INTRAMUSCULAR STIMULATION (IMS) / DRY NEEDLING
Frequently asked questions about IMS
Eastgate Physiotherapy and IMS, Sherwood Park answers FAQs
What is IMS?
Intrasmuscular Stimulation (IMS) is a total system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions that occur in the musculoskeletal system when there is no obvious sign of injury or inflammation). IMS is grounded in Western Medical Science, and has a solid foundation in its radiculopathic model of pain, which is now supported by many experts in the field. It was developed by Dr. Gunn while he was a physician at the Worker's Compensation Board of British Columbia in the 70's, where he investigated the large number of mysteriously stubborn cases after frustration with the ineffective modalities at his disposal. The treatment, which utilizes acupuncture needles because they are the thinnest implements available that are designed to penetrate deep within muscle tissue, specifically targets injured muscles that have contracted and become shortened from distress. .
IMS relies heavily on a thorough physical examination of the patient by a competent practitioner, trained to recognize the physical signs of neuropathic pain. This physical examination is indispensable since chronic pain is often neurological as opposed to structural, and therefore, invisible to expensive X-rays, MRI Tests, Bone and CT Scans. Failure to recognize these signs will result in an inaccurate diagnosis, and thus, a poor starting point for physical therapy.
The treatment involves dry needling of affected areas of the body without injecting any substance. The needle sites can be at the epicenter of taut, tender muscle bands, or they can be near the spine where the nerve root may have become irritated and supersensitive. Penetration of a normal muscle is painless; however, a shortened, supersensitive muscle will 'grasp' the needle in what can be described as a cramping sensation. The result is threefold. One, a stretch receptor in the muscle is stimulated, producing a reflex relaxation (lengthening). Two, the needle also causes a small injury that draws blood to the area, initiating the natural healing process. Three, the treatment creates an electrical potential in the muscle to make the nerve function normally again. The needle used in IMS, by stimulating muscle spindles, essentially becomes a specific and unique tool for the diagnosis of Neuropathic Muscle Pain.
The goal of treatment is to release muscle shortening, which presses on and irritates the nerve. Supersensitive areas can be desensitized, and the persistent pull of shortened muscles can be released. IMS is very effective for releasing shortened muscles under contracture, thereby causing mechanical pain from muscle pull. IMS, in effect, treats the underlying neuropathic condition that causes the pain. When competently performed, IMS has a remarkable success rate, as proven by the alleviation of symptoms and signs, even for chronic back pain with root signs.
IMS is comparable in some ways to acupuncture; however, there are a number of important differences. IMS requires a medical examination and diagnosis by a practitioner knowledgable in anatomy, needles insertions are indicated by physical signs and not according to predefined, non-scientific meridians, while subjective and objective effects are usually experienced immediately.
Information supplied by istop. For more information, please visit www.istop.org
Who may treat patient with IMS?
Only physicians and physiotherapists who have attended an GunnIMS course, are allowed to treat patients with IMS.
I have been in many clinics to treat my back and leg. I have had many medical investigations including X-rays. I have tried physiotherapy, manipulations, and pills without any lasting relief. My doctors tell me they have found nothing wrong, but why are my 'aches and pains' still with me and so difficult to treat? Is surgery necessary?
Pain is not one entity but three. Type One is well known and easily understood. There is an obvious painful cause from injury. Think of a burn on the skin, or a cut from a knife. Type Two pain is the pain of inflammation, such as a sprained ankle when there is obvious swelling, redness, and the ankle is hot to touch. These two types of pain and their treatment are well understood by the medical profession.
Since an obvious cause of pain from injury or inflammation has not been found, it is very likely that there is no actual source of pain. This is not unusual; the pain you feel is caused by abnormal and excessive sensitivity of your body's nervous system. This is medically known as 'supersensitivity.' Unfortunately, supersensitivity has received little attention in medical circles. Since there is no pain source, surgery will not help, and is definitely not indicated. .
