What is Intramuscular Stimulation / Dry needling, and how does it work?
IMS Dry Needling; IMS is the abbreviation for Intramuscular Stimulation, and is also known as trigger point dry needling, or simply dry needling.
IMS Dry needling is also sometimes referred to as ‘Western Acupuncture’ or ‘Medical Acupuncture, and it is a technique used by physiotherapists to treat muscle pain and tightness. A small needle is inserted into the muscle with dry needling to create a ‘local twitch response’.
This may be felt as a slight cramp or muscle contraction of a short duration (usually 1-2 seconds) and is the desired reaction. It sets off the correct physiological response to treat the pain.
The physiotherapist will first assess to determine if this treatment intervention is suitable for the patient. Special tests, autonomic evaluation, palpation, and functional movement screening are used to determine if IMS dry needling is the correct intervention.
The physiotherapist will then work with you to locate a muscular trigger point, “muscle knot.” Localized areas of muscle spasms ‘trigger points’ develop and become tight for many different reasons. The common causes are usually trauma, mechanical, emotional and psychological factors.
The physiotherapist will use a similar needle to an acupuncture needle during the treatment. The area is sterilized, the needle is inserted through the skin and into the tight muscle, the therapist manipulates the needle by gradually changing the depth and direction. This causes the patient to feel a twitching sensation or as if the muscle is going to cramp. Once achieved, the needle is removed from the muscle.
The twitching and cramping happen because the muscles are contracting and relaxing due to a sensory stimulation mechanism known as the stretch reflex. This reaction is a sign that the muscle may not be functioning optimally, as you typically do not get this reaction when IMS is performed in a loose and relaxed muscle. The primary aim of IMS is to reset the stretch reflex response and return the muscle to its normal length-tension state.
IMS dry needling often achieves quick results and complements other treatments such as active exercise programs and joint mobilization/manipulation.
What depth do the needles insert during IMS?
The depth of the IMS needling ultimately depends on the depth of the trigger point. Some muscles (like in the forearm) are very close to the skin’s surface, and the needling depth is subsequently relatively superficial and can be 1-2 cm. Other times, such as in the gluteal muscles, the trigger points are deeper and 5-10 cm below the skin.
Do you need advanced training to perform IMS Dry Needling?
Yes, you need advanced training to perform IMS!
Physiotherapists will first require a degree in physiotherapy and have two years of clinical experience. They will then take advanced post-university training, including self-study, class-room based practical hands-on training, and a set of rigorous practical examinations – (the type you wouldn’t wish on your worst enemy). Once completed, the needling department at the College of British Columbia Physical Therapy regulators screens the needling roster application, training and qualifications. Once the verification is complete, the skilled intervention is added to the physiotherapist’s license number, and practice approval is permitted.
Is IMS Dry needling safe?
Yes, dry needling is safe.
Your physiotherapist will undertake a thorough screening process to confirm that you are a suitable and safe candidate for needling. Clean needling techniques involve using single-use sterile needles, cleaning the site of the body with a special rub called Stanhexadine and the continuous wearing of gloves. Next, your physiotherapist will review and work with you to locate the area to be treated and explain how they will preserve safety precautions. The most common side effect is minor bruising and aching, which usually resolves quickly.
Is IMS painful?
Those who have had Acupuncture before will say that IMS is more painful due to the direct Insertion of the needle into the affected and sore muscle. Once the IMS session is over, there may be a residual ache or soreness in the area, which depends on the technique and aims of the treatment session.
What kind of results can I expect with IMS Dry Needling?
The two main positive results typically expected with IMS dry needling are increased movement as the muscle tissue loosens and resolved pain as the compressive forces around the tight muscle bands reduce.
What to do after an IMS treatment session?
Afterwards, keep the region moving. The movement will help to reduce the post IMS ache, leaving you feeling loose and with reduced pain. It is normal to experience some soreness in the first 24-48 hours after treatment. During this period abstaining from vigorous exercise is recommended; this helps maximize the benefits of the treatment. After this time, the soreness should diminish with no further discomfort, and the muscles will feel recovered, ready for normal function to resume.
Other common side effects of IMS dry needling include bruising and local tenderness at the treatment area. To help relieve soreness, we recommend all of our patients drink plenty of water and use heat over the affected areas to flush the body and activate the healing (e.g. warm bath, warm compress).