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Diagnosing and Treating Your Pain With Electric Currents
By Daniel Casciato

Experiencing any tingling, muscle weakness, numbness or some type of muscle pain? It could be some-thing minor like carpal tunnel syndrome or an even more serious condition such as a nerve disorder. An electrodiagnostic study is a useful way to find the cause, or causes, of your symptoms and is considered to be the most reliable way to assess nerve damage. It can also be used to study the effects of diseases such as diabetes.

"It determines what pathology there is and help guide what further diagnostic study needs to be performed as well as guide what further treatment is needed, if any," says Dr. Anthony Kirby, a pain management physician with South Hills Pain & Rehab.

Think of your body as an electrical generator where your nerves and muscles create electrical signals that deliver messages to and from your brain. Injuries affecting your nerves and muscles can slow these elec-trical signals. If you suffer from any pain, weakness or numbness in your back, neck or hands, measuring the speed and degree of electrical activity in your muscles and nerves through an electrodiagnostic study can help your physician diagnosis your condition.

Only physical medicine and rehab doctors and neurologists will conduct an electrodiagnostic study, mak-ing South Hills Pain & Rehab one of the few practices in the region to conduct this non-invasive proce-dure. The electrodiagnostic test is comprised of two separate tests: nerve conduction studies (NCS) and electromyography (EMG). During the nerve conduction study, electrodes are tape in various places along the nerve pathway.

"Your nerves are like wires. We use a small current of electricity at one end of the wire to stimulate the wire to assess the function of the nerve," explains Dr. Kirby, one of the pain management physicians who conducts the electrodiagnostic study, which is an extension of his physical exam.

As the signal propagates along the wire, Dr. Kirby records the signal at the other end of the wire. If a nerve is a pinched at the wrist or elbow, there will be changes. In healthy nerves, electrical signals typi-cally conduct electricity at the same rate. If the nerve is damaged, however, the signal is slower and weaker.

"I can tell by how much of the signal gets through and how strong of a signal I get at the other end," says Dr. Kirby. "And if a nerve is pinched, I can tell how severe it is."

The second part of the test is the EMG which records and analyzes the electrical activity in your muscles. During an EMG, small, pin electrodes containing a teflon coating are placed in the muscle to record the electrical activity. Dr. Kirby explains to patients that he is listening to the electrical (E) activity inside their muscles (M) while using a machine that gives him a signal he can see and hear (G for graphy). A normal muscle at rest is electrically silent. There will be irregularity if the muscle is diseased or injured.

"This test allows me to listen to individual muscle fibers within the muscle," he says. "If there's a prob-lem with the muscle itself or with the nerve that goes to the muscle, I can tell by listening to the muscle. Although it's not necessarily a comfortable test, most people tolerate the test very well."

The combined tests take about a half hour total and Dr. Kirby notes that there are no residual effects or pain from the test.

"The patients are informed of the results and treatment recommendation before they leave the office," he adds. "They always know the results before their own doctor."

To schedule an appointment with South Hills Pain & Rehab, call (412) 469-7722. Their main office is in Jefferson Hills and they have satellite locations in Bethel Park, Monessen and Brentwood.

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