EMG/NCV (Electromyogram/Nerve Conduction Velocities)
EMG/NCV is a specialized test to determine the integrity of nerve and muscle function. This test is commonly ordered when a patient is experiencing pain, numbness or weakness in a limb. The test determines how fast the nerve transmits its message as well as how the nerve and muscle communicate. It can also tell if there is previous or existing muscle or nerve damage. Typical diagnoses that are sent for evaluation include radiculopathy, carpal tunnel syndrome, peripheral neuropathy, plexopathy, and myopathy. The findings obtained with EMG/NCV are useful in confirming diagnoses and directing treatment.
Trigger Point Injections
Trigger points are tight bands of muscle that cause pain and restricted range of motion. They are often treated with medications, therapy, and modalities. However, sometimes despite these treatments, the pain and accompanying muscle spasms persist. When this occurs, an injection of lidocaine and/or a steroid medication can help break up the cycle of muscle spasm and relieve the pain. When accompanied with modalities and strengthening as well as postural changes these injections can effectively relieve pain.
When joint pain is present, it is often caused by inflammation. An injection of cortisone directly into the joint can be a fast and effective to relieve pain. Cortisone has strong anti-inflammatory properties and is good for temporary relief of pain but is not a long term solution.
These injections are better known by their brand names such as Synvisc and Hyalgan, among others. They are derived from hyaluronic acid which is naturally found in joint fluid. The injections are performed once a week for three to five weeks depending on the medication used and whether they have been performed previously. By increasing joint lubrication, viscosupplementation injections can help relieve stiffness and pain. They can often give relief for six months or longer and can be repeated potentially avoiding joint replacement surgery.
Dr. Vlachos is a Qualified Medical Examiner and has been certified by the Division of Worker’s Compensation to perform disability evaluations and write medical legal reports. Independent Medical Evaluations are evaluations for long term disability that Dr. Vlachos performs as well.