Intramuscular Stimulation (IMS)

What is INTRAMUSCULAR STIMULATION (IMS)?

Intramuscular Stimulation (IMS) or dry needling is an effective treatment for chronic pain of neuropathic origin. Neuropathy is the term used to describe a problem with the nerves, usually the ‘peripheral nerves’ as opposed to the ‘central nervous system’ (the brain and spinal cord). Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. … These nerves now misfire and cause pain. This technique uses needles similar to the needles used in acupuncture to find and diagnose muscle shortening in deep muscles. This technique has few side effects.

When chronic musculoskeletal pain persists with no obvious injury or inflammation, neuropathy (“sick nerves”) is suspected. Accompanying neuropathy is muscle shortening, causing pain in muscle, tendons, their connective tissue attachments and joints. IMS has shown to be effective in the release of muscle shortening, thus relieving pain.

The acupuncture needles used are very thin (much thinner that the hollow needle used to inject medicine or take blood samples). You may not even feel it penetrating the skin, and if your muscle is normal, the needle is painless. However, if your muscle is supersensitive and shortened, you’ll feel a peculiar sensation – like a muscle cramp or Charlie Horse. This is a distinctive type of discomfort caused by the muscle grasping the needles. Patients soon learn to recognize and welcome this sensation. They call it a “good” or positive pain because it soon disappears and is followed by a wonderful feeling of relief no longer tight, you no longer feel it. What has happened is that the needling has caused your abnormal muscle shortening to intensity and then release. It is important that you experience this sensation in order to gain lasting relief.

 

Who can benefit from IMS?
  • Patients with neuropathic pain
  • Those who have not found pain relief with other physiotherapy treatments
  • Women who are not pregnant
  • Patients with no infection in the area
  • No history of hemophilia
 How is IMS different than acupuncture?

 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.

The difference between acupuncture and dry needling is the target.
In acupuncture we target the meridan points. In dry needling we target the muscle, particularly the trigger point in the muscle. The needle will create a reflex which will relax the tight muscle.
 
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.

Conditions that can be treated using IMS

A broad range of musculoskeletal problems are now successfully treated using Intramuscular Stimulation.

  • Achilles tendonitis
  • Arthritic conditions
  • Chronic Tendonitis or Bursitis
  • Headaches
  • Low back pain
  • Myofascial Pain Syndrome
  • Neck pain and whiplash
  • Patellofemoral syndrome
  • Plantar fascitis
  • Recurrent or Persistent Injuries (including sports injuries)
  • Repetitive Stain Injuries
  • Sciatica/piriformis syndrome
  • Shin splints
  • Shoulder injuries (including frozen shoulder)
  • Spinal disc problems
  • Tennis/Golfers elbow
  • TMJ pain
  • Torticollis

 

Success of Treatment

Treatment can be quite successful if used appropriately. This is again depending on the severity and duration of the condition, general health and how quickly your body can heal.   Better outcomes can be achieved if you perform the home stretching exercises given by your physiotherapist, on a daily basis.
 

 For more information visit: www.istop.org

Ali Zareh PT, DPT, MScPT, CGIMS

Ali is a highly qualified and very experienced physiotherapist. He has been practicing physiotherapy for the past 20 years. Ali holds a Bachelor of Science and a master degree in physical therapy. He also holds a doctorate degree in physical therapy from Andrews University in Michigan, USA.

Ali has completed a postgraduate program in advanced musculoskeletal physical therapy in Toronto. He has also completed a medical acupuncture program with McMaster University.  Ali is a cerificant of the Gunn intramuscular stimulation program from University of British Columbia in Vancouver and is an active member of The Canadian Institute for the study and treatment of pain.

Ali is a very passionate physiotherapist and loves working with people. His areas of clinical interest are orthopaedic physiotherapy, sport injuries, chronic pain and post-op rehabilitation of ligaments and joint arthroplasty.