acupuncture

Use of Intramuscular Stimulation

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WHAT IS GUNN IMS?

Intramuscular Stimulation (IMS) is a total system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions that occur in the musculoskeletal system when there is no obvious sign of injury or inflammation). Gunn IMS is a specialized physiotherapy service that PRI provides to our patients. It requires practitioners to have extensive physiotherapy experience before being admitted to training.

HOW DOES IMS WORK?

IMS is grounded in Western Medical Science, and uses acupuncture needles that are designed to penetrate deep within muscle tissue, specifically targeting injured muscles that have contracted and become shortened from distress.

IMS TREATMENT DESCRIPTION

IMS therapy relies heavily on a thorough physical examination of the patient by a competent practitioner, trained to recognize the physical signs of neuropathic pain. This physical examination is indispensable since chronic pain is often neurological as opposed to structural, and therefore, invisible to expensive X-rays, MRI Tests, Bone and CT Scans. Failure to recognize these signs will result in an inaccurate diagnosis, and thus, a poor starting point for physical therapy. The treatment involves dry needling of affected areas of the body without injecting any substance. The needle sites can be at the epicenter of taut, tender muscle bands, or they can be near the spine where the nerve root may have become irritated and supersensitive. Penetration of a normal muscle is painless; however, a shortened, supersensitive muscle will ‘grasp’ the needle in what can be described as a cramping sensation. The result is threefold. One, a stretch receptor in the muscle is stimulated, producing a reflex relaxation (lengthening). Two, the needle also causes a small injury that draws blood to the area, initiating the natural healing process. Three, the treatment creates an electrical potential in the muscle to make the nerve function normally again. The needle used in IMS, by stimulating muscle spindles, essentially becomes a specific and unique tool for the diagnosis of Neuropathic Muscle Pain.

CAN YOU SHOW ME HOW THE SPINE MAY BE INVOLVED?

The most common cause of nerve irritation and neuropathic pain is “spondylosis,” degeneration of the spine, which can result from normal wear and tear. Spondylosis irritates the nerve root and leads to neuropathy and muscle shortening.

WHAT IS THE GOAL IN USING IMS?

The goal of treatment is to release muscle shortening, which presses on and irritates the nerve. Supersensitive areas can be desensitized, and the persistent pull of shortened muscles can be released. IMS is very effective for releasing shortened muscles under contracture, thereby causing mechanical pain from muscle pull. IMS, in effect, treats the underlying neuropathic condition that causes the pain. When competently performed, IMS has a remarkable success rate, as proven by the amelioration of symptoms and signs, even for chronic back pain with root signs.

HOW OFTEN SHOULD I HAVE IMS?

Treatments are usually once a week to allow time between treatments for the body to heal itself. The number of treatments you require will depend on several factors such as:

1. the duration and extent of your condition
2. how much scar tissue there is, (usually increased after previous surgery)
3. how quickly your body can heal depending on the condition of your nerves.

If the pain is of recent origin, one ims treatment may be all that is necessary. In published studies of patients with low back pain, the average number of IMS treatments required was 8.2.

IS IMS THE SAME AS ACUPUNCTURE?

IMS is comparable in some ways to acupuncture; however, there are a number of important differences. IMS requires a medical examination and diagnosis by a practitioner knowledgeable in anatomy, needles insertions are indicated by physical signs and not according to predefined, non-scientific meridians, while subjective and objective effects are usually experienced immediately.

If you have been injured athletically, at work or in an automobile accident and haven’t had success with traditional types of treatment, IMS may be worth trying.

Acupuncture for Jaw Pain Relief

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During the past twenty years, a multidisciplinary approach to the management of jaw pain disorders has been advocated by many pain practitioners including physicians, dentists, physical therapists, chiropractors, and acupuncturists.

One technique often overlooked in the treatment of temporomandibular (jaw) disorders and the resultant painful symptoms is acupuncture. Acupuncture and acupressure have long been utilized by the Chinese and Japanese for the relief of pain in the temporomandibular regions.

Although acupuncture initially was used for disease management, its use has evolved as a pain control modality. Late in 1997, the National Institute of Health (NIH) released a consensus statement supporting the use of acupuncture as part of a comprehensive treatment plan for some conditions. Some researchers specifically recommended acupuncture for the facial pain of trigeminal neuralgia (tic doloreux) and of TemporoMandibular Joint (TMJ) dysfunction. This modality is most successful when the cause of the pain is neuromuscular rather than due to joint damage. The NIH panel pointed out that acupuncture is associated with a lower risk of adverse events than those associated with drugs or other medical intervention.

