IMS: Intramuscular Stimulation

How it Works:

There are multiple needle insertions into muscle tissue. (Does not leave the needle in like acupuncture). The goal is to hit taught bands in the muscle, that have contracted over time due to decreasing health of the nerve or a compensatory movement pattern. Looking to elicit a twitch response when possible or a deep cramping sensation. Twitch responses generally signifies an immediate release of the shortened muscle and a deep cramping feeling the muscle will release over the course of 1-2 days.  


Stimulating the reflex arc between the alpha-motor neuron, the muscle spindle or golgi tendon reflex and the central nervous system. This is what causes the twitch or cramping contraction.

Allows you to access the central nervous system via the neuromuscular system.

Needles vs Manual Therapy:

Generally manual therapy is tried first as a needle is both a very large stimulus and carries a bit more risk (though small when performed correctly).

Using a needle you can be more specific with your release as well as go sub-dermal, which allows for insight into both deeper tissue as well as a mechanism to feel the health of the tissue you are putting the needle through.

When to use Needles?

1)     For trigger point release of tight muscles. This is kinetacore or dry needling from my understanding.

2)     Acupuncture – local micro injury, stimulating chi, bloodflow etc.

3)     GUNN IMS Theory – Neuropathic/chronic pain (over 3 months duration).

Nerve health is on a spectrum and it has decreased due to repeated pathological stimuli (injury pool), with the most common being spondylotic/spondylosis (degenerative effects). Hence the radiculo-neuropathic model. Needling affected muscles as well as corresponding segmental distribution axially, to access central nervous system (posterior AND anterior ramus distribution) 

Based on Cannon’s Law of Denervation Supersensitivity:

Describes what happens to an unhealthy/injured  nerve. Can have sensory, autonomic or musculature changes described as, superduration of response, hyperexcitability (lower threshold), Increased susceptibility producing normal response, super reactive tissue.

Normal Treatment:

Trial of 4-6 sessions. Often have some relief in first session, and generally more by 3rd. If no change in symptoms/signs or pain levels by 4th treatment, likely not the right treatment for that patient.

Causing slow changes in muscle resting tone and length. IS causing micro-injury and producing a novel stimulus to the nervous system.  Patient likely will be mildly sore and tired that day, but generally better the next day.

Contra-Indications: Pregnancy, infections

Precautions: Blood thinners and excessive co-morbidities.


Gunn Textbook

Interesting in IMS? Call to book an appointment with Jennifer today!