Introduction of Needle Electromyography

A well-planned needle electromyography (EMG) and the patient’ s cooperation have several advantages. (If you are not sure, consult the experienced electromyographer for the following procedures.)

Obtaining the maximal information for the working diagnosis.
Minimizing the patient’ s discomfort.
Shortening the length of examination.
Minimizing the number of needle penetrations etc.

A complete successful needle electrode examination includes the following:

History and physical examination
- Review the history for the reasons of referral for the test.
- Do a brief physical examination on the focus of the neuromuscular and musculoskeletal system.
Take steps to reduce patient anxiety and fear of pain or discomfort
- Explain the different phases of the procedure using simple language
- Clarify that a disposable needle will be used (except when doing single fiber EMGs)
- Explain that no electric current or stimuli will be emitted by the needle
- Assure the patient that no substances will be injected through the needle
- Inform the patient that sounds will be produced by his or her muscle activity and amplified by the equipment
- Reassure the patient that the minimum number of muscles will be tested, consistent with a complete diagnosis
Patient position: Find the most comfortable position possible on the examination table or in the chair for the patient and the most convenient position for the examiner.
- Supine lying.
- Lateral decubitus (side-lying): fetal position (full flexion of neck, trunk, hips, and knees) is very helpful for full relaxation of the paraspinal muscles.
- Prone position (to support and relax the testing areas, pillows are placed at various parts of the body: neck, chest, abdomen, hip, knee, (ankle).
- Sitting.

Place the patient in a comfortable position on the examination table with the site of needle insertion visible and comfortably reachable for the examiner. The distance from patient to examiner to EMG machine must be comfortably reachable.