The difference between Traditional Acupuncture vs IMS/Dry Needling

What’s the difference between Traditional Acupuncture vs IMS/Dry Needling?

This is a question often asked by clients receiving Physiotherapy. Traditional Acupuncture (TA) was developed thousands of years ago based on Eastern medicine principals of balancing energy and uses pre-mapped points on the body that relate to meridians of energy. The needles are inserted into the skin where the energy pathways intersect, in the hopes of releasing the energy pathways that are “blocked” so the energy can run freely throughout the body creating a balance in the body. Intramuscular stimulation (IMS) and Dry Needling (DN) is a Western medicine treatment approach that focuses on neurophysiology of pain and muscle trigger points. When using this technique, the needle is inserted into a muscle or fascial tissue where the tissue is “knotted or tense”, in the hopes of releasing this tension.

Both techniques will use thin filiform needles, but the location choice of insertion will vary. While TA focuses on choosing points to balance energy, IMS/DN points are determined by the Physiotherapist using their knowledge of anatomy, muscle balancing, biomechanics of the body, neural input and palpation of tissues. Some acupuncture points may be a muscle trigger point and elicit a twitch response from a muscle, but when using IMS/DN, the therapist is actively searching for these points.

In the province of Ontario, Physiotherapists must be rostered with the College of Physiotherapists of Ontario to perform either acupuncture or IMS/DN. Conditions to be treated can only be within their scope of practice, which area conditions related to pain, musculoskeletal and neural conditions. It should also be noted that eligibility to be rostered for acupuncture, IMS, and DN involves post-graduate degree education that includes knowledge of anatomy, indications, contraindications, precautions and competency to perform the act.

What is IDN or Intramuscular Stimulation (IMS) used to treat?

• Pain persisting in the absence of on-going tissue damage
• Sensations of burning , searing , deep ache
• Pain in an area causing numbness
• Brief stabbing or shooting pain
• Constant dull and deep aching pain
• Hypersensitivity to pain
• Exercise increased pain
• Trigger points or taut bands in the muscles
• Relief with de-activation of the trigger points
• Twitch in the muscle with pressure
• Jump response when trigger point palpated

What are the dangers of IMS/DN and Acupuncture?

In the province of Ontario, all Physiotherapists must be rostered for performing IMS, DN and Acupuncture. They have completed additional training to their university education to ensure that they are performing IMS, DN and acupuncture competently. This continuing education involves being aware of all contraindications, precautions and potential side effects of treatment to identify clients who will benefit from this form of treatment.

Contraindications include: pregnancy (some specific points), clients with uncontrolled movements, edematous limb with lymphedema, scars, keloids, incisional wounds, into a joint capsule if there is blood thinners being used, clients unable to communicate well or give consent, fear of needles, local or systemic infections, into varicose veins

Precautions: following surgical and joint replacement procedures, clients with abnormal bleeding tendency, severe pain

Although the risk of side effects of IMS/DN and Acupuncture is low when used appropriately, clients should be informed before beginning treatment. These minor complications include: bleeding, bruising, pain during treatment, pain following treatment. Less common complications include: aggravation of symptoms, drowsiness, fatigue, feeling fain nausea, headache, release of emotions, feeling shaky, numbness, nerve irritation. A stuck or bent needle is uncommon, but Physiotherapists trained to deliver IMS/DN and acupuncture are trained to deal with this event. Serious complications are very rare and usually require other medical care provider intervention are: breakage of a needle in the body, infection, puncture of a vital tissue (e.g. lung pneumothorax)

To reduce the risk of complications, it is recommended that clients: eat before your session, be rested, let your Physiotherapist know if any changes in your medical health, any negative past experiences with needles, let your Physiotherapist know if you are feeling unwell before, during and after your treatment.

Some patients respond really well to acupuncture or IMS dry needling, so if you are experiencing symptoms listed above, you should give it a try. Ask our therapists about traditional acupuncture or IMS/dry needling for your problem.