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Neck/Arm pain and root search

Last updated on Thursday, April 30 2009 by blondarb

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Nerve Conductions Studies

Median sensory recording the index and middle fingers.

Ulnar sensory recording the ring finger. 

Radial sensory recording the dorsal thumb.

Median motor recording the abductor pollicis brevis with F-Waves.

Ulnar motor recording the abductor digiti minimi with F-Waves

Needle Examination

Perform needle exam on the symptomatic limb.  Test the minimum of one muscle innervated by the C5, C6, C7, C8 and T1 spinal roots.  Test the cervical paraspinals at one or more levels.

One approach is to sample the first dorsal interosseous, pronator teresbiceps brachii, triceps and the deltoid muscles.

If abnormalities are detected, examine one or two additional muscles innervated by the suspected roots and different peripheral nerves.  There should be documentation of normal muscles above and below the involved root.  Perform needle exam on the asymptomatic limb muscles for comparison as needed.

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