@A MyChronicPainTeam Member - I really like your explanation (or your neurologist's explanation, whoever) on what an electromyography (EMG) shows regarding what's happening to the nerves. Without the myelin sheath/wire coating an electrical signal (which is part of what nerves use to transmit signals [along with some chemicals called "neurotransmitters"]) cannot get through to the next nerve or if it's kind of shredded the nerve kind of misfires and doesn't transmit the entire message. When the myelin sheath has problems, and something happens to the nerves (wires with broken coating) then that area that the nerve travels to is usually considered "denervated" or "without a live nerve". I'm in the same position where a lot of areas in my right arm and leg have been "denervated). Now here's the kicker - some of the nerves transmit sensory signals (like pain) or motor control (muscles and other types of cells), which can cause spasms in those areas. I've got both on the right side. We're going back to redo both the arms and the legs, both sides, in two separate sessions, and then we'll try to figure out if we have sufficient information to go and do some nerve biopsies (cut the skin open and take out 1-2 top layer nerve cells [I'm guessing as to the number of nerves they actually take]). Those cells will be checked by a pathologist and tested to see if we can figure out what is actually doing this to the peripheral nervous system (versus the central nervous system [spinal cord and brain]). I hope this gives everyone some more information. Nerve physiology is extremely complex - I had to study the entire nervous system when I took systems physiology which basically studies how the entire body, systems, organs, cells, and within the cells. I have a bachelor's of science degree in Biochemistry, so I had to be able to not only memorize all of these things, but be able to draw various chemical pathways for things like the breakdown of sugar so that the cells can use that for energy (also known as the "Kreb's cycle".)
If anyone finds that my comments are too long (which I tend to do) and/or too technical (like this one) please let me know, and I'll try to make it less technical - Brian, you did a wonderful job explaining the damage to your nerves! I just expanded on your explanation, but it can get too technical at times! So let me know if it's too much, or if you have ideas on what I can do to either shorten and/or simplify the comments! Thanks!!
Blessed be to everyone!
I would ask for an MRI scan of your back, as well as Electromyography (EMG) and Nerve Conduction velocity - or EMG/NCV. Neurologists do this. Do not have it done on your back or neck because if you do have nerve problems there it will cause extraordinary pain (my neurologist revises to do my back and neck because of imaging results I had of my spine. Definitely see a neurologist and/or a rheumatologist (who is best suited to diagnose fibromyalgia after ruling out other auto-immune diseases first. The American College of Rheumatology was the only organization to my knowledge that officially came up with the diagnostic criteria for Fibromyalgia (a hypersensitivity syndrome that actually starts in the brain), and that criteria is still used to this day! If needs be, get referrals from your Primary Care Doctor for these two types of doctors. If it is FMS, then the rheumatologist is the best doctor to care for you. I would try Cymbalta (duloxetine) first as that not only helps with widespread body pain and depression that may come with the widespread body pain. I've tried both gabapentin (an anti-seizure med) and Lyrica (also approved for FMS treatment) but that is pregabalin, a precursor o0f gabapentin. Neither worked for me at all, hence my recommendation for Cymbalta. But definitely get the testing done first!
I have terrible nerve pain in my back and very severe neurapathies in my arms and legs, after my EMG the neurologist couldn't explain why I have them as I do not drink alcohol nor do I have diabetes. when he tried to explain it he told me that the nerves are like electrical wires and the coatings (myelin sheath) were broken and cracked, but not only that the wires (nerves) too were frayed and broken. I get miobloc injections (botox) in my back placed with the help of EMG to pinpoint where the nerves are most active. it helps calm them down for a few months(2 or so). I get them every 3 months (per insurance) and they have been a life saver for me.
I am not sure if that is a real diagnosis. Fibromyalgia comes from central spinal over stimulation of painful nerve signals but it would not only occur in the back. You may be having irritation along a nerve root from discogenic pain or slippage of a disc or herniation, or tight muscles from stress, at least that is a very strange and dumb down explanation you were given. What are you supposed to do with an answer like that?
Ì have hypersensitive nerves everywhere, including my back. Some of it is due to neuropathy (so far, only diagnosed with EMG/NCV for the right arm and leg) but my neurologist, who refuses to test my back because of the amount of pain it would cause, is planning on retesting both arms first, and then separately test both legs. That should give us some idea as to what motor AND sensory nerves are affected, and possibly come from the spine. These are tests that should be done to determine what sensory nerves are affected. Also, I would recommend getting MRI scans of your entire spine as well as your brain. I agree about not having the EMG/NCV testing on your back and neck - I have had those tests done up my right arm up to the lower neck (C4 to C6) which was excruciating, and that pain didn't go away for 2 to 3 days! Definitely see a neurologist as well as your pain management specialist to figure out testing and treatment strategies. For the time being I would try something topical like Bio-freeze or Capsaicin P, which will deplete your nerve endings of Substance Pamela, a more pain mediator in the nerves. Be sure to wash hands thoroughly afterwards and don't touch your eyes!