What is IMS/Dry Needling?

Dry needling, a popular and effective physiotherapy treatment!

Do you suffer from pain and tightness in your muscles? What about nerve pain, chronic pain, or joint pain and stiffness? If so, IMS/dry needling may be the treatment for you!

Read on to learn more about this treatment and how it may help you.

A BRIEF HISTORY

One of the most popular physiotherapy treatment techniques these days, IMS (intramuscular stimulation) has historical roots from the 1940s when it was discovered that “dry” needling without injecting medication still produced benefits in decreasing pain. This underlies the concepts of trigger point mapping and referral patterns. In layman’s terms, when tight muscle bands or “knots” that have local pain and tenderness when pressed, radiate pain to areas away from the trouble spot. Picture that tight knot in your upper trapezius muscles that when you squeeze, pain is felt at your neck or even up to your temples, or perhaps you have a nagging wrist pain that doesn’t go away when massaged, the source could be coming from a trigger point at your forearm or upper arm.

Research continued through the mid to late 1900s, where in the 1970s, Dr. Chan Gunn developed a dry needling technique for the treatment of myofascial pain that targets the muscle tender points and its neuropathic origins—he coined this technique, intramuscular stimulation. His technique has influences from acupuncture, hence the usage of the same tool— thin sterile filiform needles, although the theory and mechanism between IMS and acupuncture differ greatly.

HOW DOES IMS/DRY NEEDLING HELP

IMS effectively targets and releases trigger points that can cause muscle pain, boosts circulation and your body’s natural healing response, provides a novel neurophysiological input to decrease pain and “reset” the nervous system, aids in decompressing irritated nerves and joints aggravated by myofascial tightness.

You may wonder now, what are trigger points? Trigger points are tight, hyper irritable spots in the myofasical system. These bands are a few millimetres in size (around 2-10mm), and usually have the following characteristics when pressed or when the muscle contracts: (1) Local tenderness when compressed, (2) Jump sign, a disproportionate amount of pain felt when the spot is palpated, making the individual react strongly or exclaim! (3) Twitch response, a reflexive and involuntary contraction of the local muscle fibre when the trigger point is needled, (4) Referred pain, pain radiates and is experienced distant from the original pain site; pain from trigger points can follow a referred pain map.

Trigger points can be active or latent, and they can develop from causes such as:

• Overuse, repetitive behaviours and motions

• Poor and prolonged postures

• Injuries and traumatic accidents

• Physical manifestations from emotional and/or mental stress

• Under-activity and being sedentary

• Aging and factors relating to delayed recovery, including poor sleep and nutritional deficiencies

• Accumulation of muscle micro-trauma from lifting weights and inadequate recovery

• Joint conditions including arthritis, degenerative tears, hypomobility or hypermobility

• Poor tendon health including tendinitis, tendinosis and tendinopathies

WHAT TO EXPECT

Prior to receiving the dry needling treatment you will first be assessed by your trained and licensed practitioner to determine whether you are a good candidate, as well as which myofascial regions will be targeted. Thin needles from sterile packaging will be threaded to the area of the trigger point. At this point, the tight band will be stimulated by the needle, often resulting in a twitch response. Depending on the desired effect the needle may stimulate the trigger point for a few seconds (3-10 seconds on average), or it may be left at the target zone with or without electro-stimulation added to the needle for further muscle relaxation and nervous system reset effects.

The typically reported sensation is that the dry needling feels more unique than uncomfortable; a very tolerable achey, heavy feeling may be experienced along with the involuntary twitch of your muscles as the tight myofascial bands are released. Afterwards, the treated areas may feel some soreness, heaviness and/or fatigue—everyone’s recovery timeline differs, anywhere from the individual experiencing no discomfort, a few hours, or up to one to three days. The post treatment sensation is similar to a post workout soreness you may have experienced before.

The positive effects of treatment often can be felt right away, such as improved mobility, and less perceived sensations of tightness and pain; for some individuals these benefits are felt after treatment recovery is complete. Sustained positive benefits may require more sessions for best effect, along with consistency with habit changes and adherence to your home management program. IMS/dry needling treatment is done in adjunct with other treatment techniques such as manual therapy and exercise for best results.

WHAT CONDITIONS CAN IMS/DRY NEEDLING HELP WITH

IMS/Dry needling can improve and treat a variety of conditions that cause you pain, tightness, and a loss of function. These include:

• Muscle spasms, strains and tears

  • Whiplash

  • Postural pain and repetitive strain injuries

  • Sport injuries

  • Lower back muscle spasms

  • Wry neck

• Ligament sprains

  • Ankle sprains

  • Shoulder sprains

  • Knee sprains

  • Cervical sprains

• Tendon injuries, tears, tendinosis, tendinitis, tendinopathies

  • Tennis elbow

  • Rotator cuff tendinopathy

  • Calcific tendinopathy

• Nerve conditions

  • Nerve impingement

    • Cervical and lumbar radiculopathy, herniations

  • Carpal tunnel syndrome

  • Sciatica

  • Piriformis syndrome

  • Thoracic outlet syndrome

  • Meralgia paresthetica

• Joint conditions

  • Arthritis, stenosis, spondylosis

• Myofascial restrictions and scar tissue adherence after injury and post-surgical

• Plethora of other soft tissue conditions

  • Bursitis

  • Patellofemoral pain syndrome

  • Frozen shoulder

  • Shin splints

  • Plantar fasciitis

It should be noted that individuals with an active oncology problem or an uncontrolled autoimmune disease may not be suitable candidates for dry needling treatment unless they have been cleared and approved by their medical professional/specialist. Pregnant women are not recommended to receive this treatment as well. If your medical situation is complex or if you have uncertainties, it is always best to consult with your physician first!

If you feel like you would benefit from IMS/dry needling, book in with our physiotherapist to schedule your treatment!

Reference Links:

https://www.researchgate.net/publication/262695179_A_History_of_Dry_Needling

https://www.physio-pedia.com/Trigger_Points