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Intramuscular stimulation (IMS) treatment uses tiny needles to stimulate a reaction in muscles, tendons and the nervous system. This type of treatment has been adapted by traditional acupuncture practitioners with the focus being on the neurological and musculoskeletal systems in the body.
Injury leading to structural or functional damage and peripheral nerve sensitization can lead to shortened and tight muscles which restricts movement, causes soreness, and makes it difficult for those muscles to perform.
Inserting and manipulating a dry needle at the site of a trigger point (muscle knot) within a muscle can create a twitch response in the muscle which sends a rush of your own body’s pain relieving hormones up to the brain. This signals the muscle to relax and the body to restore its natural healing state.
We have seen those who couldn’t play tennis, complete housework, or perform work duties without pain feel a big relief with IMS treatment. This left them feeling liberated to start living their lives again, all without the use of pain medications.
Physiotherapists will use IMS in combination with movement education and exercise, as both together is better than IMS alone. Together these will rebuild the strength of the muscles, tendons and joints and that will allow you to fully engage in your everyday tasks.
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Looking for a new way to relieve your muscle and nerve pain that doesn’t involve medications? One of the bright new stars quickly gaining ground in the pain treatment world is IMS treatment – intramuscular stimulation.
IMS therapy, founded by Dr. Chan Gunn in the 1970s, uses ultra-thin needles like those used in acupuncture, but in a very different manner and for a very different purpose. We’ll discuss the differences between these treatments a bit later.
IMS treatment works to relieve your pain allowing the nervous system to calm down. Sometimes patients report dramatic improvements after just a couple visits. For other conditions, longer treatment plans are needed, and IMS treatment is helpful in tandem with a physiotherapy treatment plan.
So, when might IMS treatment be used? Let’s dive a little deeper.
Broadly speaking, IMS treatment can be a very effective method for treating pain in your muscles, joints, and tendons, especially when the communication between the nerves and the muscles are part of the problem.
If you have muscle tension, tightness, or soreness that refuses to go away and seems to linger or get worse when you’re just trying to go about your day, IMS therapy may be the fastest way to help the problem. Getting help from a physiotherapist trained in IMS treatment and in how to assess these issues will help you determine your best course of action.
When the issue causing your pain is involved with the communication between the nerves and the muscles, IMS therapy may offer your best chance at fast relief.
This is because IMS treatment can play a role in improving muscle activation potential. This is the amount of nerve activity that occurs at a particular muscle. An example of IMS influencing this is when muscles are weakened due to prolonged inactivity. If you are recovering from a severe injury like a broken bone and have gone several weeks to months with a cast, unable to use the muscles surrounding the injured area, IMS physiotherapy can help you rebuild the strength of these muscles and tendons in combination with a strengthening program. IMS will increase the activation potential of the muscles surrounding the previously broken bone, helping improve your strength.
If you have jaw pain, ankle pain, shoulder pain, back pain, elbow pain, knee pain, or pain almost anywhere else, IMS treatment can be targeted to that specific area. Sometimes it is also helpful to be used on the surrounding areas. Often, the ‘compensating muscles’ nearby the site of injury will play a role in your pain. Your physiotherapist will be sure to assess and address these areas as well as your specific needs to create an individualized plan just for you!
IMS treatment has been used with great success to treat conditions such as:
Read the caption on this post by Infinity Physio Centre to learn more about how IMS works:
The short answer is – not much, but you may feel mild soreness for a day or two.
Because IMS treatment often involves more needle movement than acupuncture, most patients who receive it say they feel the after effects a bit more as well. It is described by most as a ‘dull ache,’ or a deep cramp, sort of how you feel after a good workout. This is because the muscles have been stimulated, which is a good sign!
But yes, you do feel it afterward, and sometimes minor muscle soreness can linger for a day or two. You can manage it with heat, ice, or sometimes light exercise. Once this post-treatment soreness subsides, you’ll notice the pain you were treated for will decrease significantly!
Other people compare the feeling of intramuscular stimulation to that of getting a flu shot. It lingers a bit and then goes away. So not everyone has the same experience.
See the videos below showing patients receiving IMS treatment.
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The use of dry needles is one of the few things in common between intramuscular stimulation and acupuncture. The differences are more on the basis of technique, the foundations the technique is built on, and the clinical reasoning of the 2 modes of treatment. A skilled physiotherapist will assess the many factors that brings you to the clinic and determine the appropriateness of incorporating IMS into your care plan.
Physiotherapists practice with science as their number one tenet, however other factors interact with their clinical decision making process. That is why the traditional knowledge and philosophy behind the technique has its place in therapy.
Traditional Acupuncture uses meridians that interact with the nervous system and organ systems which channels energy throughout the body along particular lines. This determines where the needles get placed. When practiced by a traditional acupuncturist they assess based on the interaction with all the body systems with each other. When a physiotherapist performs acupuncture their focus is mainly on muscle pain, tissue healing, swelling, and nerve pain, but they still insert their needles along the traditional meridian lines.
In IMS therapy, needle placement is more specific to the injury, the muscles involved, the nerves in question, and other specifics that will be different for each patient. There is no ‘standard’ approach to IMS for where to place the needles. Each injury, and therefore each treatment, is different depending on the patient.
Check out this post, courtesy of Peak Health Calgary, to learn more about different types of acupuncture:
In a typical acupuncture session, once all the needles have been inserted, they will be left in for 15 to 30 minutes, undisturbed.
In an IMS treatment session, needles may be inserted for only a few minutes, sometimes much less. Sometimes the needle will be placed in for only a few seconds to elicit a muscle contraction. Overall IMS is a much faster treatment than acupuncture.