If my pain is Type Three, what makes my nerves supersensitive?
The basic problem is that the nerves going to your painful area are unwell. Doctors call it neuropathy. Unwell nerves behave abnormally - they are too sensitive; they tend to magnify ordinary inputs, and change them into painful sensations. Supersensitivity usually occurs when there is some irritation to the nerve roots that come from your spinal cord. Probably your nerves were already weakened (through wear and tear, or aging), and only a minor accident can trigger them into supersensitivity.
How can my supersensitive nerves be treated?
Supersensitivity cannot be operated on and "cut away," but it can be desensitized. "Pain killers" and other pills only mask pain briefly. What your nerves need is energy to heal themselves. That is why we instinctively massage a painful part to provide mechanical energy and to revitalize it. Heat - or thermal energy - is another commonly used form of treatment. In fact, all effective treatments for Type Three pain are different forms of energy.
But I've tried massage and heat. They only give me temporary relief. Why?
All types of local treatment have their limitations. They cannot penetrate deeply into the body, and the duration of their energy input is temporary. For instance, the energy of a massage does not last much longer than the massage itself. That is why I prefer to use a needle treatment that is a modification of traditional acupuncture. A needle causes a minute local injury, and the injury does two important things. Firstly, the injury generates electrical energy (as proven by Galvani over 300 years ago), and muscle spasm is released. The injury also releases fresh blood into the painful site and blood platelets have a healing effect. The needle's main purpose is not to block pain (although it does this too), but to stimulate the body to heal itself. It's as close to a "cure" as you can get.
I've heard of acupuncture and that it can help the pain. How is IMS different?
Acupuncture is an ancient philosophy, and its diagnosis and practice in Traditional Chinese or Oriental Medicine are not based on modern science. What was a great approach four thousand years ago can be improved with today's medical knowledge. Intramuscular Stimulation or IMS relies on neurology and a Western understanding of anatomy for diagnosis and treatment.
Why did some of my friends, who have had acupuncture, not feel the cramping sensation?
Many doctors perform traditional acupuncture by inserting needles into locations according to acupuncture "maps." They are not seeking the epicenter of the painful muscle. Sometimes they may add electrical stimulation to the inserted needles. This type of acupuncture is not so painful, but the results are unlikely to be as good as IMS.
How long will the benefits last?
The effects of IMS are cumulative. Each needle injury stimulates a certain amount of healing until, eventually, the condition is healed, and the pain disappears. Blood also brings a healing factor known as the Platelet-Derived Growth Factor to injured tissues. IMS is like pruning a plant: you produce small injuries to stimulate new growth to replace injured tissues, but once healing has occurred, you are back to where you were before the pain occurred.
How often are treatments necessary?
Treatments are usually once a week because time is needed between treatments for the body to heal itself. Also, stimulation for healing remains for several days, lasting for as long as the injuries caused by the needle are present. Treatment can be spaced out over two weeks.
How many treatments will I need?
The number of treatments required depends on several factors: your general health, the duration and extent of your condition, how much scar tissue there is (previous surgery is bad news), and how quickly your body can heal. The rate of healing also depends on the condition of your nerves; young people usually heal quicker, but older is not necessarily slower. If the pain is of recent origin, one treatment may be all that is necessary. In a published study of patients with low back pain, the average number of treatments required was 8.2.
Does IMS always succeed?
There is no absolute guarantee, but if the diagnosis of nerve supersensitivity pain is correct, and the part of the body requiring treatment is capable of healing, then the probability of healing should be the same as that for a cut on your finger. Treatment fails if the diagnosis is wrong, or if the treatment is improperly applied. For more information, please visit www.istop.org , the official site of Gunn IMS
Eastgate Physiotherapy Clinic Sherwood Park has been offering IMS- Intramuscular stimulation treatment to Sherwood Park residents for over 20 years.