Electromyography (EMG) (2024)

How does an EMG test work?

To understand how an EMG test works, it helps to understand how your muscles work.

Your motor nerves (motor neurons) send electrical signals to your muscles to tell them what to do. (These signals originate in your brain, travel down your spinal cord, through your motor nerves and to your muscles.) This electrical stimulation causes electrical activity in your muscles, which causes them to contract (tighten). The muscle contraction itself also produces electrical activity.

Normally, a muscle at rest has no electrical activity. A slight contraction of the muscle results in some electrical activity, which increases as the muscle contracts more intensely.

In electromyography, a healthcare provider inserts a small needle with an electrode into one of your muscles to record its electrical activity. The provider doesn’t deliver electrical stimulation through the needle. Instead, you can think of the needle as being similar to a microphone — it’s only a recording device.

As you rest or contract your muscle, the needle electrode records the electrical activity. The needle is attached through a cable to a computer that allows the provider to see what your muscle is doing both at rest and with movement. It appears as waves on a screen. They may also use an audio amplifier so they can hear the pulses of electrical activity.

The provider then analyzes these readings to look for signs of issues. For example, if your muscle is damaged, it may have abnormal electrical activity when it’s resting. When it contracts, its electrical activity may make abnormal wave patterns.

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How do I prepare for an EMG test?

Before you have an EMG, you should:

  • Bathe or shower and wear comfortable, loose-fitting clothing.
  • Avoid putting cream, lotion or perfume on your skin. Creams and lotions can affect the test’s accuracy.
  • Tell the healthcare provider who’s performing the EMG if you’re taking a blood thinner medication (anticoagulant) such as warfarin. Blood thinners may increase your risk of bleeding after an EMG. But don’t stop taking your medication without talking to the provider who prescribes the medication.
  • Tell the provider if you have a pacemaker or any other electrical medical device.

In some cases, your provider may instruct you to not smoke cigarettes or drink caffeinated beverages, such as coffee or tea, two to three hours before testing. These substances may interfere with the test.

What happens during an EMG test?

Neurologists usually perform an EMG test right after a nerve conduction study. During the nerve conduction study, a provider will put electrodes (stickers) on the surface of your skin. They’ll then deliver a small electrical impulse that will feel like a shock to nerves and record the response. In most cases, they’ll test several different nerves.

The process can vary for an EMG, depending on the reason for the test and which muscles and nerves the provider is assessing. But in general, you can expect the following during an EMG test:

  • You’ll sit or lie down for the test.
  • A provider will locate the muscle(s) they want to test.
  • They’ll then insert a small needle with an electrode through your skin and into your muscle. These needles will stay in your muscles, and the duration of the examination for each muscle generally takes one to two minutes. You may feel slight discomfort or pain when they insert the needles.
  • The provider will ask you to relax and then use your muscles in certain ways, such as lifting or flexing one of your limbs, at certain times. A machine will measure and display the electrical activity of your working muscle. There will also be an audio (sound) component to the machine.
  • After the provider has recorded enough data from your muscle, they’ll remove the needle. They’ll repeat the same process in the next muscle until the test is concluded.

How painful is an EMG test?

You may feel some pain or discomfort when your provider inserts the needle into your skin and muscles. But most people can complete the test without issues.

After the test, the muscles they tested may feel tender for a few days.

How long does an EMG test take?

The test usually takes 60 to 90 minutes. It depends on how many muscles your provider needs to test.

What should I expect after an EMG test?

You may have sore or tender muscles for a few days after the test. The muscle soreness isn’t usually severe and should get better in less than a week. You may also see some bruising where the needles entered your skin.

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What are the risks of an EMG?

EMG is generally safe. Complications are rare. Some people (especially people who take blood thinner medications) may bleed after the test.

Electromyography (EMG) (2024)

FAQs

Can EMG results be wrong? ›

Like any diagnostic procedure or test, EMG is not perfect. A normal result does not mean a patient does not have a deficit in their nerve or muscle.

