What to Expect During Nerve Conduction Study and EMG Test

Nerve conduction studies (NCSs) and electromyography (EMG) tests help doctors determine if your muscles or nerves have been damaged and, if so, how to treat you. Learn about preparation for the tests, how they are performed, and what is done with the results.

This video is produced by the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM). A special thank you is extended to the UW Health Orthopedics and Rehabilitation and the University of Wisconsin School of Medicine and Public Health and TweeDee Productions for their support in the production of this video.

By downloading the video, the user agrees to abide by AANEM’s position papers including 'Who is Qualified to Practice Electrodiagnostic Medicine' and 'What Does ‘On Site’ and ‘Real Time’ Mean?' AANEM retains the right to ask that the video be removed from any website if for any reason, in AANEM’s sole discretion, the AANEM believes the video is not being used appropriately.

[Asahel]

Unfortunately, anxious patients about to undergo this procedure who read many of the comments here will only go into the procedure with more tension and fear.  An EMG is not a walk in the park but it is tolerable.  The needle is thin bore, but long. I had this done years ago on my leg. The needle was painful on entering but if you relax and practice controlled breathing, you can get through it much easier than you might think. The electrical shocks were also painful, but not unbearable. My leg was actually jerking from the electrical shocks that were firing my nerves. I do think a root canal is more painful. I have had a lot of needles in my life, so I am not too fearful of them. I think one person who commented below had it right - at least for me - pain was a 5/6 on a scale of 1-10.  For the very anxious patient, your doctor can prescribe a low dose of valium, which you can take 45 minutes before the procedure. That will help take the edge off.  An EMG does provide a lot of good information to your doctor. Also, don't be embarrassed to express your apprehension to the doctor doing the procedure.  They should help to ease the patient's anxiety level, after all.

[rbrendli]

I rarely ever comment on Youtube, but felt compelled to write one.  I just had an EMG test today.  For weeks, I have been DREADING this EMG because I made the mistake of reading the comments below.  I am the biggest wimp when it comes to pain so hearing how painful the procedure was sent me into crippling anxiety.

The EMG is a bit unpleasant (I wasn’t smiling like this woman haha), but it is NOT painful.  The shocks are short little zaps that feel like when you accidentally shock someone.  The needles are thin and look like acupuncture needles.  Just like a shot, you feel a pinch for a second and then they only remain there for a few seconds before the doctor removes them.  Every so often you might feel a small cramp in your muscle when you move it.

I write this because I don’t want people out there who get anxious like me to worry.  The waiting for the procedure was MUCH worse than the actual procedure!  Like I said, I have zero tolerance for pain and I didn’t think it was that bad.

[VictorGonzalez-ddfu]

After reading the comments I was pretty apprehensive about this test and almost rescheduled. Glad to say I had it done this morning, the discomfort is mild and completely tolerable. Don’t stress.

[shannonhammond]

I have had 4 of these test done. They started at my feet and went up to my tongue. It is not as bad as it sounds. The person giving the test makes a lot of difference. I was told I have als so please pray for me

[FromAMovingTrain]

I had this test conducted this morning at the Mayo Clinic in Jacksonville, FL for some numbness that comes and goes in two toes in my right foot. I can attest to the fact that this nerve study is nothing to worry about. The electrical stimulations, done by a technician, are quite tolerable and absent of pain. They're akin to a rubber band being snapped on your skin. The follow-on needle in the various muscles (the needle is very fine) was again, no worse than a shot in your shoulder muscle; in fact, I hardly noticed it. This was by done by a neurologist. The doctor indicated if you're in pain when you come in for the procedure, that can affect your sensations. Additionally, if you're anxious about the tests, that can affect you as well. Finally, she indicated that the test on the arm, versus the leg, can produce slightly more acute sensations. Bottom line, relax and breath. BTW, my test results were normal.

[jessica]

Watched this because I was nervous about the tests and wanted to know what I was getting into. All of the comments had me worried. But it wasn’t as bad as I thought it would be. It was uncomfortable but not painful. It was bearable and didn’t last very long. Everyone is different and has varying levels of pain tolerance, but as long as you relax and take deep breaths you will okay! 😊

[ED-lepr]

Let me going ahead and give an unbiased, truthful, and thorough rundown at what happened to me today because i honestly think that some people here are trying to scare other people. I get scared of flu shots or even just visiting a doctor. So today i had an EMG test. 30 minutes before going in i took 2 Advil and made sure the neurologist knew about that which was still ok with going through with it.

First he talked to me about the procedure, refresh discussion about my symptoms (numbness and weakness on my left leg) and which they also found i have arthritis in my L4/L5. Then I undressed and put on the gown. I laid down on the table facing up and he proceeded to apply the electrodes which were very similar to when you are using a TENS unit on my left leg.