Possible Mechanisms

The stimulation of specific sites on the body surface exerts a marked inhibitory influence on pain. The acupoints have been known to the Chinese for many years. Their validity in pain control has been verified by numerous researchers.

One experimentally well-documented mechanism for pain relief by acupuncture is the modulation of endorphin levels. Myofascial pain is relieved primarily by inactivating the source of pain. According to one research article, acupuncture alleviates the awareness of pain.

Additionaly, multiple studies of acupuncture verses splint therapy have been reported in the literature. These studies show the comparative effectiveness of acupuncture in the treatment of temporomandibular disorders.

In the study by Johansson, et al, forty-five individuals with long-standing facial pain or headache of muscular jaw origin were randomly allocated into three groups. The first group was treated with acupuncture, the second group received an occlusal splint, and the third group served as controls. Both acupuncture and occlusal splint therapy significantly reduced subjective symptoms and clinical signs. No differences between these two groups were found with regard to treatment effects. It was concluded that acupuncture is a great alternative method for individuals with craniomandibular (jaw) disorders of muscular origin.

In a different study by Raustia and Pohjola, acupuncture seemed to be a useful early form of therapy in patients with TMJ disorders. Acupuncture could well be complimentary to stomatognathic treatment — either preceding or following — to achieve full neuromuscular rehabilitation, to ease the treatment, or to eliminate other possible contributing factors.

Additionally, Rosted wrote an article to review the scientific validity of published papers on the efficacy of acupuncture in dentistry based on pre-defined methodological criteria. Acupuncture, in 11 out of 15 studies, proved effective in the treatment of TemporoMandibular Dysfunction (TMD) and as analgesia. Rosted concluded that the use of acupuncture in treating TMD and facial pain seems real and that acupuncture could be a valuable alternative to orthodox treatment.

Acupuncture for Fertility

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Recently researchers discovered that when acupuncture was combined with some pharmaceutical medications used to stimulate ovulation, it was more effective than hormonal pharmaceuticals alone for the treatment of infertility. The combination of acupuncture plus pharmaceuticals produced significantly higher pregnancy rates for women with anovulatory. This data was published in the report entitled Effects of Acupuncture on the Endometrium in Anovulatory Cases Treated by Clomiphene: A Clinical Observation.

The addition of acupuncture to pharmaceutical therapy increased pregnancy rates, lowered the resistance and pulsatility indices of the uterine arteries, and reduced the adverse effects caused by a pharmaceutical fertility drug. The increase in positive patient outcomes combined with reductions of adverse effects supports the findings of the research team’s from Taian Maternal and Child Health Care Hospital. Their conclusion, “TCM [Traditional Chinese Medicine] can be either applied alone or combined with Western medicine to up pregnancy rates and treat infertility. With the help of TCM acupuncture, treatment for infertility can be more effective while producing much less adverse effects.”

The researchers conclude that the addition of acupuncture to a pharmaceutical treatment regimen mitigates the drug’s adverse effects and ups the pregnancy rate.

The TCM acupuncture treatment protocol was as follows. Patients rested in a supine position. Upon disinfection, a 0.30 mm x 40 mm filiform needle was inserted into the following acupoints:
•CV4 (Guanyuan)
•CV3 (Zhongji)
•Zigong
•ST29 (Guilai)
•SP6 (Sanyinjiao)
•ST36 (Zusanli)

CV4, CV3, Zigong, and ST29 were inserted transverse-obliquely (15° angle) to a depth of 1–1.2 cm. SP6 and ST36 were needled perpendicularly and manipulated with the Ping Bu Ping Xie (tonify and sedate) technique. Additional acupoints were administered based on differential diagnostic patterns.

For liver qi stagnation, the following acupoint was added:
•BL18 (Ganshu)
For phlegm and dampness, the following acupoint was added:
•ST40 (Fenglong)

For blood stasis, the following acupoints were added:
•SP10 (Xuehai)
•LV2 (Xingjian).

Work Cited: Effects of Acupuncture on the Endometrium in Anovulatory Cases Treated by Clomiphene: A Clinical Observation. Journal of Taishan Medical College. 2016, 37(9):1029-1031.

Intramuscular Stimulation for Chronic Pain

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Intramuscular Stimulation (IMS): What is it and how can it help get rid of your chronic pain?