With acupuncture, the needles are inserted straight and left alone once all have been placed according to the treatment plan. The patient is undisturbed for 15-30 minutes. But in IMS therapy, often the therapist will twirl or manipulate the needles so as to produce the designed response from the muscles and the nerves.
Remember, the idea with IMS treatment is to stimulate the muscles to grip the needle and then relax their tension and to reset their communication with the nerve. This often requires some twirling motion and other techniques.
Watch this quick video to see how the needles are manipulated by a physiotherapist (courtesy of Sporting Edge Physiotherapy):
Needles can be placed deeper into the muscles with IMS treatment. IMS typically targets muscle, as the purpose of the treatment is to produce a reaction from the muscle. If you don’t reach the muscle or go deep enough to stimulate it, you won’t achieve the goal of the treatment.
With acupuncture, needles are sometimes inserted into ligaments or joints which will produce a more shallow insertion.
To get a better idea, take a look at this quick video that shows exactly how deep the needles are inserted (courtesy of Sporting Edge Physiotherapy)
For injuries to a specific muscle or nerve, IMS therapy will likely be the more effective treatment option because it can target that area. IMS can be applied to very specific muscles for shoulder injuries, jaw clicking, back pain, and other conditions.
Acupuncture is a more general approach to pain that may or may not be localized in a specific part of the body. For instance, WebMD points to several studies showing acupuncture to be an effective treatment for migraine headaches – a condition with a less specific and often less obvious cause. It is also effective with inflammation that is not localized to a particular muscle group.
Take a look at this quick video of a physiotherapy from Sporting Edge Physiotherapy performing targeted IMS treatment on a patient’s tight jaw muscles:
As mentioned earlier, IMS treatment sometimes leads to muscle soreness for a day or two. This is because of the increased levels of needle manipulation and targeted nature of the therapy. Because acupuncture is less invasive, it tends to produce less soreness. Most people report feeling no soreness at all.
Before conducting an acupuncture session, the therapist uses a more routine and systematic inspection, and follows the methods that are recommended based on the theory of needle placement.
For IMS treatment, an examination and assessment from a clinician certified in IMS therapy can involve much more. This trained specialist knows how to identify the symptoms of trigger points, specific nerve involvement and individual factors like activity level to provide you care that is directly tailored to you.
Back pain, especially low back pain, has a long list of possible causes, including:
What makes low back pain particularly troublesome is that it can transition from a temporary pain to a chronic injury. If the discs in your spine get injured or there have been changes to the spine that makes it difficult to tolerate activity, these types of injuries can be very difficult to remedy and cope with.
Therefore, keeping your low back pain from becoming a chronic condition is a battle against time. Fixing the problem early, before it gets worse, can mean the difference between getting back to the life you want to live and developing chronic pain.
Do you want to be able to play with your grandkids on their level? Want to be able to do more than just sit and read to them (as good as that is!)? Then do whatever it takes to keep you moving well for the years leading up to and during those times.
Just like muscle injuries elsewhere in the body, when the nerves in an area become more sensitive, they can start sending the wrong signals to the affected tissues and back up to the brain. Muscles tighten up and when stress or strain would typically feel okay in normal circumstances, a sensitive nerve and affected muscle becomes intolerant to stressors. This ultimately tells your brain that there is “danger” in the area making you feel your pain.
Intramuscular stimulation can target these areas of your back, relax the muscles, reset the nerve-muscle communication, and relieve the pain. More importantly, because the IMS therapy is addressing a root cause, nerve sensitization, you can get back to living your life sooner than later. This contributes to positive health outcomes.
Once your IMS session has finished, you might feel sore for 24-36 hours. This is normal and expected. As long as you keep moving, the achiness should completely resolve leaving you feeling loose and with reduced pain.
Though back pain seems to get more attention in the media, shoulder pain is often even more debilitating and can severely reduce your quality of life. Think about how many basic tasks in life depend on having a shoulder and rotator cuff that work properly:
Shoulder pain can lead to neck pain and back pain because your body may try to compensate for the lack of motion, stiffness, and pain in your shoulder.
The rotator cuff muscle group is very reactive to pain signals. This means pain in and around the shoulder can make it difficult for those cuff muscles to do their job. The change in cuff activity can change the way we move our shoulder and therefore contribute to tension and sensitivity in the tendons.
The resulting loss of pain-free motion combined with inflammation of the shoulder and surrounding areas can lead to major problems and a great loss in your quality of life.
We have seen many shoulder injuries in Waterview’s physiotherapy clinic. IMS therapy combined with physiotherapy has consistently resulted in the best possible outcomes. IMS helps relieve the muscle tension, nerve pain, and assist the shoulder in pain-free movement.
In most situations where IMS treatment is recommended, it will be safe. Situations where IMS might not be safe include when it is used on people who are on certain medications like blood thinners, or who have a bleeding disorder. You should also not do IMS therapy while pregnant. Consult your IMS treatment specialist to be sure if it is safe and recommended for your situation.
IMS therapy helps relieve muscle and nerve pain by helping constricted muscles relax and by improving nerve communication. By relaxing muscles and reducing pain there will be an improvement in movement. The better we feel moving the healthier our body is and therefore contributes to recovery.
This is just technical language. A ‘wet needle’ is a needle that injects something into the patient. A ‘dry needle’ is a needle that does not inject anything. Thus, IMS treatment and acupuncture are both forms of dry needling.
IMS treatment is one of several possible methods for relieving pain that do not rely on prescription medications and all the side effects and baggage they come with. Not to mention that most drugs can only mask pain, but rarely address root causes. Find a clinic if you are suffering from muscle tightness, soreness, or pain to improve your quality of life, today.
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