We then started with running the shock to my feet and also explained the scale of the sensation. He would indicate it by saying a small shock to intense shock. The mild shock didn't phase me but still made me very nervous and then the intense shock was enough to twitch my leg hard which had me say "woah!" but it wasn't painful just intense. He continued along my leg up to my upper thigh, and then my lower back with varying intensities. Surprisingly the ones on my lower back, along my spine were not as bad as the ones on my leg and feet. Pain scale: Flu shot 2/10 or 3/10, stubbing your toe hard 5/10 to 6/10. This first test was like a 3/10 to 4/10.

Then came the actual nerve test which requires stabbing you with a needle. Let me say this folks, when he mentioned that it was also going to be applied on my spine, i was scared out of mind. The 2nd stab on my leg was enough to have me grunt in pain but that was because i was so nervous and my muscles were so tense. So it helps A LOT if you try to relax. The stabbing sensation are EXACTLY like if you were getting a flu shot and perhaps less because once it pierces the skin, it doesn't really hurt, but you feel the needle there. During the leg tests, he did ask me to bend, twist and curl up my feet which was hard to do because of the sensation that i was feeling on my leg. Pain scale i would say it was a 5/10 to 6/10 where a flu shot is like a 3/10.

Now...the spine part, not exactly on the spine but right next to it. This part freaked me the f*ck out. He had to do it 4 times on different parts along my spine. 1st, ill admit wasn't too bad, but sensation of the needles going in made me jolt and again once the needle was in, it wasn't bad. The 3rd and 4th stab wasn't too bad either but the 2nd, holy sh*t!. Since he had to move the needle around a little bit and asked me to re-adjust my back to a more relaxed position, this amplified the discomfort. 1, 3, and 4th stabs were like 4/10 on the pain scale but the 2nd stab like an 8/10! I even punched the wall and yelled "f*ck!" It wasn't so much the pain by itself but it was feeling the needle there AND the pain mixed made it into a very uncomfortable sensation.

My neurologist is a bad ass though. He was professional, very calm, thorough, kept me talking, did it very efficiently and as painless as he could. He was also very patient and told me to take my time to mentally prepare to what was going to happen with the spine part. Really cool guy. He laughed at some parts saying "its not that bad, you'll be fine, i personally hate the first part" and we both laughed. So definitely helps a lot if you have a cool doctor that is able to take off the fear.

So overall the experience is not THAT bad. Before going in, and remembering some of the comments on here i was expecting the pain scale to be 15/10 lol! When it was actually maybe a 5/10 to 6/10 average. If you stubbed your toe hard against the foot of a bed hard to the point where you are cussing your a$$ off, then this is probably less lol. Remember, relaxing is key and realize that it will be over sooner than you think. You are not going to feel any pain afterwards or anything like that. Its kinda like, getting on a crazy roller coaster where you are waiting in line and the anxiety is pretty intense but once you are done youll feel much better and relieved. Good luck to those that are getting one but you probably wont need it lol. Relax and dont forget to breathe.

[subratadasgupta]

I have done this test today. Believe me it is not painful at all but slightly discomfort. You will enjoy it. Go for it

[carlitobecool]

I had this procedure done two hours ago. It's hard to convince you not to be anxious if you already are, but I promise you you have nothing to worry about. "The bad part" with the needle, IS in fact, just mild discomfort, and I personally had a more adverse reaction to the electricity which was also very modest. It is a rollercoaster type situation, you're nervous beforehand and afterward think how silly you were to be nervous. I encourage you not to be nervous at all, take deep breaths, and hope this guides you on your way to finding out what is troubling you. If you have the personality for it, try talking to the technician doing the procedure, talking always helps me as a distraction. Pain was legitimately a 1 or 2 out of 10, when considering "real" pain (injuries, lacerations, broken bones). Please do not be scared, it's very easy.

[randybeck]

I had it done today in both arms and I was extremely nervous from reading other comments, but in the end it was wasted worry because it was not bad at all, you can barely feel the needle, it more just feels like pressure than a sharp pain, like they were just pressing on a point. The needle was tiny (although I have a habit of not looking at the needle ever) and much much less than an injection needle. The areas they hit the needle for me (was a test for carpal tunnel) were the shoulder, tricep, bicep, forearm, webbing between thumb and index, base of thumb and back of neck on each side of my spine. I thought the thumb would be bad but I literally just felt like he was just pressing on it, no sharp pain. The back of the neck stung a bit but not bad. I have a needle phobia and dread shots but realize most shot (like tetanus/flu shots) don’t hurt as bad as the anticipation of them. I had to wait three weeks for this damn test and worried myself sick waiting, now I feel silly for that. I would do it again tomorrow without hesitation if I needed to, and not even think about it. Granted that some conditions could cause more pain, and the administrator of the shots could make a big difference, but this was cake for me, and I was extremely nervous and near phobic of it until it started. The shock part at worst felts like I bumped my funny bone a bit, it’s annoying but not terrible or even bad. The value of the test should outweigh the phobia around it. I hope I ease someone’s nervousness with this as I was making myself crazy reading comments here and other sites about it.

