If you suffer from chronic musculoskeletal pain like low back pain or neck pain, then you might have considered intramuscular stimulation treatment (also known as IMS or “dry needling”) or acupuncture. IMS involves the use of needles inserted into your skin and/or muscles to achieve pain relief. Acupuncture is a very similar method that also uses needles inserted into the body to relieve pain. What are the similarities and differences between these two treatments? What specific disorders do they treat? Let’s find out.
What Is IMS?
Dr. Janet G. Travell pioneered the technique of IMS. She was a professor of medicine at Cornell University and George Washington University. Dr. Travell was also United States President John F. Kennedy’s personal physician. She treated Kennedy for severe back pain caused by injuries he suffered during his service in World War II.
IMS involves the use of either solid or hollow needles for trigger point therapy. Why the use of the term “dry needling?” This is due to Dr. Travell’s work using both injections with local anesthetic as well as inserting needles without any injection or a dry needle. Acupuncture needles are much thinner than the needles used in Travell’s original treatment technique. However, today some IMS practitioners use thinner, acupuncture-style needles.
What Disorders Are Treated with IMS?
IMS is mostly used to treat myofascial pain syndrome (MPS). For those with MPS, you experience chronic pain at various trigger points in your body. The trigger points are areas of irritated fascia which is the fibrous connective tissue that surrounds your muscles. With MPS you can have nodules (“knots”) and tightness in your muscles. IMS has also been used to treat other kinds of muscle pain and neuropathic pain.
MPS may occur when you use a muscle over and over again. Certain types of jobs, sports, hobbies, or stress-related muscle tension can contribute to the development of MPS. This condition is not just sore or achy muscles. MPS-associated pain continues and may get worse over time, and it may interfere with your daily routine or work. Some people who have MPS may go on to develop fibromyalgia, which is characterized by even more widespread pain.
What Is the IMS Technique?
IMS practitioners are trained to be able to insert needles into identifiable pain trigger points. When the needles reach the trigger point, your body naturally produces a twitch response which causes muscle contraction. The practitioner can feel this twitch at the end of the needle indicating that it has been inserted in the correct location with the goal of pain relief. However, a twitch response is not mandatory for IMS to be effective.
In most cases, IMS does not cause pain. However, some discomfort may be experienced. If the twitch response also causes a muscle spasm, this might lead to more severe pain.
What Does the Scientific Research Say About IMS?
Overall, the medical research surrounding IMS is inconclusive. One study published in The BMJ analyzed 416 publications regarding IMS treatment studies. In some of the studies, those who received IMS treatment experienced significant relief.
The researchers concluded, however, that the size and quality of the studies weren’t sufficient to make any real conclusions. This means, according to conventional medicine, the jury is still out on the effectiveness of IMS. Still, some studies did show people had relief from problems, such as tension headaches, chronic shoulder pain, and MPS of the trapezius muscle. Further research needs to be conducted to understand the benefits of IMS better.
What Is Acupuncture?
Acupuncture also uses needles inserted into the body surface, and the practice is part of traditional Chinese medicine. Some forms of acupuncture may have existed as far back as 2000 B.C. The practice recognized today, using thin needles, probably originated around 100 B.C. Since then, many different techniques and philosophies have evolved around the practice. This makes it difficult to evaluate the efficacy of acupuncture as a medical treatment since there is no single standard of practice.
What Disorders Are Treated with Acupuncture?
Depending on the country and practitioner, acupuncture has been used to treat a wide range of disorders, such as:
- Musculoskeletal disorders like pain, arthritis, fibromyalgia, and myofascial pain syndrome
- Low back pain
- Tension and migraine headaches
- Post-operative and cancer-related pain
- Nausea associated with cancer treatment
- Sleep disturbances
Still, in other publications through the years, acupuncture has been documented in the treatment of nearly any kind of illness, including alcohol dependence, drug addiction, allergies, Alzheimer’s disease, heart problems, lung disease, diabetic neuropathy, irritable bowel syndrome, obesity, and even schizophrenia.
