Neuropathic Pain and Intramuscular Stimulation (IMS)
January 30, 2010
By Adler Giersch PS
Chronic muscular pain, also known as “neuropathic pain,” can occur when nerves continue to transmit signals that are exaggerated or misinterpreted as painful ones. This is known as “supersensitivity,” a term coined by Chan Gunn, MD. Neuropathic pain has long bedeviled many healthcare practitioners as this type of pain shows no “objective” signs of tissue damage or inflammation and medical tests are negative.
During his service as a clinical physician at the Workers’ Compensation Board of British Columbia., Chan Gunn, MD developed a treatment technique of “dry needling” (Intramuscular Stimulation or IMS) as a method of diagnosing and treating chronic muscular and neuropathic pain. Dr. Gunn currently serves as a clinical professor and teaches IMS at the University of Washington Multidisciplinary Pain Clinic in Seattle and at the University of British Columbia’s Medical School.
IMS is a method of diagnosing and treating muscles shortened as a result of chronic pain and spasm. Muscle shortening causes pain by putting tension on tendons and, in turn, resulting in restrictive pressure on joint motion. Chronic muscle shortening can lead to greater than normal degenerative changes, including osteoarthritis and tendonitis.
Because nerve and nerve endings become very sensitive and/or conditioned to pain stimulae, they become “supersensitive” and respond with neuro-chemically “learned” painful responses to typical nerve signals. The goal of IMS is to release muscle shortening by desensitizing the muscle with dry needling treatments. This is done by inserting very thin needles in the painful muscle areas. If the muscle tissue is normal, no pain is felt by the patient. However, if the muscle is shortened, the patient will feel a particular sensation, akin to a muscle cramp, as if the muscle is grasping the inserted needle. The reaction of the abnormally shortened muscles is to tighten even more and then release. This release is the lengthening of to muscle tissue back to its more normal length. The patient feels the release and the lessening of pain. Relaxation of the muscle allows for further healing and ultimately interruption of the chronic pain neuro-pathways. According to published studies, IMS treatment on average requires 8-9 sessions.
When acute traumatic injuries turn into chronic pain, patients become frustrated that their primary care physician is not able to offer treatment options other then physical therapy and medications. The key to sorting out treatment approaches turns on having a proper diagnosis. When the proper diagnosis is made, IMS might be another valuable treatment resource to compliment other approaches and is worthy of consideration.
We understand the importance of patients and providers having multiple treatment options available for chronic pain and to ensure that the responsible insurer pays for it. It is well-known that not all patients respond the same to the same treatment approaches. At Adler Giersch PS we have the experience and ability to turn this understanding into tough and successful advocacy for our clients.