[hallita]

Thank you for you commentary is 2.33 am and I can't sleep for the anxiety; tomorrow I have the appointment for EMG . But after to read your history I am more relax I hope everything will be easy .

[jeremypelter]

"A little uncomfortable" my ass.

I was In a car accident 16 days ago and my right arm from my elbow to my fingertips are screwed. My pinky and ring finger are 100% numb, and I can't move them. My wrist and elbow are constantly in pain.

I'm supposed to have surgery in 4 days but the surgeon wanted me to take this test first. I took the EMG test yesterday for the first time (and last), and I've never felt pain like that.

The first shock, I quit, but then I remembered the fact that if I want my arm fixed, I need to undergo surgery, which means I needed to keep going.

After the second shock, I quit again. The pain was untolerable. No pain pill could've helped this treatment. I was in tears, but all I could do was grab the chair I was sitting in with my left hand and squeeze for dear life. After a few minutes, I knew I had to keep going.

Going in for this, I should've researched what I was getting into. This is how you torture someone - no joke. The doc basically kept shocking me over and over, and my funny bone felt *most* of the shocks. The doc shocked me maybe 10 times.

I won't know the results of my test, but this was my experience with the EMG.

[douganderson]

I'm about to have my 7th done in last 25 years. Best advice is from Janea Lowe below: It is "uncomfortable but it is just a moment in time, step aside and let it pass"

[paulbrungardt]

I had this this today. No big deal. More Pain in routine dental cleaning. Don't worry! Be Happy! It is valuable to know just what is causing pain and what options are. I need both wrists done for CTS. Prognosis is great after surgery and I can get back to my sports that I have been missing .

[Russian]

I had an upper EMG recently and since there is a wide variation of experiences in the comments I thought I'd post mine.

After reading about the test and watching this video, the actual test was just about exactly what I expected - I would trust anything you read on a medical website more than you trust any of the comments.

During the first portion they hook up cathodes to various parts of the hand and forearm, then use a taser-looking device to shock your arm - they also do several measurements. I wouldn't say ANY of this is painful, the strongest shock was bordering on pain, but very slight - a static shock you'd get around your house is more severe. In fact, it's kind of fun to see your fingers and arm bounce around. Nothing to worry about here.

The second part of the test involved the needle being inserted into muscle, and then having to move that associated muscle. The one surprise here is that I expected one or two insertions of the needle in each arm, but it was more like 6-10 and they did an insertion in my neck as well. The whole process took about 10 minutes. Unless you're very scared of needles or have a very very low pain tolerance - this is also very easy.

The only pain in the whole test was flexing the bicep with the needle inserted, but again, it was very minimal.

I would say this entire test had less pain/discomfort as a standard teeth cleaning.

Get in a happy place, close your eyes if you need to and the whole test will be over before you know it.

Good luck!

[boogiesmommy]

I had this done yesterday. I had watched this video and read the comments the day before, and I got a bit nervous. I wanted to come back and comment to let everyone know that is is not nearly as bad as many have made it out to be. I had my arms, legs, and back tested. The initial shocks on my arms/hands were small, it felt like a TENS unit. There were only a couple of jolts on my legs, behind my knees, that were mildly uncomfortable and made me jerk hard. I only said one cuss word the whole time, which I am pretty sure is a personal record. It still hurt less than if you get shocked by a 110 electrical outlet. The needle part was cake. The needle is very thin, more like a wire than a needle. It hurts less than getting an injection. My back was the most uncomfortable with the needle, but still not unbearable. If you have stubbed your toe, you have lived through more pain than this test.

[dreamcottie]

This video makes the test so simple and painless! That is not the case at all. It's very painful!

[samdog]

I had this done yesterday....have ZERO fear, there is ZERO discomfort..

[deborahflowers]

I've had these tests annually since 2000. Never thought to take a Valium beforehand. I'll do it next time. I don't like them bc they do hurt, but only briefly. I'm always happy when it's over.

[AFrick-fm]

I had this procedure for carpal tunnel syndrome and the test was extremely painful!