Mild ulnar neuropathy, major pain?

[Fluffysmom]

I just got back from my nerve conduction study of my right arm; I have some slowing of signal below my elbow, so it's still called a mild ulnar neuropathy even though it glows with pain when I'm having a flare of symptoms, and somewhat less all the time.

I asked him why it hurt so badly if it was mild, and he looked like I had asked a really stupid question, and said it could be orthopedic, he had no idea.

So, my question is does a nerve conduction study give a clear picture of my nerve pain?  Would it show up the same, no matter the source?  BTW, it is glowing now after being zapped so many times, all the way to the shoulder.  I've had to start taking and extra Lyrica because of this issue; would that affect the results?

Must take extra Lyrica NOW.

Kathy

[tfoux999]

I had an EMG done and the have said its mild nerve neuropathy. I go next week to orthapedic doctor to see what the next step is. But since I had the EMG I'm in more pain than I was before. Is this normal?

[Quixotic1]

Let me describe my answer in a different way.  Let's say that you have pain in your forearm.  There is no injury to account for the pain, so we think it is nerve (neuropathic) pain.  The sensation from the wrist travels up the arm to the shoulder and then enters the cervical spinal cord and travels on up to the part of the brain that perceives sensation in the forearm.  For example.

Forearm--> elbow --> upper arm/shoulder--> entry to cord ->cervical spinal cord--> brain.

||----------------------------NCV----------------------------------------------||---------------SSEP-------------------||

                     (peripheral nervous system)                            (central nerous system)

A nerve conduction study looks at the sensory signal from the hand -->wrist --> elbow -> shoulder --> spine.  When we see a slowing of the signal or a break in the signal at the elbow, we know that the damage has already occurred.  So we can say that the nerve damage is below the elbow.  The more sites that are monitored the closer we can pinpoint the site of nerve injury.  If the sensation travels normally from the finger to the wrist, but then we see that the signal is slowed or absent at the elbow, we know the damage is in the wrist or forearm.

If the signal is fine until the entry point into the cervical spine then we can assume some type of compression as the peripheral nerve emerges from the spinal column.

An SSEP is similar to the NCV but it measures slowing within the spinal column and finally in the brain.  So we would see a normal signal at the point that the sensory nerve impusle entered the spinal cord.  Then we can't measure that particular, exact nerve, but we know what kind of signal to expect as the signal rises in the cord and finally as the sensation is experienced in the brain.  OVer the brain the test uses electrodes like for an EEG.  In fact, an SSEP is like a very localized EEG.

Quix

[Fluffysmom]

Thanks, I should have figured that one out on my own, especially since he said that the signal is abnormal below the elbow.

All the neurologist was interested in was getting the test done, not answering any questions.  In my opinion, that's not an office visit, its a test, and I shouldn't have had to pay a co-pay.

I did get one answer out of him; I have LFCN entrapment because of hypermobility in my SI joint, and have considered getting it released because it adds way more pain than I need, for no good reason.  I asked him who does such procedures, and he answered "a neurosurgeon"  That was worth my $5, lol.

Kathy

[Quixotic1]

First - the fact that you have "mild" peripheral neuropathy has NO bearing whatsoever on how much pain it will cause.  The amount of pain a person has is the amount of pain they feel.  Any neurologist should know that.  I get totally frosted when I hear a doctor say something shouldn't hurt "so much."

If the nerve impulse was found to be abnormal out in the periphery - ie, your arm, then what you have in that area is a peripheral neuropathy.  By definition problems from MS are in the spine or brain and the testing in the limb will should normal conduction.  So, no, an SSEP would show that the nerve signal was already delayed when it arrived at the spine.

By this testing the pain in your arm is a peripheral neuropathy.  

Quix

[Fluffysmom]

Would a SSEP be a better indicator of what is going wrong with my nerves as opposed to this nerve conduction study?

Thanks,

Kathy

[Akcowboy]

  I to don't get much pain on the out side as I have cut my finger a good share off as well as other cuts and don't know it till I see blood then I'm having to look around for it

  but opp was not to bad so far lol but I have to have the same thing done later to the other arm (oh joy) I'm having to do the one finger typing for now lol

  Cowboy

[Fluffysmom]

People are always amazed that I don't need anesthesia for SI joint injections, facet joint injections, and take the pain from all sorts of stuff calmly.

You're so right; when you're in a lot of pain, what's a little more, especially if it might help reduce the pain.

I didn't have carrot cake, I had a good dinner and then some pineapple coconut frozen yogurt, which was really yummy.

The pain in my arm has calmed down; must be the combination of Lyrica and prayers!  

Hugs,

Kathy

[Fluffysmom]

I'm glad you're doing well enough to be posting!  Are you doing OK?  Pain under control?

The neurologist that did my test said more than once that mine wasn't bad enough for surgery.  He tested me in 2000 and 2001, and according to him, not much has changed.  My pain level sure has increased.

Take it easy and heal quickly.

Kathy

[Akcowboy]

I just had the same test done a few weeks ago and now I'm out of the day surgery as I had just got back home and seen your post I had the ulner nerve moved over in my left elbow and cts opperation, as I had the same thing going on

  look up ulner nerve on the net sorry to cut it short but like I said I just got out from the opperation from this today

Cowboy

[doni54]

Nope, no electrolosis.  Guess I'll just get to enjoy it as a first timer, huh?  I'm in so much pain all the time, a little more shouldn't bother me....hahaha

If it makes the pain worse I might have to zap him....heehee

Ummmm, carrot cake......dog gone you, now you've made me want some!!!!

Take care, sweetie, I hope the pain will ease off since you've taken your Lyrica.

ttys
doni

[Fluffysmom]

I took the Lyrica, and am breathing deeply, slowly, calm.

The test itself isn't real bad, he just marked different areas on my arm, put conduction gell on it, and zapped it, first lightly, and then with more current.  The stronger ones can really make things jerk!  He repeated this all over my fingers, wrist, around my elbow, and a few other areas that I'll probably find the ink for later.

I think the zapping irritated the nerve, so it kind of flared up. Hopefully yours will be a piece of cake.  Ooh, I only had a granola bar for lunch, so when I wrote cake, I saw a big piece of carrot cake with walnuts in it (vegetable and protein, right?).  Tee hee hee!

Have you ever had electrolosis?  It's kind of like that, only somewhat stronger.

Kathy

[doni54]

Hi Kathy,

That is the test I will have on my first neuro appt so you will have to fill me in on how bad it hurts....heeheehee

I can't answer your question about the pain.  I wouldn't think that the test would give a clear picture of the pain, just if there is something wrong with the nerves as far as how they work from one point to the next.  That is just a guess, though.

Praying your pain will ease soon.

Hugs
doni