hand atrophy and how long are EMG results good for?

[jerseygirl]

Hi everyone,

Thankfully I haven't been on in awhile which means I am moving in the right direction but not home free just yet. I just came back from an orthopedic dr. appt and to make a long story short, he noticed my thenar and arm atrophy right away. He said it is from a C6/C7 injury but of course, I got that old knot in my stomach. I had an emg on the same hand 14 months ago so just wondering a couple of things:
1. anyone else have this kind of atrophy from a cervical herniated disc?
2. anyone's dr.s say how long negative results of an emg are good for?

I dislike this place I am in so much right now and want to get back to healing so any advice would be so welcome!

Thanks and good health to everyone,

Jersey girl

[Cobber]

Hello

I have BFS and spinal stenosis.

I have an atrophied left calf and weak left toes that won’t lift off the ground which are due to spinal problems. 15 years ago I had a herniated disk that was painful for 2 years. I fixed it by doing months of exercises in the pool and then became pain free. Then in early 2013 I got muscle twitching in my calf plus other BFS symptoms following a bout of the flu and then (following doctor visits, neuro visit and EMG, MRI) was diagnosed with spinal stenosis or long term disk heriniation. The L5, S1 area is very narrow so they concluded that it has caused muscle thinning in my left leg due to nerve damage.

My understanding is that nerve damage from the spine can cause atrophy and muscles to shrink. For some people this can become a major problem (especially the elderly who don’t move a lot) and the specialists recommended to keep exercising to maintain the muscle that I have. I’m a keen sportsmen and have been running, cycling and swimming regularly ever since my teens (I’m 43 now). So even though my leg muscles have thinned gradually over the years it’s not like they are too weak to exercise. I think if I just sat around all day though it could become an issue over time.

Hope this helps. I think spinal related nerve damage may be more prominent on this site than what people realize. Especially if you don’t have back pain (like me) then it may not be obvious. I was very concerned when I noticed my toe weakness and 24/7 twitching in the calves (no exaggeration, I probably get around 40 per minute for the past 16 months non stop) and it wasn’t until the MRI of my back before they could see just how narrow my spine is. Obviously the EMG was helpful too but it won’t show spinal canal thinning.

Cheers

[jerseygirl]

Thanks Cobber for your detailed response. It is certainly alarming for a health anxiety individual to have a doctor say "wow look at your arm and thenar atrophy" as you can imagine. But I also have pain from arthritis in my thumb and palm and now a burning sensation in my arm so my practical side says it has to be the C6/C7 but again for a recovering health anxious person, it is certainly hard to process this. I also wish I knew how long EMG results are good for. . . then I could hopefully find peace in knowing that my 14 month ago one should ease my mind but for some reason, I think I remember lots of people redoing them every year?

[DoubleD]

There is NO pain in als. dont even look in that direction. Get the real problem fixed.

DD

[jerseygirl]

Yes but the dr said the thenar is atrophied

[Yuliasir]

My dear.
compression of the nerve root at the cervical level can cause atrophy so this is not strange. Any physical trauma preventing nerve from normal operation causes atrophy. Even a simple immobilization in a cast causes atrophy due to limited usage of muscle, so there could be differnt causes for atrophy and this diagnosis itself does not mean a death sentence anyway. Carpal syndrome and cubital syndrome at which nerve is pinched at the levels distal to the spine (elbow or wrist joint) causes atrophy too (and quite severe).

EMG results are as good as there is no significant change in your neuromuscular condition.
if you got neck trauma after your EMG, then results are not valid and have to be reassessed again. If you did not have acute trauma but a chronic one, then again EMG might changle if the chronic trauma caused denervation. But it still willdefinitely show in your case lack of upper motor neuron disfunction common for MND

normally there is no need to repeat EMG ever, unless you do not have significant impairment of the motor function.

[jerseygirl]

Well interestingly enough, my doctor called today and asked me to go for an emg which he scheduled for today. It was with a neurologist I have never met before and was very nice. One dr. did the Nerve part in the beginning and then she came in, looked at me and said "I am pretty sure you don't have ALS". She put one needle in one hand, another needle in the other and said you don't have it. I have had a couple of emg's but never just two needles. She also said that I have carpel tunnel syndrome along with atrophy from my C6/C7. Has anyone every heard of this abbreviated emg???

[Yuliasir]

well this was not abbreviated but targeted one.
why the hell they need to stick needles everywhere if you have clear points of damage?
Carpal syndrome, as for many of us, and compression trauma confirmed, no ALS, GOOD!!!!!!!!!!

[jerseygirl]

You are so right Yulisiar!

[Yuliasir]

Yes but the dr said the thenar is atrophied

again, muscle atrophy DOES NOT MEAN ALS.
atrophy may be present (except MND) in the following cases:
- low muscle activity (cast, other issues preventing active usage of muscle)
- compression trauma of the nerve
- neuroinfection resulted in decreased innervation
- weak paralysis caused by stroke
- chronic ishemia of the muscle (bad circulation)
- muscle deterioration due to rabdomyolisis (for example, casued by methabolic diseases)

for example, famous Russian tyrant Iosif Stalin was known to have his left hand partly atrophied since his childhood. he was still able to use it, but it was smaller than his right hand and definitely less mobile. Stalin itself had explained this as a result of childhood trauma and subsequent infection, so you can see that this was not fatal for him.


ALS is not a disease of external signs like atrophy or even paralysis, or bulbar issues etc.
Root cause of ALS is degradation of motor zones in the brain ans subsequent (or concurrent) degradation of anterior horns in the spinal brain. As this is a general disaster for motoric function, paralysis, paresis and atrophy result from it. But for any scary symptom we should look for what is the underlying process. That is why EMG is done - to see, if your deficicte is local or global. Yours is local and probably even could be reverted.

[Capital H]

Aha I have left hand atrophy too. It is annoying to say the least, and it is both sides of the hand, it comes from multiple nerve compressions, I have had the elbow and wrist operated on, but I also have a problem in the C spine, you bet I do, it is very painful at times. It does sometimes cause a problem down the whole left hand side right down to my toes. It was actually numbness in my leg that started this whole story getting on for a decade ago now. Be reassured it won't kill you.

[jerseygirl]

Thank you for that! Your post is very helpful