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How Intramuscular Stimulation (IMS) Can Help You Recover: Is It Right for You?

December 18, 2017

The majority of patients with pain recover quickly from injuries and are fully functional after 6-8 weeks. However, there are individuals, who continue to have persistent pain. These individuals often describe that prescribed medications and therapies do not produce lasting relief.

There are three distinct definitions of pain that we must consider first: Nociception, Inflammation, and Neuropathy.

  • Nociception: An immediate response conveyed to the brain, which signals tissue injury (noxious input). For example, the sensation of hitting your elbow.
  • Inflammation: A local response to injury resulting in redness, swelling, heat, pain and sometimes loss of function. For example, am an acutely sprained ankle.
  • Neuropathy or Radiculopathy Pain: Ongoing pain with no obvious signs which is caused by a malfunction in the peripheral nervous system, leading to a hypersensitivity of the nerves supplying the muscles.

Long-term pain can exist in ongoing nociception/inflammation such as a fracture or certain kinds of arthritis. These examples would not be considered neuropathic as there are obvious structural reasons for the pain. Neuropathic pain is different and has several indicators:

  • There is a pain in the absence of ongoing tissue damage.
  • There is a delay in the onset of pain after a precipitating injury.
  • Mild stimuli are very painful.
  • Pronounced summation and after-reaction from stimuli (i.e., the pain gets worse with exercise).


Neuropathic pain is usually caused by everyday wear or overuse ( consider the office worker who gets “tennis elbow” but doesn’t play tennis). The hypersensitivity of the nerves resulting in shortened, taut bands in the muscle. These muscles then do not fire properly and contract with minimal stimuli. This can lead to pain and then further dysfunction as one tries to continue using the muscle. This can become a vicious cycle.

How does IMS work?

Intramuscular Stimulation (IMS) is a system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions that occur in the musculoskeletal system when there is no obvious sign of injury or inflammation). IMS is rooted in western medicine.

The treatment involves dry needling of affected areas of the body without injecting any substance. The needle is inserted into the center of the taut, tender muscle bands. The supersensitive muscle will ‘grasp’ the needle in what can be described as a cramping sensation. There are many results: One, as the taut band is released, there is a lengthening of the muscle. Two, the needle causes a small injury that draws blood to the area, initiating the natural healing process. Three, the nerve begins to function normally again.

The goal of treatment is to release muscle shortening, which presses on and irritates the nerve. This results in proper function of the nerve and muscle, which decreases pain and improves function.

The effects of IMS are cumulative. Each needle injury stimulates a certain amount of healing until, eventually, the condition is healed, and the pain disappears or is lessened significantly.

What can IMS treat?

IMS can help you with:

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  • Pain with no clear underlying cause
  • Overuse injuries such as tennis elbow or Achilles tendinitis
  • Inhibited range of motion
  • Conditions causing you to compensate your movement patterns
  • Chronic muscle tightness that just won’t stretch out

Is IMS right for you?

During your first appointment with your physiotherapist, he or she will get a detailed history from you and examine you physically. Together, you and your physiotherapist will decide if you would benefit from IMS.

Next steps

Contact Pleasantview Physiotherapy to schedule an appointment. We’ll discuss in detail the risks and benefits before getting started.