Intramuscular Stimulation (IMS) / Dry Needling
Author: Jacob Carter – Physiotherapist at One Wellness
Intramuscular Stimulation / Dry Needling is a therapeutic treatment procedure that involves the use of filament needles (acupuncture needles) being placed into tight muscles and trigger points. Trigger points are very irritable spots in a tight muscle band that are painful and can cause referred pain. Researchers have found that trigger points are acidic and contain a lot of metabolites, which irritates the local nerve endings and results in pain. If the trigger point creates sufficient pain for long enough, the nervous system can become hyper-aware of the dysfunction, which serves to increase the pain response even more.
These findings have been supported in the scientific literature since the 1940s when Dr. Janet Travell first described the existence of trigger points, and the effectiveness of needling to help treat them. IMS has been validated in dozens of research studies to be an effective and safe treatment of acute and chronic pain.
During a typical treatment, each needle is placed the muscle for only a few seconds. The level of discomfort can vary from patient to patient, however, most patients are surprised at the relative lack of discomfort of the procedure. A healthy muscle will feel very little discomfort upon insertion of the needle; however if a muscle contains trigger points the patient may feel a sensation much like a muscle cramp (this is referred to as a ‘twitch response’). This twitch response is very brief and unexpected. During your visit, multiple trigger points in several areas may be treated.
The twitch response causes (1) biochemical changes within the muscle, and (2) reduces muscle tension via modulation of the central and peripheral nervous systems. In addition, (3) the act of inserting the acupuncture needle into the muscle increases local blood-flow to the area for several hours which helps to provide oxygen and nutrients to the malnourished trigger point, thus improving its recovery. Patients soon learn to recognize and even welcome the twitch sensation, as it signifies an immediate deactivation of the trigger point, thus reducing pain and improving function of the involved muscle.
After the treatment, you may feel achy and sore for up to 3 days, although usually patients only feel discomfort for a few hours. This is a muscular soreness, and is best dealt with by using a heating pad, stretching, and low-moderate intensity exercise.
Typically, positive results are apparent within a couple treatment sessions but can vary depending on the cause and duration of the symptoms, and the overall health of the patient.
IMS is an effective treatment for acute and chronic pain, rehabilitation from injury, and injury prevention. This technique is highly valued in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.