Gunn IMS (Intramuscular Stimulation)
What is Intramuscular Stimulation?
Intramuscular Stimulation, also known as Gunn IMS, is a needle technique, whose method is used to treat neuropathic pain. It uses a fine, flexible needle to treat peripheral nerve dysfunction, which causes pain and altered function. This nerve dysfunction results in tender and shortened muscle bands causing pain in muscles, tendons, their connective tissue attachments, and joints.
Unlike acupuncture, needles are inserted directly into the source of the pain in the muscle to release tension and are immediately removed. These nerve dysfunctions are detected by performing a full musculoskeletal examination, and IMS is offered when appropriate.
For more on how IMS and acupuncture differ view the article: Acupuncture vs Intramuscular Stimulation
Development of the GUNN IMS Therapy
Intramuscular stimulation, also known as Gunn IMS, is a needle technique based on the work of Dr. Chan Gunn, president of the Institute for the Study and Treatment of Pain (ISTOP).
Dr. Gunn developed this method in the 70’s while he was working as a physician at the Worker’s Compensation Board of British Columbia.
Frustrated with the modalities at his disposal, he wanted to develop a treatment that could penetrate deep within muscle tissue, specifically targeting injured muscles that have contracted and become shortened from distress.
IMS is grounded in Western Medical Science, and has a solid foundation in its radiculopathic model of pain, which is now supported by many experts in the field.
Gunn IMS Training
Gunn IMS training is now offered at a variety of schools as it is a continuing education course that any registered practitioner can take to add to their skill set.
Our therapists completed the Gunn IMS program at The University of British Columbia, which is part of the UBC Faculty of Medicine and has been taking place at the Chan Gunn Pavilion UBC Vancouver campus since 2013.
To read more about course overview and certification at UBC please click here
How Does Gunn IMS Work?
IMS involves the insertion of fine acupuncture needles into muscles that have contracted and become shortened. The overall goal of treatment is to release muscle shortening, which presses on and irritates the nerve. The needle itself is inserted directly into the muscles, then removed, achieving relaxation, and decreasing its constant bombardment on the nervous system. The needle also transmits feed-back information on the nature and consistency of the tissues that it is penetrating.
When the belly of the muscle is stimulated by the needle, it will often contract, or “twitch” one time. This is the ideal outcome as it indicates that optimal muscle relaxation has been achieved.
Common ailments treated by IMS include:
- Chronic muscle pain
- Limited range of motion
- Stiffness in muscles and joints
Since IMS specifically targets chronic musculoskeletal pain, it is not an effective treatment for other types of conditions such as chronic inflammatory pain caused by rheumatoid arthritis, cancer pain, metabolic neuropathies (such as diabetes), or degenerative neurological conditions (such as Parkinson’s disease).
There are 3 different results that can be achieved when administering IMS on a patient:
- A stretch receptor in the muscle will be stimulated, producing a reflex relaxation (lengthening of the muscle).
- The needle will cause a small injury that draws blood to the area, initiating the natural healing process.
- The treatment creates an electrical potential in the muscle to make the nerve function normal again.
These results will vary from person to person and some people can experience relief right away in the session, while others experience the relief a few days later. In addition to increased movement and function of the muscle, the overall pain state should be improved.
Depending on the injury, IMS can be effective after one treatment, but can sometimes take up to 7 or 8 sessions to see a drastic difference. Patients with more recent pain often see results faster (2-3 treatments), while others with deeply rooted pain that has developed over a longer period of time may need more sessions.
To allow the tissue to heal in between treatments, your physiotherapist will likely schedule your appointments with a few days in between or in weekly intervals.
Is Gunn IMS Safe?
IMS is relatively safe but as with most things, there are risks involved with receiving it, especially due to it being an invasive treatment (a procedure that invades/enters the body).
The main risks with IMS are:
- Contusion – A needle may be placed inadvertently in an artery or vein, which can cause a bruise to develop.
- Paraesthesia – If a small nerve is punctured, it may cause a sensation of tingling, which can continue for a day or two. Due to the needles being very fine, the risk of permanent nerve damage is extremely rare, but possible.
- Pneumothorax – When a needle is placed close to the chest wall, shoulder or lower neck areas, there is a possibility of lung puncture producing air in the chest cavity. If shortness of breath on activity is experienced after treatment, you must seek medical attention and notify your IMS treating practitioner.
IMS is not a recommended course of treatment if you are pregnant, have had a recent surgery or a local infection. All of our patients have the opportunity to speak with their therapist and sign our consent form before receiving IMS treatment, so they understand the complications and risks associated with this treatment.
Case Studies
Acute example
“Bob” has a knot in his back between the shoulder blades, massage and heating it will make it feel temporarily better, sometimes he would use a golf ball to try to release it. When he comes to get IMS, the needle will go right into the muscle and release it like a pressured balloon. He gets relief faster than he would with other methods!
Chronic Example
“Julie” has a history of long-term lower back pain that is exacerbated by tight muscles. After 4 treatments of intramuscular stimulation, her symptoms decreased and her muscles relaxed, putting less pressure on her lower back and easing her neuropathic pain.
Gunn IMS Frequently Asked Questions
- Does Dry Needling/IMS hurt? Most people describe IMS as unpleasant but not painful. The treatment itself does not last very long, with the needles sometimes inserted for only a few seconds each.When the needle first enters the muscle the pain should be minimal, however, you may feel some cramping when the muscle grasps the needle. The severity of this pain will vary depending on the person and the severity of the muscle shortening, afterwards easing into a feeling of relaxation.
- How deep do IMS needles penetrate? The length of needle penetration depends on which body part is getting treated. We have a range of needle lengths starting from 1.3 cm for facial points all the way to 10 cm for lower back and hips on a larger person. The most common lengths of needles that are used are 4.5 to 6.5 cm in length. It is important to note that needles do need to penetrate deep enough to reach the contractures (fixed tightening of muscle) deep within the muscles which are beyond the finger’s reach and can only be discovered by probing with a needle.
- Is anything injected with IMS? IMS treatment involves dry needling of the affected areas of the body without injecting any substance. Needles are normally inserted and then immediately removed; however, some may stay in momentarily.
Getting Started
IMS relies heavily on a thorough physical examination of the patient by a competent practitioner, trained to recognize the physical signs of neuropathic pain. At our clinic, we have 2 physiotherapists who are trained to administer intramuscular stimulation. An initial assessment will need to be conducted before the treatment to make sure you are a considerable candidate for receiving IMS.
What to Expect After Treatment
IMS may cause an increase in pain for one or two days, followed by an improvement in the overall pain state. The increased pain is related to overactive and sensitive muscle bands that have not been released. Symptoms and signs typically disappear when tender and shortened muscle bands are needled and contractures are released.
Quite often people feel fatigued after treatment, so it’s good to rest for a day or two after having IMS done, and not do any rigorous activities such as a workout. Utilizing mild heat may help to relieve post-treatment soreness.
Take the next steps to feeling better…
If you have questions about whether this treatment is right for you please give us a call (604) 474-1276