In this article I am going to focus on the treatment of chronic muscle and nerve pain and why it can be so difficult to find a solution for this type of pain. It is estimated that over one third of the adult population in North America suffers from chronic pain. That is a staggering statistic! This means that 1 of out of every third person out on the street is dealing with ongoing daily pain. Research shows that suicide is nine times more prevalent in people with chronic pain than with depression and it is estimated that in Canada and United States, chronic pain affects more people than diabetes, cancer and heart disease combined.

So, why is chronic muscle and nerve pain so common? To understand this question we have to look at the gradual process that happens to all of our bodies to some degree over many years. As harsh as it sounds, the reality is that as we age our bodies are slowly ‘rotting’. By the time we reach our 50’s and 60’s we will all get some amount of arthritis in our spine. How fast we ‘rot‘ depends on a variety of factors including our overall fitness levels, nutrition, the types of jobs we do, family genetics and any traumatic injuries we sustain along the way ie. motor vehicle accidents. As the arthritis in the spine progresses, the nerves that exit the small spaces between each spinal bone (vertebrae) start to become irritated. In response to this irritation, the muscles that these nerves supply then start to form tight bands. These bands are the ‘knots’ you feel when you rub sore muscles. The muscle bands not only cause pain but they also begin to pull at joints and tendons as well as compress the already sensitive nerves at the spine. These tight bands often do not respond to traditional treatment approaches such as stretching, massage and spinal manipulation.

A form of treatment that has been gaining popularity in the last 5 to 10 years for chronic muscle and nerve pain is Intramuscular Stimulation (IMS). This treatment technique was developed by a Doctor in Vancouver by the name of Dr. Chan Gunn. Dr. Gunn developed this technique while working with people who were injured on the job and whose pain was not going away with traditional treatment approaches. What he found in these patients was that by stimulating their tight muscles with an acupuncture needle, the pain very often significantly improved or in many cases disappeared.

So the key to addressing this chronic pain process is to release the muscle tension. In an IMS treatment, when the needle enters the taut band the muscle will ‘grab’ the needle and a deep, cramping sensation is felt. Once the muscle grabs it then typically will ‘reset’ itself and begin to relax. When the tight muscle relaxes, a decrease in pain typically follows. IMS is now being recognized and used by physiotherapists and doctors around the world to treat chronic pain of musculoskeletal origin. If you are suffering from ongoing muscle or nerve pain and haven’t had success with traditional types of treatment, IMS may be worth trying.

Acupuncture and seasonal allergies

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Symptoms of running nose, sneezing, and watery itchy eyes that recur during specific parts of the year are a cause of much suffering of a large segment of the Canadian and U.S. population. Millions of dollars are spent on medications and the allergy shots for the treatment of seasonal allergies.

Western medicine views seasonal allergies as a form of immediate hypersensitivity reaction which occurs when anti-bodies produced by lymphocytes interact with airborne particles such as pollen. Western medicine describes the locations of lymphocytes in addition to being in the blood stream as also in Peyer’s patches in the gastrointestinal tract, spleen, lymph nodes, and bone marrow.

Interestingly in practice of acupuncture the Spleen, Stomach, and Large Intestine meridians are utilized to treat seasonal allergies a great deal. One can clearly see an overlap of Western and Chinese medical thought. Also, Chinese medical thought views sweets as being harmful to the Spleen function. Sweets are often a major factor in the persistence and intensity of seasonal allergy symptoms.

There is often a quick response when treating seasonal allergies with acupuncture. Often patients get some relief during the first visit while lying on the exam table with their acupuncture needles in place. Patients are asked to score their nose stuffiness on a zero to ten scale. Zero meaning no stuffiness at all and 10 being the worst possible stuffiness for the patient. A score may be determined before and after the acupuncture treatment. Patients can also determine the effectiveness of acupuncture treatment by tracking the number of sneezes per day and the number of itching episodes around their eyes. After an initial series of treatments, patients come in for further treatments on an as needed basis. Some patients come back in once or twice a year for a booster while others may come more often. In general, patients do better if they avoid sugar and milk in their diets. They have better and longer lasting responses. A lot of patients who failed medication and allergy shots respond to acupuncture. Patients continue with whatever standard treatments they are currently undergoing while getting acupuncture treatments. Most patients end up significantly reducing or eliminating their dependence on allergy medications.

There are many different ways of performing acupuncture, for example Traditional Chinese Medicine, Japanese, Korean, French Energetics, Worsley 5 Elements, etc. In choosing an acupuncturist the specific style a practitioner uses is not as important as the success rate a practitioner obtains with whatever style they use. Prospective patients should speak with the acupuncturist and inquire about past experience in treating seasonal allergies and their success rate.

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