IMS - What's the Point?

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For those who follow us on Instagram and Facebook, you probably saw Nicole and I gleefully inflicting pain on each with needles. We were furthering our education with Level 2 of Kinetacore’s Functional Dry Needling (and using each other as pin cushions in the process). While we have been needling for awhile now, this course opened us up to new muscles we can treat. These include muscles in the jaw, thoracic spine, shoulder girdle, deep hip, back of the knee and foot. Overall, it was a great course and we are excited to integrate these new treatment options into our practice.

Why would we do this to ourselves? Why would we do this to you? These are great questions!

Intramuscular Stimulation, also known as IMS, uses acupuncture needles to get into those deep muscles that are hard to reach with our hands. Both Nicole and I practice Functional Dry Needling - our needles are solid (not hollow - we cannot inject anything!) and we are going after areas of the muscle that are impeding normal movement and function. (How do IMS and acupuncture differ? Check out this earlier blog post for that answer!)

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So what exactly does IMS do? The research behind IMS has been picking up steam in the last 20 years. Here are the main effects borne out in the research:

  1. Increases Blood Flow - several studies have shown increased blood flow in both the muscles directly treated and the other muscles with the same innervation.

  2. Restores Normal Muscle Length - one of the things that can happen with dysfunctional muscles is the become tight and short; we often refer to this as “increased tone”. IMS helps decrease the tone of these muscles back to normal levels.

  3. Decreases Spontaneous Electrical Activity - both nerves and muscles rely on electrical impulses to work properly. Sometimes the muscles and nerves fire off impulses spontaneously and inappropriately; this leads to impaired movement and function. IMS has been shown to reduce the number of spontaneous events in the muscle.

  4. Decreases Pain Chemicals in the Tissue - Substance P and CGRP, two nociceptive (aka pain) neuropeptides found in muscles, are reduced with IMS.

  5. Increases Capillaries in the Muscle - with repeated needling, we see an increase in the capillary density improving the circulation to the muscle.

  6. Changes in the Central Nervous System - the brain changes with repeated needling! Pain thresholds decrease, substance P reduces in the nerves and endorphin levels increase.

To sum it up: IMS works. It helps muscles work and move better. It reduces pain at the tissue level and in the brain. It improves circulation in both the short and long term.

Have we convinced you yet? If it’s something you’d like to try, give us a call at (778) 630-8800.

For more information on the science behind these claims, check out these research articles:

  • Ballyns JJ, Shah JP, Hammond J, Gebreab T, Gerber LH, Sikdar S. Objective sonographic measures for characterizing myofascial trigger points associated with cervical pain. J Ultrasound Med. 2011;30:1331-1340.

  • Bron C, et. al. Interrater reliability of palpation of myofascial trigger points in three shoulder muscles. J Manual an Manip Ther 2007;15(4):203-215.

  • Cagnie B, Barbe T, DeRidder E, Van Oosterwijck J, Cools A, Danneels L. The influence of dry needling of the trapezius muscle on muscle blood flow and oxygenation. J Manip Physiol Ther 2012;35(9)685-691.

  • Cagnie B, Dewitte V, Barbe T, Timmermans F, Delrue N, Meeus M. Physiologic effects of dry needling. Curr Pain Headache Rep 2013;17:348.

  • Chen JT, Chung KC, Hou CR, Kuan CR, Chen SM, Hong CZ: Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Am J Phys Med Rehabil 2000;80:729 –735.

  • Chen QB, Basford JR, Thompson JM. Identification and quantification of myofascial taut bands with magnetic resonance elastograpy. Arch Phys Med Rehabil 2007; Dec(88):1658-1661.

  • Chou LW, Kao MJ, Lin JG. Probable mechanisms of needling therapies for myofascial pain control. Evid Based Complement Alternat Med. 2012;2012:705327

  • Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: A systematic review. Arch Phys Med 2001;July(82): 986-992.

  • Federation of State Boards of Physical Therapy. Intramuscular manual therapy (dry needling)-Resource paper. March 2010.

  • Gerwin R: Myofascial pain syndrome: here we are, where must we go? Journal of Musculoskeletal Pain 2010;18(4):329-347.

  • Gunn C.C. (1996) The Gunn approach to the treatment of chronic pain: Intramuscular myofascial pain of radiculopathic origin. Churchill Livingstone.

  • Hsieh YL, Kao MJ, Kuan TS, Chen SM, Shen JT, Hong CZ. Dry needling to a key myofascial trigger point may reduce the irritability of satellite myofascial trigger points. Am J Phys Med Rehabil 2007;86:397-403.

  • Jimbo S, Atsuta Y, Kobayashi T, Matsuno T. Effects of dry needling at tender points for neck pain (Japanese katakori): near infrared spectroscopy for monitoring muscular oxygenation of the trapezius. J Orthop Sci 2008;13:101-106.

  • Mense S: How do muscle lesions such as latent and active trigger points influence central nociceptive neurons? Journal of Musculoskeletal Pain 2010;18(4):348-353.

  • Niddam DM: Brain Manifestation and modulation of pain from myofascial trigger points. Current Pain & Headache Reports 2009, 13:370–375.

  • Sikdar S, Shah JP, Gebreab T, et al. Novel applications of ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue. Arch Phys Med Rehabil 2009;90:1829-38.

  • Srbely JZ, Dickey JP, Lee D, Lowerison M: Dry needle stimulation of myofascial trigger points evokes segmental anti-nociceptive effects. J Rehabil Med 2010; 42: 463–468.

  • Tsai CT, Hseih LF, Kuan TS, Kao MJ, Chou LW, Hong CZ. Remote evvects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle. Am J Phys Med Rehabil 2010;89:133- 140

Ladner Village Physiotherapy exists in what is colonially known as Delta, on the traditional, occupied and unceded territory of the hən̓q̓əmin̓əm̓ speaking people. As health care providers, we actively strive to understand the role of intergenerational trauma and health inequities applied through systemic and institutionalized racism with the goal of providing equitable and person-centred health care for all.