Is an EMG always accurate? ›

The sensitivity of EMG for the diagnosis of radiculopathy ranges from 36% to 64% in patients with only pain,2,4 and 51%–86% in patients with an abnormal examination. Studies of specificity are limited. One study reports 54%–58% specificity for any EMG abnormality.

What if EMG is normal but still have symptoms? ›

Your doctor may order an electromyography, or EMG, to see how well your nerves are working. If your EMG is normal and you continue to have symptoms of neuropathy, your doctor may order a skin biopsy to look at nerves that are too small to be tested with an EMG.

What is the most common cause of abnormal EMG results? ›

If your EMG shows abnormal electrical activity when a muscle contracts, then you may have a herniated disc or a nerve disorder, such as ALS or carpal tunnel syndrome. Depending on your results, your doctor will talk to you about any additional tests or treatments that might be needed.

What diseases does a normal EMG rule out? ›

An EMG can be used to diagnose a wide variety of neuromuscular diseases, motor problems, nerve injuries, or degenerative conditions, such as:
  • Amyotrophic lateral sclerosis (ALS)
  • Carpal tunnel syndrome.
  • Cervical spondylosis.
  • Guillain-Barre syndrome.
  • Lambert-Eaton syndrome.
  • Muscular dystrophy.
  • Myasthenia gravis.

Does EMG show all nerve damage? ›

An EMG can help diagnose a pinched nerve and issues related to it, but it can't “show” a pinched nerve. Imaging tests like X-rays, CT scans and MRI scans help healthcare providers see a pinched nerve and what's causing it (such as a herniated disk).

Can an EMG rule out neuropathy? ›

EMG, which consists of nerve conduction studies and needle electromyography, is an essential diagnostic tool in the evaluation of patients with suspected peripheral neuropathy. Many neurologists order an EMG for all patients with suspected peripheral neuropathy.

Does a normal EMG rule out ALS? ›

A common abnormal result in ALS patients is spontaneous electrical activity when the muscle is at rest. A normal EMG result will often result in a diagnosis of primary lateral sclerosis (PLS), but does not rule out the possibility of ALS developing later.

Why was my EMG test so painful? ›

Pain is commonly associated with EMG, because the procedure involves the use of needles and electric shock. Not only friends and relatives who have had a previous EMG experience, but also physicians can sometimes discourage patients from undergoing EMG, believing that the test is very painful and of little benefit (1).

Does an EMG show inflammation? ›

Electromyography shows how the nerves and muscles work together by measuring the electrical impulses along nerves, nerve roots, and muscular tissue. The results can help doctors distinguish inflammatory myopathies from other neuromuscular diseases, such as muscular dystrophy.

Can EMG miss peripheral neuropathy? ›

Since the EMG/NCV only picks up large fiber dysfunction, one can certainly have a negative EMG/NCV and still have peripheral neuropathy.

What is the No 1 medical condition that causes neuropathy? ›

Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes of neuropathy is diabetes.

What does an EMG rule out? ›

EMG results are often necessary to help diagnose or rule out a number of conditions such as: Muscle disorders, such as muscular dystrophy or polymyositis. Diseases affecting the connection between the nerve and the muscle, such as myasthenia gravis.

What do abnormal EMG results look like? ›

Abnormal EMG results can show up in two ways. First, the muscle may show electrical activity at rest. On the other hand, the muscle may show abnormal electrical activity during contraction. This shows up as an abnormal action potential pattern with changes in the size or shape of the wave.

Does MS show up on EMG? ›

The test can also measure the ability of peripheral nerves to conduct impulses. EMG results are usually normal in multiple sclerosis (MS) patients, as MS doesn't affect the peripheral nervous system.

What can affect EMG results? ›

Certain drugs that act on the nervous system (such as muscle relaxants) can interfere with electromyography results. You may need to stop taking these three to six days before the test. Have had bleeding problems or are taking blood thinning drugs, such as warfarin (Coumadin®) or heparin. Have a pacemaker.

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