Diagnosing nerve and muscle conditions is complex. If done incorrectly, the patient may not get the treatment he or she needs, or they may get surgery that they don’t need, said Dr. Ron Bingham, who practices at Bingham Nerve & Muscle.

“Hundreds of nerve and muscle diseases can cause weakness, pain or a sensory disturbance,” Dr. Bingham said. “It is very difficult to differentiate one from another.”

But patients at Bingham Nerve & Muscle can rest assured knowing that they will receive top-notch care from board-certified physicians and nationally certified technicians in an accredited facility, Dr. Bingham said. He and Dr. Miles Johnson are both dual board-certified physicians by the American Board of Physical Medicine and Rehabilitation and the American Board of Electrodiagnostic Medicine. Dr. Charles Hubbert, who also practices at the clinic, is board certified in neurology and clinical neurophysiology.

“Patients with complaints, such as pain, numbness and tingling in the arms and legs, often require an evaluation by our clinic,” Dr. Bingham said. “Patients with unexplained weakness of the face, arms and legs often require a visit as well.”

Bingham Nerve & Muscle specializes in electromyography (EMG/NCS) - an accurate test that evaluates the health of nerves and muscles. The clinic has become an industry standard for accurate and comprehensive evaluations of the peripheral nervous system - the “electrical system” of the body, Dr. Bingham said.

“We are like electricians. An electrician checks the wires in your house; we check the wires in your body - the peripheral nerves.”

During an EMG, doctors evaluate various muscles to determine if they are functioning properly. They place a small electrode inside the muscle to record the electrical activity.

A Nerve Conduction Study (NCS) measures the time required for a small stimulus to travel across a nerve. With new technology and the special techniques developed by Dr. Bingham, this test can be performed with very little discomfort.

“We routinely perform this test on adults and children,” Dr. Bingham said. “The procedure takes about 30 minutes. No premedication is required, and you will be able to return to usual activities immediately.”

The test helps doctors isolate the source of the problem. If a patient feels tingling or weakness in their arm, leg or face, it can be a problem with their nerves (the wires) or their brain, Dr. Bingham said.

“If we test the wires, and the wires are all normal, then by exclusion we can determine the patient has a problem with the brain,” he said. “Typically, our patients are referred by doctors who want to know if there is a problem with the nerves.”

The exam process for patients at Bingham Nerve & Muscle is easy. They are referred by another provider who wants to know why a patient has pain, weakness or numbness in a particular part of the body, typically in the arm or leg.

Dr. Bingham starts the visit with a physical exam of the patient and the patient’s medical history. A physical exam tests the strength, range of motion and reflexes. He looks for atrophy and signs that a muscle might be weak. He also looks for abnormal twitching.

Dr. Bingham then tells one of his certified technicians what nerves to test based on his evaluation and the patient’s symptoms. He then reviews the nerve conduction test and follows up with an electromyography test, which involves placing an electrode under the skin into the muscle. This test measures how well the muscle works.

A report is then sent to the referring physician. Patients go back to the referring provider for treatment.

Doctors refer patients to Bingham Nerve & Muscle because of the clinic’s experience. It’s one of the busiest EMG clinics in the country, performing 150 procedures a week. It’s also been in business for 26 years.

Dr. Bingham and Dr. Johnson, as well as their technicians, are certified through the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM). This new credential for the technicians is tailored to capture the specialized knowledge, skills and abilities of professional electroneurodiagnostic technologists trained and educated in nerve conduction studies.

The Certified Nerve Conduction Technologists at Bingham Nerve & Muscle are Suzanne Bingham, Melonie Brasher and Amanda Casey. To be certified to do a nerve conduction study, the technicians took written and practical exams, were supervised by a physiatrist or a neurologist experienced in electrodiagnostic medicine for a year, and worked with at least 250 patients.

The clinic also received the Electrodiagnostic (EDX) Laboratory Accreditation with Exemplary Status from AANEM. This accreditation is a voluntary, peer-reviewed process that identifies and acknowledges EDX laboratories for achieving and maintaining the highest level of quality, performance and integrity based on professional standards developed by AANEM.

“We think it’s important that the doctors and technicians be board-certified to increase the accuracy of the diagnosis,” Dr. Bingham said. “No one except a neurologist or a doctor certified in physical medicine and rehabilitation should perform the test. It’s important that an EMG is done correctly. Things worth doing are worth doing right.”

Interesting cases at Bingham Nerve & Muscle

Dr. Bingham, Dr. Johnson, Dr. Hubbert and the certified technicians at Bingham Nerve & Muscle do much more then evaluate neuropathy, carpal tunnel syndrome, or other common nerve and muscle problems.

“We find ourselves seeing more and more complex cases and serving a wider geographic area,” said Dr. Bingham. “We see a lot of interesting cases.”

 
  • A woman couldn’t put her makeup on well. Her hand was numb, and it felt like it wouldn’t do what she wanted it to do. Her doctor thought she had carpal tunnel syndrome. But after her exam at Bingham Nerve & Muscle, she was diagnosed with a pinched nerve in her spinal cord. She underwent surgery to resolve the problem.
  • A man had a water skiing accident and dislocated his shoulder. His shoulder muscle became weak. “We tested and determined that the nerve to the deltoid muscle had been injured, but not severed,” said Dr. Bingham. “The outlook was good; no surgery was needed.”
  • A patient was unable to shrug or raise his right shoulder. He got a lump in his throat when trying to swallow. During the physical exam, Dr. Bingham noticed that the shoulder muscle was smaller on the right side of the patient’s body. “Based on the patient’s history and the exam, we found that the man had a pinched nerve in the base of his skull. We recommended special X-ray studies; a cancerous tumor was found and surgically removed.”
  • An elderly man came in with weakness; he couldn’t raise his leg to get into the car. “Our testing determined he had a muscle disease called inclusion body myositis, which was treatable with steroids. He had been suffering for two years, seeing numerous physicians before he was sent to us.”
  • While grocery shopping, a woman couldn’t let go of a can of soup. Instead of picking up items for her grocery cart, she slid them off the shelves and into the cart. In another case, a man couldn’t let go of a handshake, creating social problems. Both were diagnosed with myotonia congenita, or the inability to relax certain muscles.
  • A woman complained she could no longer push the hairspray button with her index finger. “We found she had a pinched nerve in her forearm,” said Dr. Bingham. “Surgery released the nerve, and her problem was solved.”