Lower Back Pain – Functional Studies

Transcript

One thing that doesn’t have to do with imaging because those are structural studies, how things are put together. So MRI and CT are both structural studies. You may want a functional study and it’s called EMG/NCV and we have lots and lots of initials in medicine. But EMG is electro electric, myo, muscle, gram, study. NCV as nerve conduction studies, nerve conduction velocity. So we can look at nerves and we can tell how well they’re functioning was certain limits. The tests have their limits, but you stimulate, one thing you can do is you can see, gee, how fast the nerve travels. In other words, this is like going out with a radar gun on I-10 and see, gee, some of the nerves are traveling at 70 meters per second. Some are traveling at 50 meters per second. Some are traveling at 30 meters per second. And so it’s a function of telling you how fast that nerve is conducting. That’s one part of it and that’s a gross oversimplification but is still useful for patients to understand. The second part is the needle exam where needles are actually put into muscles. We know that just like highways that end in streets that end in particular places that the nerves and in particular places. Gee, that C6 nerve root that comes out of our neck is going to come down and is going to go to a muscle called the pronator which twists our hand in. I’m not a tennis player, but twist your arm in at the end of that. Maybe in golf someone pronates, I don’t know. But if you put a needle in that muscle and ooh, you see particular changes called fibs or positive waves and it’s not important what they’re called, but you see those changes that can tell you that that nerve root is irritated. And if you see one nerve root irritated, that may tell you one diagnosis. If you see lots of nerve roots that light up, it may tell you a different diagnosis and then used in conjunction with the nerve, conductions can tell you whether this is really peripheral neuropathy or whether this is a pinched nerve or whether this patient avulsed some of their nerves and their fall off of the truck. And so it was really helpful too, and it’s a functional study as opposed to a structural study.