Relevance of EMGs in Diagnosing Carpal Tunnel Syndrome
Several Bloggers have discussed having the problem of feeling pain and discomfort that is radiating into their hands - one, Mike, a patient of the Mayo clinic - had neck surgery then experienced pain in the distributions of median nerve.
EMG test presumably failed to confirm carpal tunnel syndrome (reported as "negative"). But surgery was recommended. I presume to decompress the median nerve at the wrist AKA carpal tunnel release.
First, EMG is the standard test and usually confirms or documents carpal tunnel syndrome - but there are exceptions. It may have been performed before changes takes place in the nerve and muscles. It usually takes 3 to 4 weeks or changes to occur. Every Hand Surgeon has cases in which EMG does not confirm what appears to be a strong clinical case of carpal tunnel syndrome.
If I feel strongly that a patient has carpal tunnel then I discuss the situation with the patient and frequently I have done carpal tunnel release- and there is unfortunately a small number of patients that do not see any improvement.
EMG is not a 100% test- a patient has to discuss the options with his or her doctor. The carpal tunnel release surgery is not a major procedure as an abdominal or thoracic procedure. It's straightforward- and can even be done under local - so it may be worth a try in order to relieve "carpal tunnel symptoms". I stress that I think about the indications long and hard and always have a frank discussion with the patient.
I would be interested in the experience of anyone who has had a negative EMG in the presence of strong clinical suspicion of carpal tunnel syndrome- what happened and how it was resolved- and if surgery was done.
Another problem is scaphoid fractures that don't heal- It is thought the natural progression is painful arthritis- initially localized then more extensive- I would like to know the experience of those known to have scaphoid fractures that have healed and whether they have had problems after they refused or rejected surgical definitive treatment.
Related Topics:
Technorati Tags: EMG,, wrist,, pain,, carpaltunnel
EMG test presumably failed to confirm carpal tunnel syndrome (reported as "negative"). But surgery was recommended. I presume to decompress the median nerve at the wrist AKA carpal tunnel release.
First, EMG is the standard test and usually confirms or documents carpal tunnel syndrome - but there are exceptions. It may have been performed before changes takes place in the nerve and muscles. It usually takes 3 to 4 weeks or changes to occur. Every Hand Surgeon has cases in which EMG does not confirm what appears to be a strong clinical case of carpal tunnel syndrome.
If I feel strongly that a patient has carpal tunnel then I discuss the situation with the patient and frequently I have done carpal tunnel release- and there is unfortunately a small number of patients that do not see any improvement.
EMG is not a 100% test- a patient has to discuss the options with his or her doctor. The carpal tunnel release surgery is not a major procedure as an abdominal or thoracic procedure. It's straightforward- and can even be done under local - so it may be worth a try in order to relieve "carpal tunnel symptoms". I stress that I think about the indications long and hard and always have a frank discussion with the patient.
I would be interested in the experience of anyone who has had a negative EMG in the presence of strong clinical suspicion of carpal tunnel syndrome- what happened and how it was resolved- and if surgery was done.
Another problem is scaphoid fractures that don't heal- It is thought the natural progression is painful arthritis- initially localized then more extensive- I would like to know the experience of those known to have scaphoid fractures that have healed and whether they have had problems after they refused or rejected surgical definitive treatment.
Related Topics:
Technorati Tags: EMG,, wrist,, pain,, carpaltunnel
