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What is IMS? Is This Treatment For Me?

Van Sports Physio IMS

What is Gunn IMS Treatment?

If you’ve heard about Gunn IMS and are wondering what it is, here’s some information to determine if it’s a potential treatment for you.

Gunn IMS is a type of IMS needling technique (intramuscular stimulation) in which its theory and practical application were developed by Dr. Chan Gunn who worked as a physician for the Worker’s Compensation Board of BC. He observed that some patients with stubborn cases of pain and dysfunction did not respond to standard rehabilitation treatments. Dr. Gunn theorized that following injury, bands of muscle contracted and stayed shortened leading to chronic stress on soft tissue, nerves, and joints that are associated with the affected muscle. Over time, hypersensitivity of these structures led to persistent pain, joint stiffness, and altered nerve function (such as sensation) although the initial “injury” was no longer there – Dr. Gunn referred to this as neuropathic pain.

 

Who needs IMS Treatment?

IMS is beneficial for people with the following characteristics:

-Neuropathic pain (absence of permanent injury or inflammation)
-Myofascial pain syndromes (ex. tennis elbow, plantar fasciitis, or piriformis syndrome)
-Persistent pain over 3 months in duration
-Conventional treatment (including manual therapy, massage, and modalities) does not help or only provides temporary relief
-Exercise training does not help or can aggravate the pain

IMS is contraindicated for people with the following (or precautions should be taken):
-Acute trauma or inflammation (where there is redness, swelling)
-Psychogenic pain (pain propagated by mental, emotional or behavioral factors)
-Fearful of needles
-Uncontrolled bleeding disorders
-Systemic infection or compromised immune system
-Pregnancy
-3 to 6 months post-surgery

Physical Examination

A thorough physical examination is performed by the therapist to look for abnormalities in motor, autonomic (related to the involuntary nervous system), sensory, or trophic (related to hormonal or nutritional effects) functions. It is also an important step to screen for patients who have contraindications and are not suitable for GunnIMS.

 

Motor

-Visible bands of muscle when at rest
-Altered joint alignment
-Decreased joint range

 

Autonomic

-Trophedema (excess fluid under the skin)
-Sudomotor (sweat response)
-Vasomotor (alterations in circulation)

 

Sensory

-Hypersensitivity (ex. Tenderness to touch)
-Altered sensation (ex. Pins and needles, numbness)

 

Trophic

-Skin, hair, or nail changes (ex. brittle nails, dry cracking skin)

 

Technique

IMS involves the insertion of a sterile dry needle (as it does not deliver or withdraw any fluid as compared to a hypodermic needle) into taut and tender muscles at the site of pain or near the spine where the nerve that’s associated to the affected muscle originates from.

Accurate insertion into an affected muscle will trigger a “twitch” response or a dull soreness; a healthy muscle band will be painless. This leads to three physiological effects: relaxation (lengthening) of the muscle, a healing response due to mild trauma from the needle insertion, and improved nerve signalling due to the generation of an electrical potential.

 

Benefits of Gunn IMS Treatment

It is important to rest and drink extra fluid following Gunn IMS treatment as the following normal responses may be experienced post-treatment.

-Muscle soreness and cramping (1-2 days)
-Increased sweating or emotional
-Increased joint range of motion and ease of motion
-Reduction in pain intensity (following the resolution of treatment muscle soreness)

Some adverse reactions may be experienced as well but will typically resolve within a few days:
-Bleeding/bruising
-Local inflammation
-Nerve irritation
-Fainting
-Allergic reaction

If you believe that Gunn IMS could be a suitable treatment technique for you, schedule an appointment with one of our certified therapists to discuss further.

References:

1. Gunn, C. Chan. The Gunn Approach to the Treatment of Chronic Pain: Intramuscular Stimulation for Myofascial Pain of Radiculopathic Origin. Elsevier Science, 2002.
2. “What Is Gunn IMS?”. GUNN IMS, 2020, https://www.gunnims.com/what-is-gunn-ims-dry-needling.html. Accessed 14 Dec 2020.
3. Solomons, Lyndal. “Preparing to Treat.” UBC Gunn IMS. 2020.
4. Massitti, Susan. “Theory of Neuropathic Dysfunction.” UBC Gunn IMS. 2020.