve in My Neck?
You have likely heard of someone complaining of a “pinched nerve” when referring to pain experienced in the neck or back that extends into the limbs. What exactly is a “pinched nerve” and how does it happen in the neck? What are the signs and symptoms of a pinched nerve? Who should you see if […]
Q & A: Is Electrodiagnostic Testing or Neuromuscular Ultrasound Superior in Diagnosing Peripheral Neuropathy?
Q: Which test is better with localization of the lesion? A: Electrodiagnostic (EDX) testing remains the gold standard in diagnosing focal neuropathies. It can provide useful differential diagnosis information to determine the site of lesion responsible for hand and foot numbness, e.g., median neuropathy at the wrist versus cervical radiculopathy. On the other hand, ultrasound […]
Lessons and Tips for a Novice Electrophysiologist
You have been working as a physical therapist for years treating all sorts of conditions, but you are looking to specialize and set yourself apart from others while also expanding your future options. You are seeing the trend in physical therapy reimbursement and are looking for ways to help supplement or offset the decline. The […]
Nerve Facts
“I never knew how hard it could be to button a shirt without feeling my fingers.” As I work with patients experiencing nerve damage, conversations often turn in this direction. Our bodies are incredibly complex, and yet most of the time they function very well. It is easy to take this for granted. After […]
What do you Expect with an Ulnar Nerve Injury?
A patient comes to see you with numbness and tingling of the right ring and little fingers. As you are an astute clinician you infer that the patient either has an ulnar nerve injury or a possible C8 cervical radiculopathy, but how do you know exactly where the likely cause of injury is? A careful […]
It’s All In The Wrist: A Primer On Ulnar Nerve EMG/NCV Evaluation in Guyon’s Canal
Although carpal tunnel syndrome affecting the median nerve is designated as the most common entrapment mononeuropathy in the upper extremity, another player deserves honorable mention: the ulnar nerve in Guyon’s canal. EMG/NCV plays an important role in helping identify and localize a compromise of the ulnar nerve at the wrist. A brief anatomical review of […]
What do you Expect with a Radial Nerve Injury?
A patient comes to see you with wrist drop. As you are an astute clinician you infer that the patient has a radial nerve injury, but how do you know where the likely cause of injury is? A thoughtful and thorough clinical exam should shed some light on the situation. Wrist Drop. Image source: Flickr […]
It Takes Two to Tango: Why EMG and NCS Always Go Together
If you have read many of my articles, you have probably noticed that I like to refer to electrophysiologic testing as “EMG/NCS.” Although this acronym is much shorter than the tests’ other names (like “electrophysiologic testing”) it is still a bit of a mouthful, and many people prefer to shorten it even further to simply […]
The Effect of Monochromatic Infrared Energy on Sensation in Patients with Diabetic Peripheral Neuropathy
Based on 5.07 monofilament testing there was no statistical difference in lower extremity sensitivity when using monochromatic infrared energy as compared to a placebo. This study is an underpowered, negative trial due to its small sample size and inclusion of the null value. Clinical judgments prove difficult to determine due to sample size. Level of […]
How Well Do You Know Your Nerves?
Evaluating the neuroanatomy of any patient is an important part of the clinical exam that is vital in making an accurate diagnosis. Just because a patient cannot raise their arm above their shoulder does not inherently mean their ailment is a musculoskeletal shoulder issue. There should be a list of possible diagnosis that need to […]
