Dry Needling

What is it?

Intramuscular stimulation (IMS) is a dry needling technique that uses thin filiform needles to release tight and painful muscles. Hyper-irritable spots (trigger points) are needled to elicit a local twitch response. This results in decreased pain and improved function after just one session!
This is not acupuncture.

Discovered by accident, researchers were trying to resolve trigger point muscle pain by locally injecting different pain-relieving substances. What they found was that pain improved regardless of the type of substance injected. It turned out it was the insertion of the needle through the trigger point that improved pain, rather than the type of substance injected. This resulted in the discovery of IMS.


Is Dry Needling for me?

If you have muscle pain that is failing to improve after conventional methods such as stretching and massage then IMS may be for you. A thorough assessment by your physiotherapist will help determine if you will benefit from IMS (dry needling).

Some common causes of muscle pain:

  • Posture
  • Some neurological conditions cause high muscle tone. Genetics, environmental factors, and age can also cause this.
  • Repetitive use and sustained contractions.
  • High load commonly seen in sports and in the workplace.
  • Over-stretched muscles.

Dry Needling is extremely effective in treating posture-related pain, repetitive stress injuries, and overstretched muscles. It’s also useful for alleviating the discomfort caused by:

  • Whiplash
  • Lower back pain
  • Muscles stiffness
  • Tennis elbow
  • Limited ROM
  • Frozen shoulder
  • Desk posture
  • Sciatica


Once you’ve been deemed fit for treatment, your physiotherapist will insert thin needles into the affected tight muscles. In a technique called threading.

They’ll gradually manipulate the needles to induce a twitch response, after which the needles will be removed. This insertion of needles and stimulation of the muscles helps in normalizing the stretch reflex. The process resets the optimal length-tension in the previously tight muscles, helping them relax and release tension.

The muscle will twitch as it is being released (an involuntary contraction). Benefits and relief are immediate. Some insertional soreness may mask these effects for a few days.

In addition, your physiotherapist will give you corrective exercises following the procedure to prevent the problem from reoccurring.

You may need more than one session depending on the number of irritable spots. Typically patients with a chronic history of muscle pain (>3 months) will require more than one visit.

Is it Safe?

A trained physiotherapist will take a thorough history and do a physical assessment to see if you will benefit from IMS. There are minimal side effects for this procedure. Your physiotherapist will go over these during your visit.

Physiology of Dry Needling

Small strands of fibers called muscle cells make up the muscles in your body. A bundle of 100,000 muscle cells are supplied by a single nerve branch. Collectively referred to as a motor unit. Many motor units make up the muscles in your body.

Motor units can become dysfunctional and remain in a constant state of activation. This leads to pain, decreased strength, and loss of muscle function.

IMS (dry needling) involves needling these hyperirritable spots to elicit a local twitch response which ultimately decreases irritability.

The physiological effects of IMS treatment are:

  • Increased blood flow
  • Decreased banding
  • The decrease in spontaneous electrical activity (SEA)
  • Biochemical changes
  • Central nervous system changes

What is the Evidence Behind This?

By taking blood samples at painful trigger points. Scientists were able to determine what chemicals were involved. Results were a lower pH along with a significantly higher concentration of the following biochemicals: protons, bradykinin, calcitonin gene-related peptide, substance P, tumor necrosis factor, interleukin-1, serotonin, and norepinephrine.

The continued presence of these chemicals at trigger points has shown to be a necessary condition for persistent pain.

IMS (dry needling) application is able to elicit a local twitch response that helps to normalize this. Minutes after this response, tracked changes can be seen where the above biochemical concentrations are decreased and pH is increased.

Want to learn more about the differences between Dry Needling and Acupuncture? Read our handy blog post!

When you are ready,  book with our physiotherapist Gursewak Gill for this treatment!

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