Nerve Testing (Neurophysiology)

Nerve tests are commonly performed to help identify the cause of hand and upper limb altered sensation (like numbness or pins and needles) and weakness.

There are two main types of nerve or neurophysiology tests:

  • Nerve conduction studies (NCS)

  • Electromyography (EMG)

The nerve conduction study is the most commonly performed nerve test. It assesses the speed of electrical signals from your nerves (termed conduction), such as across your wrist or elbow. Slower than expected nerve signals indicate nerve dysfunction. The electromyography (EMG) test is sometimes also performed, which is a test of your muscles. Muscle activity can be reduced with nerve dysfunction.

Nerve dysfunction can occur due to multiple causes and conditions. External compression of a nerve (such as with carpal tunnel syndrome or cubital tunnel syndrome) is a common cause of hand altered sensation and weakness. Upper limb nerve compression can occur anywhere along the length of a nerve, including in the neck where the nerve exits the spine (termed radiculopathy). Nerve dysfunction can also follow an injury, such as a laceration, crush, fracture (break) or dislocation. Less commonly, diseases like diabetes can cause generalised nerve dysfunction affecting one or more nerves.

Matthew will assess the need for nerve testing and refer you if required.

Arranging your appointment

Matthew recommends Dr Fahad Shaikh, a Consultant Neurophysiologist, for nerve tests, which are usually performed at Spire Shawfair Park Hospital. Dr Shaikh is registered with all the major insurers. Patients who are insured or self-funding can contact Dr Shaikh to arrange their nerve test after referral by Matthew.

The insurance code for nerve testing is 22022 or 22023.

Arrange your appointment with Dr Shaikh

  • Nerve testing in the upper limb requires exposure of the hand, forearm and elbow, therefore you should wear loose clothing that can be rolled up. You should remove jewellery and watches and also avoid the use of skin creams or lotions on the day of your test (or wash this off before the test).

  • The Consultant Neurophysiologist who will perform your nerve test will first discuss which tests are to be performed. They will invite you to expose your hand, forearm and elbow, and also likely perform a brief examination of your hand and upper limb.

    For nerve conduction studies (NCS), adhesive pads will be applied to your skin. The pads are connected to a computer that will record an electrical stimulus delivered by a probe. The pads and probe are placed on the skin overlying the specific nerve being tested, such as the median nerve at the wrist (to assess for carpal tunnel syndrome) or ulnar nerve at the elbow (to assess for cubital tunnel syndrome). The electrical stimulus may cause your hand or arm to move or twitch. The speed of the electrical signal (termed conduction) is calculated and compared to the opposite side and/or to a list of normal or expected speeds. Slower than expected conduction indicates nerve dysfunction, with slower values representing greater severity.

    If electromyography (EMG) is performed, a very thin wire is inserted through the skin into specific muscles. The electrical signal generated naturally by your muscles is recorded through the wire both at rest and during movement. 

    Nerve testing can be uncomfortable but is usually well tolerated.

    An informative video demonstrating nerve testing is available on the Greater Glasgow & Clyde NHS YouTube.

    Following your nerve test, the Consultant Neurophysiologist will provide Matthew with a report detailing the results and their opinion regarding the likely cause for your symptoms.

  • Further information about nerve studies is available on the Neurospark website (Dr Fahad Shaikh).

The information contained on this page is for guidance only and should not be considered a substitute for medical assessment and advice by a suitably trained doctor or clinician. External links have been provided for your information and convenience and we are not responsible for their content or accuracy.