Intramuscular Stimulation (IMS)

Author: pivotalphysio

If you have been to an orthopedic physiotherapy clinic in the past decade, then chances are you have heard the term Intramuscular Stimulation or IMS. 


IMS is an effective treatment technique using acupuncture needles to treat chronic pain of neuropathic origin. Many common conditions are a product of neuropathic pain such as tennis elbow, headaches, backaches, and tendinopathies. Pain that radiates down a limb such as sciatica also has neuropathic origins.


To understand how IMS is effective in relieving pain we first have to understand what neuropathic pain is.

  • When nerves coming out of the spinal column are irritated, they can cause all the structures that the nerve innervates to become supersensitive.
  • The most common cause of nerves being irritated is called “spondylosis”, which is basic wear and tear and degeneration of the spine over time. 
  • Unfortunately, we are all prone to spondylosis.  Spondylosis can lead to nerve irritation; and when a nerve is irritated, it can cause the muscles it is responsible for to become too short and too tight.
  • Tight overactive muscles can be painful, cause joints to move incorrectly, and even lead to osteoarthritis and tendon injuries.

Think of it this way...

  1. Nerves cause muscles to fire using an electrical current.
  2. Now imagine there is a constant electric current going to a muscle due to the nerve is being irritated. 
  3. The muscle stays working and shorts consistently, pulling on its attachments and fatiguing from all the unnecessary work.
  4. Over time, this causes pain and dysfunction that can be debilitating without any known mechanism of injury.
  5. Most of us can relate to suddenly developing pain or musculoskeletal problems without doing anything to “earn it”. Luckily, IMS is now available to specifically treat these ailments!


The inventor of IMS, Dr. Chan Gunn, discovered that introducing an acupuncture needle into the muscle belly of a shortened or supersensitive muscle causes a muscle contraction. This is followed by a reaction that normalizes the length and desensitizes the muscle.

The acupuncture needle stimulates the muscle causing a contraction or a “twitch” of the muscle. Because of the way our stretch reflexes work, this twitch is then followed by a normalizing of the length and the sensitivity of the muscle. 

Here is another way to look at it.

When your computer freezes, the common fix is to restart the computer by turning it off and on. This usually returns the computer to default settings allowing it to work normally again. By needling the shortened muscle, we are basically rebooting the muscle to default lengths, returning its function to normal and providing substantial pain relief!


I won’t lie. IMS is not comfortable but not as bad as you think. When your muscle contracts as the needle stimulate the muscle (twitch), you can get a charlie horse or deep ache-type feeling.

Luckily the needle only stays in the muscle for a few seconds.  Quite often for a day or two after the muscle is needled, it will feel like it has had a big workout, and you can experience that familiar delayed onset muscle soreness you get from going to the gym or playing sports. 

The beauty of this pain is that it is productive pain; because afterward, your body will begin to feel better and the original pain you came to get treatment for will start to resolve. 

And Yes, it is very safe!  IMS practitioners take an intensive course to be able to provide effective IMS treatment and require many prerequisites to learn IMS. Physiotherapists have excellent anatomical training and safety while needling is always our top priority.

I can honestly say that adding GunnIMS to my treatment repertoire has made me a much more effective Physiotherapist!

Please visit us at Pivotal Physiotherapy to find out if Intramuscular Stimulation is an effective treatment choice for you!

Patrick Toner
Physiotherapist at Pivotal Physiotherapy

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