Intramuscular Stimulation (IMS) Trigger Point Dry Needling
“WHY Intramuscular Stimulation - IMS Trigger Point Dry Needling?”
“...Gunn’s Intramuscular Stimulation technique is most effective...there is no other pain treatment available...that can immediately predict, in an objective fashion, whether a patient will respond to (IMS) treatment.”
Jennifer Chu-Andrew, M.D. Emeritus Associate Professor,
Department of Physical Medicine and Rehabilitation,
Traditional medical evaluation and treatment of musculoskeletal pain is based on the identification of acute tissue damage and inflammation. Clinical signs of swelling, redness and warmth, and imaging studies such as X-rays, MRIs and bone scans seek to identify the source of structural abnormality and inflammation and direct appropriate treatment. Common diagnoses include lumbosacral strain, rotator cuff tear/tendonitis, lateral epicondylitis, herniated disc, gluteal bursitis, Achilles tendonitis or patellofemoral chondromalacia to name a few. Therapeutic interventions typically consist of rest, elevation/compression, ice/heat anti-inflammatory/muscle relaxant medication, exercise and surgery if indicated. Most patients treated in this manner recover within several weeks to months depending on the severity of the injury and return to their pre-injury level of function.
While physicians and physical therapists usually have no difficulty identifying and treating pain attributable to acute injury, they are often perplexed by pain that persists despite no signs of ongoing structural damage or tissue inflammation. Often patients begin searching for an answer to their persistent pain and seek additional or alternative treatments. Some may receive repeated trials of therapy, multiple steroid injections and surgical procedures, a variety of alternative therapies, narcotic medications, and in severe cases spinal cord stimulators or implantable opioid pumps. Many patients become frustrated as they go from practitioner to practitioner, eventually becoming depressed and seeking psychological help or treatment at pain clinics. Some become disabled.
Studies have shown that many if not most of these patients have undiagnosed and inadequately treated myofascial trigger point pain (See references 1,2,3,4 below). Unlike acute pain that is self-limited in its timeframe and usually resolves within three months, myofascial pain is self-perpetuating and can become chronic. Despite this, when properly recognized and treated, it can be reversed and allow patients to return to pain free and productive lives. If recognized early, it can help patients avoid ineffective therapies and unnecessary medications, MRIs, EMGs, injections, spinal procedures, surgeries, addiction, job loss and disability.
IMS trigger point dry needling is based on a neuroanatomic and pathophysiological model of myofascial trigger point pain that provides a rationale for the physical examination of the patient which forms the basis for treatment. Students will be taught how to evaluate and select appropriate patients for treatment based on this model, and how to integrate postural exercise, manual therapy and electro-therapeutics into a comprehensive rehabilitation program. The value and limitations of MRIs and EMG studies in this patient population will be discussed.
IMS trigger point dry needling is highly effective in safely and efficiently reducing pain and restoring normal range-of-motion while leading to true functional rehabilitation.
IMS has been validated by clinical research studies.
C. Chan Gunn, M.D. first published clinical research on IMS in a paper titled, “Dry needling of muscle motor points for chronic low-back pain: A randomized clinical trial with long-term follow-up”. That paper was the runner-up for the Volvo Award Competition for Research in Low Back Pain in 1979. Since then numerous clinical studies in the peer-reviewed medical literature have confirmed the efficacy and safety of IMS. (See references 5, 6, 7, 8, 9, 10, 11 by 'click' on adjacent button)
A LearnIMS course will revolutionize your understanding of musculoskeletal pain and add a powerful treatment option to your practice that will significantly increase the success of your clinical outcomes. Many patients who have failed standard treatment are able to taper and discontinue medications, avoid unnecessary surgery and return to happy, productive lives as a result of effective IMS treatment. It is truly wonderful to participate in and witness this.
As a physiatrist Dr. Goodman is able to integrate an understanding of traditional approaches to neuro-musculoskeletal pain into the application of IMS, including postural evaluation, exercise, activity and ergonomic prescription. The appropriate role of other therapeutic approaches including manual therapy and electrotherapeutic modalities will also become properly appreciated. In addition you will learn the role of MRI imaging and EMG/NCV studies as they relate to IMS. Learning and practicing IMS will distinguish you from your peers and increase your satisfaction with your career!
“Dr. Gunn has made significant contributions to the understanding of chronic pain by introducing a theoretical basis which explains many of the enigmatic problems seen in chronic pain patients. His methods, which can be used in everyday medical practice, are an innovative neurologic approach that yields effective, safe and inexpensive treatment for the many patients who might otherwise remain without pain relief….his methods are grounded in a solid, physiological conceptual scheme…(and)…can elicit spinal reflexes and central nervous system responses that promote healing and more important, rehabilitation. His procedures are a viable alternative to the prescription of drugs, which foster toxicity, and to surgery which all too often causes more harm than benefit.”
John Loeser, M.D.
Professor, Neurological Surgery and Anesthesiology
Director, Multidisciplinary Pain Center 1982-1997
University of Washington, Seattle, Washington
“IMS has been an amazing tool. Following the LearnIMS course I practiced IMS on almost all of my clients with very positive and significant results. I have practiced medicine since 1990 as a student trainer/ATC then PT in the late 90's and have never had such a powerful tool to maximize my patients’ rehabilitation potential/goals. The power of treating clients with biomechanic training, eccentric strengthening, gentle stretching, and IMS is truly wonderful and fulfilling to me as a physical therapist. IMS is allowing me to be more effective…I thank you for providing me with the skills needed to be safe, efficient with time, and effective.”
Aric Thorne-Thomsen, MSPT
Missoula, MT
“After 25 years of dealing with problems from the locomotor system I have the opinion that Dr. Gunn’s IMS technique is the most important contribution in the field in the last 10 years.”
Bengt Johansson, M.D.
Chairman Swedish Society for Orthopedic Medicine