FAQs

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.

Motor neurons transmit electrical signals that cause muscles to contract. An EMG uses tiny devices called electrodes to translate these signals into graphs, sounds or numerical values that are then interpreted by a specialist. During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle.

The EMG/NCS study examines the integrity of the peripheral nerves and muscles of the body. The study does NOT examine the brain or spinal cord. It is important to realize that you can have a nerve or muscle problem, even though you may not “think” you have any nerve or muscle problems. This test does NOT measure pain. You may have a normal EMG-NCS study, even though you have severe pain.

EMG stands for ELECTROMYOGRAPHY and NCS stands for NERVE CONDUCTION STUDIES. The test consists of two parts:

• An Electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerves control the muscles in the body by electrical signals (impulses), and these impulses cause the muscles to react in specific ways. Nerve and muscle disorders cause the muscles to react in abnormal ways. During an Electromyography study, a very small pin (needle) is inserted in the muscle that helps us evaluate the condition of your muscles.
• Nerve Conduction Studies (NCS) are used to measure the health of your nerves. Mild electrical stimulation is administered to the skin directly overlaying the nerve. The response is measured by a second set of electrodes applied to the surface of the skin. This impulse produces a visual signal on a computer monitor and when analyzed it can provide information about the condition of the nerve.

Measuring the electrical activity in muscles and nerves can help find diseases that damage muscle tissue (such as myopathy and muscular dystrophy) or nerves (such as amyotrophic lateral sclerosis or peripheral neuropathies). EMG and Nerve Conduction Studies are often done together to provide us with more complete data.

The test is generally not painful. You may feel slight skin discomfort at the needle insertion points but it should not be painful. Afterwards, the muscle may feel a little sore for a few days.

Each EMG / NCS study varies from patient to patient. Depending on how many extremities are tested, the entire test may take between 30 to 90 minutes.

• Shower or bathe but do not use powder, oil or lotion as your skin should be clean and free of excess oil;
• Wear loose fitting clothing;
• Remove any metal objects that may interfere with the procedure such as jewelry, hairpins, eyeglasses and hearing aids;
• Fasting is not required but it is recommended that you avoid caffeine and sugary beverages for at least 2 or 3 hours before a test

People with complaints of numbness, tingling, paresthesia, weakness or pain in the spine or the extremities can benefit from EMG/NCV studies to provide valuable information towards a definitive diagnosis.

If you suffer from any of the following, you could benefit from diagnostic testing.

Low Back Pain	Weakness in the arms	Diagnosed with diabetes
Numbness in the Legs	Weakness in the hands	Diagnosed with neuropathy
Neck Pain	Weakness in the legs	Dizziness / Vertigo
Numbness in the arms	Overall Muscle Weakness	Headaches
Numbness/Tingling in the hands	Loss of sensation or decreased sensation in hands	History of Falls due to Dizziness or Unsteady gait
Numbness/Tingling in the feet	Loss of sensation or decreased sensation in feet	Hypertension or hypotension
Burning Sensation	Radiating pain in arms
Sensation of pins & needles	Radiating pain in the legs

For your safety and for the success of you test, please tell your electromyographer (your tester) if you:

• Have any bleeding problems;
• Take blood thinners (anticoagulants), including aspirin or Coumadin;
• Take medications (prescribed and over-the-counter) or herbal supplements;
• Have any immune system problems;
• Have had any neck or back surgery;
• Have AIDs or hepatitis;
• Have a cardiac defibrillator or pacemaker.

Yes. Electromyography (EMG) is an invasive procedure and, in accordance with § 54.1-3482 of the Code of Virginia, requires physician referral and direction.

A nerve conduction velocity (NCV) test — also called a nerve conduction study (NCS) — measures how fast an electrical impulse moves through the nerve. NCV can identify nerve damage.

During the test, the nerve is stimulated, usually with electrode patches attached to the skin. Two electrodes are placed on the skin over the nerve. One electrode stimulates the nerve with a very mild electrical impulse. The other electrode records it. The resulting electrical activity is recorded by another electrode. This is repeated for each nerve being tested. The speed is then calculated by measuring the distance between electrodes and the time it takes for electrical impulses to travel between electrodes.

A related test that may be done is an electromyography (EMG). This measures the electrical activity in the muscles. It is often done at the same time as an NCV. Both tests help find the presence, location, and extent of diseases that damage the nerves and muscles.

When the test is completed, your tester will review all information, put together a comprehensive report detailing the information discovered and forward the report to your referring physician who in turn will review the results with you.

Don’t forget to call their office and schedule a follow up with him / her to learn of your results and the next steps in your treatment plan.

MSKUS is very similar to the more common sonogram used during pregnancy as it uses sound waves to create an image of what’s going on in the body in real time. MSKUS captures movement of muscles, tendons and nerves and often provides a clearer image of these structures than other types of imaging. This clearer image enables your healthcare provider to more accurately diagnose strains, sprains, inflammatory conditions such as tendonitis or bursitis, nerve entrapments and hernias. 

Your physician may recommend a Musculoskeletal Ultrasound if you have shoulder or foot pain or to determine the cause of any symptomatic muscle or joint. It is also an excellent option for patients who cannot have an MRI scan because of claustrophobia or contraindications like a pacemaker. 

A Musculoskeletal Ultrasound can identify torn muscles, tendons and ligaments, as well as abnormalities such as tendinitis, bursitis and fluid inside of joints. MSKUS is also helpful for characterizing the nature of lumps and hernias. 

Ultrasound finds the real source of the problem as it enables us to “see inside your pain.”

Clinical evidence and research supports MSKUS as the first diagnostic test for many musculoskeletal injuries. Compared to X-Ray, CT and MRI, diagnostic ultrasound offers a number of important advantages including:

Chiron Diagnostics participates in most major insurance plans and also works with Worker’s Comp and No-Fault (motor vehicle accidents).

We will contact your insurance company prior to your arrival to learn the exact parameters of your coverage, including what your financial responsibility may be. 

In the event you do not have insurance or we do not participate in your insurance plan, we do offer a self-pay (cash) option.

We know you don’t want to be here, pursuing this testing. Please know our focus is ALWAYS on you and working to make this time as easy as possible.

In the event you do not have insurance or we do not participate in your insurance plan, we do offer a self-pay option.

We know you don’t want to be here, pursuing this testing. Please know our focus is ALWAYS on you and if finances are playing a role in you obtaining the testing you need, please let us know by calling or emailing Lisa (lrichter@chironptva.com) or Lindsay (lsimmons-campbell@chironptva.com) in confidence.

Your insurance company dictates what – if any – financial responsibility you may have associated with your diagnostic testing.

If you do have a financial responsibility, we accept cash, check, debit and credit card, HSA (Health Savings Accounts) and FSA (Flex Spending Accounts), with payment expected at time of service.