Intramuscular Stimulation Therapy (IMS)
A great deal of confusion has arisen because the word ‘Acupuncture’ has been used in many different ways by different practitioners and therapists and even includes techniques that may not use needles and philosophies that do not belong to Traditional Chinese Medicine. See also Acupuncture.
Medical doctors in particular have a deep understanding of anatomy of the body together with training in injections and needle manipulation. Many have moved away from the TCM philosophy and developed techniques which can be grouped under the heading of IMS.
It is important to make a clear distinction between IMS and Traditional Acupuncture. The former technique is not based on TCM philosophy and no knowledge of acupuncture points is required. IMS depends on a good knowledge of anatomy, an understanding of the way pain may be referred and the accumulated experience of practitioners.IMS is a broad term which includes a number of other techniques such as Biopuncture, dry needling, trigger point acupuncture, low energy laser therapy and mesotherapy. It is still in the developing stage, while doctors coming from the various different specialities find more effective ways to combine these different techniques into an integrated speciality with its own philosophical underpinning.
Medical doctors generally have not paid much attention to the soft tissues of the body and generally left treatment of muscles, ligaments, joints and connective tissue to physiotherapists, reflexologists and many non-registered practitioners. Medical involvement is often confined to using cortisone or anti-inflammatory injections. As the medical profession gains better understanding of the importance of the soft tissues of the body and how pain can be referred to distant areas, not only from other body parts, but also from the organs, it has developed an increasing interest in these tissues.
Definition of IMS
Stimulation of selected points on the surface of the body based on anatomy, nerve pathways and tenderness, to affect the local condition or deeper tissues and organs.
The technique uses needles, injections of drugs or natural substances but may also use low energy lasers, electrical stimulation and possibly magnetic stimulation.
The technique is completely safe when used by persons knowledgeable in anatomy and familiar with injection therapy. If drugs are used for the injection then patients need to be informed. Most practitioners however choose to use biological substances which have little or no side effects.
Anatomy of IMS
IMS practitioners have noted three basic kinds of abnormal structures that require treatment.
Tender points in the soft tissue or areas where muscles are attached to bone. In the muscle these tender points feel like hard nodules and are usually easily recognizable.
Palpable taut bands. These not only feel hard when pressed with the fingers but feel almost like bone when an attempt is made to insert a needle. They are however taut bands in the muscle.
Tender points over the periosteum of the bones especially near joints.
How does IMS work?
A great deal of research has been performed on acupuncture, and it is most likely that the IMS effect is a similar effect. Research on acupuncture for example has shown that inserting needles anywhere in the body, the so called “sham acupuncture” also has some effect, explaining why clinical acupuncture research has been difficult. The exact mechanism is however still unknown, although research has been positive in terms of showing that this is a genuine response of the body to the insertion of a needle.
Examples of IMS in practice
Case 1: Patient with neck/shoulder pain and X-rays suggesting narrowed discs in the cervical area. If the pain persists despite analgesia and anti-inflammatory medication, surgery will often be suggested.
The pain however is often not due to the narrowed disc space but trigger points causing muscle spasm, which in turn may cause some imbalance on the cervical vertebra, aggravating and causing more trigger points.
Using the IMS technique the practitioner can very quickly obtain relief, and then is able to decide whether surgery would be necessary or not. Only two or three treatments may be required.
Case 2: Patient has had a severe injury of a knee joint due to a skiing accident. Ligaments and muscles were torn and included some fractures. Healing appeared to be good over the following months but the person was left with such severe pain that the leg could not be used, Walking was almost impossible and constant daily analgesia was needed. Major tender points were discovered far from the joint itself. Using IMS technique, it required about 8 treatments and the person could begin to walk and stop all analgesia.
Case 3: Heel pain for two months. Cortisone injection and physiotherapy had not made any difference. After one treatment combining an injection approach together with low energy laser there was already some improvement.