As with any new health care technology, increased utilization of surface EMG in chiropractic practice poses potential risks as well. There is the risk that the technology will be misapplied. Chiropractors purchasing the equipment may be unaware of basic principles of proper EMG use, may be unable to accurately reproduce their data collection on repeat tests of the same patient, may be unwilling to obtain continuing education for themselves or their staff that use the technology, and may be frustrated and disappointed when subsequent EMG exams, after chiropractic care, fail to demonstrate expected improvement in at least the majority of cases. With improper application, the test data are unreliable and meaningless, revealing all patients to have multiple problems throughout their spine, both before and after chiropractic intervention. Provided surface EMG scans are performed appropriately yielding reproducible and valid data, the scans must still be appropriately interpreted.
Scans can yield valuable, objective information that can contribute to the diagnosis.
For example, an extreme loss of flexion-relaxation is rare in a pain free back, occurring in less than five percent of the pain free patients in most studies. Meeker8 and others have been unable to detect differences, using this protocol, between LBP patients and controls. However, in one of the largest as well as most recent investigations, Arena and co-workers15 demonstrated significant increases in paraspinal lumbar activity in five groups of back pain suffers as opposed to control subjects. This confirmed earlier work by Hoyt and co-workers14 were able to distinguish LBP patients from controls in the neutral standing position, after 10 minutes of continuous monitoring. However, neutral standing postures may be altered by scoliosis, short-leg syndrome and other factors, which might alter myoelectric responses and be unrelated to back pain.