What Is the Acupuncture Technique?
The acupuncture practitioner inserts very thin needles into the skin. A typical treatment session may involve five to 20 needles inserted and left in place for up to 15 to 20 minutes. Heat, pressure, or lasers can be used as adjuncts to treatment. Classically, acupuncture is individualized and based on philosophy and intuition and not on conventional scientific methodology.
Originally, acupuncture was believed to affect a “life force” that worked along meridians (channels) that ran through the body. Modern acupuncture may not implement the same philosophy. However, the practical methods have been preserved. Still, modern modifications continue to accompany acupuncture treatment.
What Does the Scientific Research Say About Acupuncture?
While there is considerable debate about the scientifically proven benefit of acupuncture, the U.S. Food, and Drug Administration approved acupuncture needles as medical devices in 1996. Thousands of studies have been conducted on acupuncture, and some have shown a benefit to the practice. Acupuncture has even found its way into conventional medical centers like the UCLA Health centers.
Many medical professionals recommend acupuncture for the treatment of pain, such as low back pain. In most cases, acupuncture is used in combination with other types of treatment. In general, medical doctors might recommend acupuncture to assist in the treatment of:
Why Do IMS and Acupuncture Work?
Even though the scientific studies may be inconclusive, there is no doubt that some people benefit from IMS and acupuncture. In MPS, the theory is that muscles remain contracted, or shortened, for extended periods of time. This leads to a sort of pinched nerve situation, and needling the trigger points may reverse this process.
Acupuncture is believed to work by other mechanisms potentially. For example, some believe that acupuncture may stimulate the release of endogenous endorphins (painkillers). Still, others claim that the practice helps improve blood flow. Another explanation is that acupuncture helps increase hormones that help relieve stress and depression. A combination of mechanisms cannot be ruled out either.
Similarities and Differences Between IMS and Acupuncture
Beyond the use of needles, IMS and acupuncture might have similar mechanisms of action. For example, the release of endogenous hormones for pain relief might work in both cases. However, as discussed earlier, the origins and the techniques behind each practice are very different.
Even though there are no concrete explanations for why these practices work, this doesn’t mean they can’t work. There are many medications on the market that don’t have a well-understood mechanism of action, but the drugs still work. This includes medication used to treat blood pressure, heart disease, depression, epilepsy, and many more.
Which One Is Better — IMS or Acupuncture?
When choosing between IMS and acupuncture, much depends on your diagnosis. For instance, if you have myofascial pain syndrome and trigger points, then IMS might be your best choice. If the pain is more generalized, acupuncture might be better.
Choosing a reliable practitioner also makes a big difference. You should ask for references and inquire if the person is a licensed practitioner before agreeing to treatment.
For your guide to eliminating neck pain, check out Neck Pain Solved, here!
A true history of acupuncture – Ramey – 2004 – Focus on Alternative and Complementary Therapies – Wiley Online Library. (2010). Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1211/fact.2004.00244
Acupuncture: Why Does It Work? (n.d.). Retrieved from https://www.webmd.com/pain-management/features/acupuncture-pain-killer#1
Brief history of acupuncture | Rheumatology | Oxford Academic. (2004, May 1). Retrieved from https://academic.oup.com/rheumatology/article/43/5/662/1788282
Intramuscular Stimulation (IMS) | NeuroMotion Physiotherapy. (n.d.). Retrieved from http://www.neuromotionphysio.com/intramuscular-stimulation-ims
Intramuscular Stimulation. (2014, September 18). Retrieved from https://www.orionhealthphysiotherapy.net/physiotherapy/intramuscular-stimulation/
Intramuscular stimulation therapy for healthcare: a systematic review of randomised controlled trials. (2012, December 1). Retrieved from http://aim.bmj.com/content/30/4/286
Travell & Simons’ myofascial pain and dysfunction: the trigger point manual (Book, 1999) [WorldCat.org]. (n.d.). Retrieved from