Newswise — At the 2017 American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Annual Meeting in mid-September 2017, Andrew J. Haig, MD, Active Emeritus Professor of Physical Medicine and Rehabilitation at the University of Michigan, Volunteer Professor at the Medical College of Wisconsin, president of Haig et al Consulting, and private practice physician at Haig Physical Medicine PLC in Williston, Vermont, was a featured plenary speaker, specifically chosen by AANEM Past President, William Pease, MD, to share his expertise with attendees.
Dr. Pease’s plenary topic for 2017 was “Enhancing the Understanding, Diagnosis and Management of Painful Neuromuscular Conditions” and Dr. Haig focused his plenary lecture on the following: “Diagnosing Pain with Electromyography (EMG)? You’ve Got a Lot of Nerve!”
“I chose to focus my plenary talk on this topic because EMG is the most important test to find out if nerves are damaged,” said Dr. Haig. “Most pain is not caused by nerve damage, and physical pain is only part of the suffering that people experience when they hurt. So, it’s important to be sure that a test for nerve damage really helps decrease suffering. For back pain, we’ve done that by refining the EMG test and then looking critically at other tests used for pain.”
In Dr. Haig’s plenary lecture, he discussed his own research on “Paraspinal Mapping,” an accurate EMG test for nerve damage in the back muscles.To determine the usefulness of paraspinal mapping, Dr. Haig conducted the first “blinded” study in the 60-year history of diagnostic needle electromyography (“blinded” meaning the testing doctor didn’t already know what the patient’s complaints were). The test group consisted of the following:
- Older people who had no pain whatsoever;
- Older people who had pain coming from joints or muscles; and,
- Older people whose pain came from spinal nerves.
To further test paraspinal mapping, Dr. Haig analyzed both the new EMG test and MRI scans of the back for this test group.
“Even though doctors assume MRI scans are accurate tests, unfortunately, normal aging on MRIs is often reported as stenosis. This causes people to seek unnecessary surgery,” Dr. Haig explained. “In my research, it was found that the EMG test was nearly 100% specific and it uncovered nerve illnesses the experts missed. In the end, even though pain is not the same as nerve damage, we discovered that the EMG found nerve damage that caused pain, and that knowledge can help us treat the pain.”
Dr. Haig hopes that AANEM Annual Meeting attendees who listened to his plenary gathered some valuable insight.
“I hope they learned that EMG is far superior to MRI in proving that a person has lumbar spinal stenosis. People headed to surgery for stenosis should have an EMG test to diagnose the problem and to find other common causes of pain that can fool clinicians,” he noted. “However, it is critical that physicians use the paraspinal mapping technique and norms, otherwise, the EMG becomes much less sensitive and specific.”
Dr. Haig’s clinical focus is on spinal disorders, electrodiagnosis of nerve diseases, and worker rehabilitation. Empowering his patients is what Dr. Haig likes best about his line of work.
“So many of my patients think a positive MRI means they need surgery. I’m so grateful when I can help patients be unafraid, understand the facts, and use the knowledge they’ve gained to choose the best course of action,” Dr. Haig explained.
Dr. Haig’s current mission is to improve pain management in the United States and around the world through Haig et al Consulting. His consulting group is making this happen by implementing innovation and efficiencies into medical rehabilitation programs.
At his small private practice in Williston, Vermont, Dr. Haig takes care of people with back pain, nerve damage, and work disability. He says his work at Haig Physical Medicine PLC, keeps him grounded “in the real daily challenges experienced by patients and doctors.” His practice also serves as a laboratory or demonstration site.
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AANEM Annual Meeting, Sept-2017