Gunn IMS & Neuropathic Pain
Gunn Intramuscular Stimulation at Lake Country Physiotherapy
What is Gunn IMS?
Hypersensitivity and muscle shortening cannot be operated on and ‘cut away,’ while ‘painkillers’ and other analgesic pills only mask the pain (often poorly) and promote toxicity, compounding the problem. Neuropathy only responds to a physical input of energy.
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). IMS is grounded in Western Medical Science, and has a solid foundation in its radiculopathic model of pain, which is now supported by many experts in the field. It was developed by Dr. Gunn while he was a physician at the Worker’s Compensation Board of British Columbia in the 70’s, where he investigated the large number of mysteriously stubborn cases after frustration with the ineffective modalities at his disposal. The treatment, which utilizes acupuncture needles because they are the thinnest implements available that are designed to penetrate deep within muscle tissue, specifically targets injured muscles that have contracted and become shortened from distress.
IMS 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 physiotherapy.
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.
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.
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.
What is Neuropathic Pain?
Often we treat pain without bothering with its definition. The majority of all pain patients recover quickly from their injuries; in fact, more than 90% will be fully functional within eight weeks simply because of the body’s ability to heal itself, regardless of treatment. However, it is the remaining people, who after months of persistent pain, become frustrated when medical examination does not yield a diagnosis and their doctors prescribe medications and therapies without producing lasting relief. The persistent physical discomfort of chronic pain can bring an individual to their emotional limit.
- Pain is an entity that is commonly misunderstood because medical diagnosis traditionally presumes that pain is only a signal of tissue injury conveyed to the central nervous system. However, there are actually
three distinct categories of pain: Nociception, Inflammation, and Neuropathy.
The immediate response conveyed to the brain, signaling tissue injury (noxious input). An example is the response from a slap to the skin.
A local response to cellular injury resulting in redness, swelling, heat, pain and sometimes loss of function, and that serves as a mechanism initiating the elimination of noxious agents and facilitating the healing process.
Neuropathy or Radiculopathic Pain:
Ongoing pain with no obvious signs caused by a malfunction in the peripheral nervous system, leading to supersensitivity in the pain sensory system.
Neuropathy is a relatively new word, specifically referring to any functional disturbances or pathological changes in the Peripheral Nervous System (PNS); though it is often used incorrectly to describe the nervous system as a whole. It is imperative to distinguish these entities as separate, since they show different outcomes and presentations. The CNS is well-protected by the skull and the spine, unlike the often overlooked PNS, which is much more vulnerable to damage and denotes the greatest number of chronic pain cases.
Medical professionals are apt to treat pain in the first two categories, but are perplexed by pain that shows no sign of tissue damage or inflammation. Long-term pain can exist in ongoing nociception/inflammation such as a fracture or rheumatoid arthritis (treated with surgery or anti-inflammatory drugs), a psychogenic disorder such as clinical depression (treated with medication or counseling), or most commonly neuropathic pain (explained further below). Neuropathic pain has several indicators:
- There is pain in the absence of ongoing tissue damage.
- There is a delay in the onset of pain after a precipitating injury.
- Mild stimuli are very painful.
- There may be a stabbing component.
- Pronounced summation and after-reaction from stimuli (ie. the pain gets worse with exercise).
This explains why you might feel fine immediately following a car accident, but a week later complain of whiplash. The most common cause of neuropathy is everyday wear and tear or overuse. The significance of this discovery is that disorders such as low back pain, whiplash, frozen shoulder, tennis elbow, fibromyalgia, myofascial pain, and Achilles tendinopathy are all physiologically the same.