General Guideline Principles for Electromyography
and Nerve Conduction Studies (Electrodiagnostic Studies)
for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Electromyography and Nerve Conduction Studies (Electrodiagnostic Studies).

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Electromyography and Nerve Conduction Studies (Electrodiagnostic Studies)

The diagnostic impressions of various peripheral nerve entrapments, including all peripheral nerves in the upper extremities, have been confirmed by electrodiagnostic (ED) Tests To differentiate a peripheral entrapment from cervical radiculopathy, they may be especially useful.

Particularly in certain mild cases of neuropathies, EMG and NCS may be normal. Tests could be redone later on in the course of treatment if ED studies are negative and symptoms continue.

It’s also critical to understand that a sizable fraction of people with ED tests who have no symptoms have abnormalities. As a result, ED investigations in a patient with a low pretest probability of peripheral nerve entrapment may lead to an incorrect diagnosis.

1. Electrodiagnostic Studies for Diagnosing Subacute or Chronic Peripheral Nerve Entrapments

   Electrodiagnostic Studies for Diagnosing Subacute or Chronic Peripheral Nerve Entrapments are recommended to help in the identification of chronic or subacute peripheral nerve entrapments, such as radial, median, and ulnar neuropathies.

   Indications – Patients with acute or persistent paresthesias, either with or without pain, especially those whose diagnoses are ambiguous. Patients with peripheral neuropathies in the elbow region should typically have the inching technique performed to identify the entrapment and help with therapeutic care. This is in addition to segmental studies (e.g., above- versus below-elbow conduction).

    

2. Electrodiagnostic Studies for Diagnosis and Pre-Operative Assessment of Peripheral Nerve Entrapments

   Electrodiagnostic Studies for Diagnosis and Pre-Operative Assessment of Peripheral Nerve Entrapments are recommended to help patients whose diagnoses are unclear obtain a definite diagnosis. ED studies are also advised as one of two ways to make an effort to accurately determine a diagnosis before surgical release.

    

3. Electrodiagnostic Studies for Initial Evaluation of Patients Suspected of Having a Peripheral Nerve Entrapment

   Electrodiagnostic Studies for Initial Evaluation of Patients Suspected of Having a Peripheral Nerve Entrapment are not recommended for the majority of patients’ first evaluations, as it has no impact on how their conditions are managed.

   Rationale for Recommendation – The main uses of ED investigations are to: 1) pinpoint the anatomic site of nerve conduction slowness; 2) find objective support for alternative diagnostic hypotheses (such as cervical radiculopathy); and 3) measure nerve function to confirm the presence of an operative condition like CTS. For the evaluation of a few cases, such as pronator syndrome, ulnar neuropathies at the elbow, and radial neuropathies, they are advised to help confirm peripheral nerve entrapments.

What our office can do if you have workers compensation injuries

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.