Today, it is not uncommon for physiotherapy and specialist physician clinics to use Intramuscular Stimulation (IMS) as a modality to treat persistent musculoskeletal pain. In this blog, we will discuss what Gunn Intramuscular Stimulation is, its uses and benefits, and how at Elevation Physiotherapy, our clinical team utilizes this technique.
What is Intramuscular Stimulation?
Intramuscular stimulation (also known as “dry needling”) is a technique involving the insertion of acupuncture needles into muscles to treat persistent pain caused by stiff, tight, and shortened muscles. Either from injury or progressive degenerative conditions, nerves near the spinal column or along the path from the spine to the extremities can be compressed, bent, or tractioned. Since nerves contain sensory, motor, and autonomic fibers, symptoms of nerve injury can include shortened/tight/weak muscles, numbness, tingling, and pain hypersensitivity (a reduced pain threshold).
Nerves exit from the spinal cord and supply our muscles, skin, tendons, arteries, bones, and internal organs. Any injury to these nerves, either within the spinal column or anywhere along its exit and pathway, can result in symptoms felt remotely from the area of compression. Common conditions such as sciatica, bursitis, plantar fasciitis, and tendinopathies can have symptoms felt at their origin or distally. Where we experience symptoms may or may not be the origin of the problem. This is the reason why a personalized assessment is crucial. A patient’s spinal history and spinal exam should always be included, even when the patient is reporting pain in a knee, foot, or hand.
How IMS Began
Gunn Intramuscular Stimulation (IMS) is named after its founder, Dr. Chit Chan Gunn. Doctor Gunn was born in Malaysia in 1931. He graduated with a medical degree in Cambridge in 1953. He then emigrated to Canada in 1966. He started using intramuscular stimulation in 1973.
Dr. Gunn was appointed to the Order of Canada in 2022 for his groundbreaking and pioneering work in developing IMS for chronic neuropathic pain, which is a form of persistent musculoskeletal pain derived from dysfunctional and hypersensitive nerve tissue. He was promoted to Officer in June 2024. He is a Fellow of the Royal College of Physicians in London and has also received the Order of British Columbia.
The teaching program which he began in Vancouver, British Columbia has run continuously since 1994. Since 2011, the teaching center has been a part of the University of British Columbia (UBC) Faculty of Medicine. His philanthropic gift led to the establishment of the Chan Gunn Pavilion, an integrated space for exercise science and sports medicine at UBC.
The Benefits of IMS
Unlike traditional Chinese acupuncture, IMS is based on the scientific principles of the neuromusculoskeletal system. It is not used to treat chi or meridians. One acupuncture needle is inserted at one time. It is inserted into muscles to elicit a muscle contraction called a latent twitch response. This contraction results in a reduction in the tightness and stiffness of the muscle. It also increases our pain threshold that has been reduced due to the injury or condition, thus normalizing our pain responses. This then allows us to move, exercise, and regain joint mobility and muscle strength.
See our previous blog: Dry Needling vs. Acupuncture: How Are They Different?
Unlike massage therapy and external massage devices, the advantage of IMS includes the following:
Depth: The needle can be inserted deep into muscles, thus treating areas that are otherwise inaccessible.
Speed: The latent twitch response creates a near immediate relaxation of the muscle that continues to have a positive effect over a period of days thereafter.
Precision: The needles are so fine that very specific parts of the muscle can be treated. This lends to the treatment’s safety and allows us to avoid areas that should not be treated.
How Does Elevation Physiotherapy Utilize Intramuscular Stimulation?
Our team uses IMS as part of a comprehensive and multi-modal approach to patient care. IMS should not be used in isolation as a sole treatment modality. For example, IMS is often used to increase a patient’s pain threshold and to reduce muscle tightness. Manual and Manipulative Therapy can then be used in combination with IMS to restore and increase joint mobility. Therapeutic exercise is then used to address any specific joint or muscle problems and to take advantage of the beneficial effects of IMS and manual therapy. The patient is then taught a home program to utilize the reduction in pain and the improved freedom of movement. A multi-modal approach that encourages an active role for the patient will always yield far superior and longer-lasting therapeutic effects than any single modality alone.
There are many reasons why people experience pain or nerve and muscle dysfunction. People differ in terms of the chronicity of their pain, their health history and fitness levels, their age, their occupation, as well as their spinal and muscle health, hobbies, and recreational activities. This is why prognosis in terms of the number of treatments needed and the outcomes of treatments vary from one person to the next. Each person is unique, and their response to treatment will always differ.
Considerations and Limitations of IMS
IMS is not a panacea. It is only one treatment modality among many to help a patient accomplish their health goals. Regardless, there is good reason as to why this dry needling technique has become an invaluable treatment tool among physiotherapists and medical specialists. It is relatively safe when performed by those with extensive training and experience with this modality. When compared to alternative treatment techniques that are unable to penetrate the skin, outcomes can be achieved at a much faster rate, thus reducing the number of treatments needed to achieve the same goals.
Are There Patients or Conditions for Whom IMS Should Not Be Used?
The insertion of a needle into the skin will always create a risk of infection. Although this risk is rare, it is a risk nonetheless. Signs of infection to monitor include redness, heat, fever, chills, and increasing pain in the areas treated for more than the usual 1-3 days after a treatment. Should this occur, it is important to see a physician immediately for treatment with antibiotics.
Additionally, patients who are immunosuppressed, on long-term blood thinners, or who are pregnant would not be appropriate candidates for this treatment. Always consult with your healthcare provider to determine if this treatment is right for you.
If you’re interested in experiencing the benefits of Intramuscular Stimulation, we invite you to book your Intramuscular Stimulation / Dry Needling services at Elevation Physiotherapy today. Let us help you on your journey to recovery and improved well-being!
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