Physio: Difference between acupuncture and intramuscular stimulation

In many injuries that persist despite little major tissue damage, there will be an underlying micro-irritation of the nerves.

I’m asked almost every other day how intramuscular stimulation (IMS) differs from acupuncture.

Both use very slim, low profile needles and both are used by physiotherapists as part of a  comprehensive approach to managing pain and injury.

IMS was designed specifically to help in the diagnosis and treatment of chronic pain stemming from a neuropathic origin.

In many injuries that persist for more than a few weeks or months despite a lack of major tissue damage, there will be an underlying micro-irritation of the nerve pathway supplying that tissue.

If this irritation of the nerve or nerve root persists, the muscle and other tissues supplied by that nerve pathway will become hypersensitive and lead to what would normally be harmless or innocent nerve signals being exaggerated and perceived as painful ones.

In response, the body tries to protect itself—typically by over-contracting the involved muscular structures, creating so-called muscular spasms or trigger points.

So whereas an acupuncture needle is placed along meridians defined according to Eastern Medicine principles, an IMS needle will be placed directly in the area of muscle contracture.

Health professionals are typically trained to look for obvious nerve irritation using nerve conduction tests or MRI.

In fact, if you have had a long-standing chronic injury or battle with chronic pain, you will almost certainly have some degree of neuropathy or micro-irritation of your nerve roots or nerve pathways leading to shortening of the muscles that they supply.

When those muscle components shorten or contract and do not relax over long periods of time, they produce pain by pulling on tendons and compressing the joints that they cross.

If this goes on for long periods of time, it will increase strain on these tendons and on wear and tear of these joints, contributing to early degenerative changes often diagnosed as isolated incidences of  tendonitis, osteoarthritis, or degenerative joint/disc disease.

When an IMS needle is placed in the “epicenter” of irritated, taut muscle bands, the injured muscles will grab onto the needle producing reflex relaxation, a small injury that stimulates blood flow and healing, and an electrical potential in the muscle, which helps the nerve to function normally once again.

If a muscle is functioning normally, without underlying nerve irritation, the muscle spindles will not grab on to the needle, meaning that IMS can also be used to help in the diagnosis of this form of chronic pain, as well as its treatment.

Sometimes needles are placed close to the spine, were the nerve root itself may be hypersensitive. The aim of IMS treatment is to interrupt muscle spasm that is pressing on the nerve and break the cycle of muscle contraction and nerve hypersensitization, which together feed chronic pain.

If you have had a chronic issue with pain or musculoskeletal dysfunction that is never fully resolved, or returns time and time again even with treatment, a full assessment and screening for signs of neuropathy and neuromuscular dysfunction using IMS may be warranted.

Intramuscular Stimulation needling technique is not a panacea that can correct all chronic pain issues, but research points towards it being a very effective tool in the treatment of chronic or persistent pain.



Tyler Dyck is an intramuscular stimulation practitioner, a Fellow of the Canadian Academy of Manual and Manipulative Therapists, and a founding partner of Sun City Physiotherapy.  He can be reached at Sun City’s  downtown location, 250-861-8056.


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