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What is Intramuscular Stimulation (IMS)?

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photo of IMS being performed in periscapular region during physiotherapy session

What is intramuscular stimulation (IMS)?

Like it sounds, IMS involves the insertion of dry needles (acupuncture type needles) into myofascial trigger points (muscle knots). When trigger points form, the trigger point and surrounding tissues have reduced circulation and heightened neurological activity. In this state, the muscle tissue is essentially ‘stuck in an on position’.

Acupuncture is not IMS but they both use the same tool (dry needles). First of all, Traditional Chinese Acupuncture is a discipline/profession in which practitioners can spend their entire career learning about and perfecting. Acupuncture is composed of many different treatment styles and techniques. Physiotherapists can perform acupuncture treatments but are generally performing parts or specific protocols that come from a wide-body of techniques.

Therapists generally use cupping to decrease muscle tension, improve range of motion and reduce muscle-related pain.  Many patients report feeling improvements in pain and function immediately after treatment but results may vary.  Cupping is yet another tool in your therapist’s repertoire and while it is helpful to many, results are dependant on many factors including the type and nature of the injury.

Secondly, ‘what is being treated’ is usually different between IMS and acupuncture. Acupuncture focuses on treatment of meridians, or energy channels, that run through the entire body; whereas IMS is directed toward myofascial trigger points. That being said, acupuncture “ashi points” are similar to what is being treated with IMS (as previously mentioned, acupuncture is diverse).

Intramuscular Stimulation is very measurable and although there is always lots to learn, physiotherapists have a relatively good understanding of how IMS works. Simply spoken, IMS works by ‘resetting’ the muscle to its normal resting state. When placed properly, the dry needles cause the muscle to twitch. The muscle twitch is a visible and measurable phenomenon. After the muscle twitch occurs, there is a restoration of normal nerve activity, resting muscle tone and consequently, blood flow. These after-treatment changes can be studied objectively. By restoring the aforementioned, muscle pain and function can improve, as well as range of motion of any nearby joints.

The effects of IMS are far reaching. Many therapists use the impact IMS has on the nervous system to treat more than just local tissues. If you look at the nervous system as a highway and the dysfunctional areas as traffic jams, IMS is thought to clear away some of the traffic jams to help the system flow smoother. This is obviously an over-simplified explanation but it may help to understand why a therapist may tell you that treating your lower back with IMS may help your legs.

Many patients find IMS quite helpful and it is now common practice for physiotherapists to perform IMS treatments. There are side-effects and risks to treatment that should be discussed with your physiotherapist.

Please note

This article is not intended to be a literature review.  While some literature may be cited in some cases, this article should not be used as scientific-evidence of a treatment or service.  Please contact your physiotherapist or other appropriate health care provider to better understand the scientific literature supporting or refuting the use of a particular treatment.