Pain perception during electrodiagnostic studies and the impact of learners

Introduction/aims: Electrodiagnostic testing (EDX) may be perceived as painful, which may influence patient expectations and test completion. Our aim was to characterize which component of the EDX was more painful, and to determine if any factors, particularly performance by a learner, influenced this perception.

Methods: Participants were prospectively recruited and completed a brief questionnaire to rate their perception of pain before and after each component of the EDX. Demographic information and information about the test itself was collected.

Results: A total of 251 participants were recruited, 55.3% female, with a mean age of 52.9 y. Most participants rated pain after nerve conduction studies (NCS) and needle electromyography (EMG) as mild to moderate with a similar number rating each component as more painful than the other. There was no effect of sex on overall ratings, although females felt that the test was more painful than anticipated more often than males. If a learner performed the EMG, it was more likely that the test would be rated as moderately to severely painful, and more likely for the EMG to be rated as more painful than the NCS (p < .05).

Discussion: The finding that NCS and EMG perceived pain were similar may help accurately inform patients of test expectations, guide test planning and help reduce the likelihood of incomplete or canceled testing. More effort might be required to help mitigate EMG pain when learners are involved.