From the Guidelines
Pain during Electromyography (EMG) procedures is a common concern for some individuals, primarily due to the insertion of thin needle electrodes into muscles, which can cause a brief sharp or pinching sensation. The procedure itself involves measuring electrical activity in muscles, and the discomfort typically arises from the needle insertion, similar to receiving an injection 1. Several factors can contribute to heightened discomfort during EMG, including:
- Lower pain thresholds
- Anxiety about medical procedures
- Certain medical conditions like fibromyalgia
- Testing deeper muscles
- Multiple insertions required
To minimize pain and discomfort, some strategies can be employed, such as:
- Taking acetaminophen (500-1000mg) 30-60 minutes before the procedure
- Avoiding caffeine
- Getting adequate rest before the test to reduce muscle tension
- Using techniques like gradual needle insertion and distraction methods by the physician performing the EMG 1. It's essential to note that while EMG can be uncomfortable, the pain is usually momentary, and the diagnostic information gained often outweighs the temporary discomfort experienced during the procedure.
From the Research
Factors Contributing to Pain During EMG Procedures
- Anxiety and worry about the test or other unrelated issues can increase the likelihood of high anxiety, which may contribute to the experience of pain during EMG procedures 2
- The use of anti-psychotic or anxiolytic drugs may also increase the likelihood of high anxiety 2
- Patient expectations regarding the test can influence anxiety levels, and misinformation about the nature of the test may contribute to increased anxiety 2
Methods to Reduce Pain During EMG Procedures
- The use of topical analgesic creams such as EMLA can partially relieve the pain of EMG needling 3
- Techniques such as vapocoolant spray, ibuprofen, slapping or stretching the skin may also reduce pain 4
- Muscle selection is a readily modifiable mediator of EMG-associated pain, and choosing less painful muscle sites may help reduce discomfort 4
Patient Experience of Pain During EMG Procedures
- Expected pain levels in response to needle EMG are often higher than experienced pain levels 5
- The experienced pain associated with EMG is generally not excessive, and most patients tolerate the procedure well 2, 5
- Providing patients with information about the expected pain levels and the procedure may help increase compliance and reduce anxiety 5