Dry Needling: A Gentle Reset for Your Renewal
If you've visited a physical therapist in recent years, chances are you've encountered a remarkable technique known as 'Dry Needling' or 'Intra-Muscular Stimulation' (IMS). Traditionally, this procedure involved the use of a slender acupuncture-style needle, called a monofilament needle. However, contemporary research has uncovered a groundbreaking twist: the integration of electrical stimulation (e-stim) through these needles, delivering even greater benefits to patients.
My name is Jason Douglas, and working at our Momentum West Springs location, I currently use e-stim IMS heavily in my practice as I have found amazing outcomes with much more expedited results for my clients. Injury timelines permitting, I use e-stim IMS for all types of clients, from car accidents and ankle sprains to post rotator cuff injuries or TMJ dysfunction, as well as my most treated injury: spinal pain.
In addition to client care, I am one of Canada’s Lead Instructors in Dry Needling; certifying clinicians across Canada in the skill of IMS to be used in their own practise. For my students as well as my clients, the e-stim addition to IMS has been a real game-changer!
Understanding Dry Needling
For those unfamiliar with IMS, it's a relatively painless procedure involving the insertion of fine acupuncture-style needles into taut muscle bands, inducing a neuromuscular reset of the tissue. This reset is often felt by the patient as a subtle 'jump' or 'twitch' in the affected area.
The reset of the tissue is illustrated in the adjacent picture: as the IMS needle is used to enter the dermal layer (skin) into the muscle tissue, causing a nerve response, called a reflex arc, along the nerves from the muscle to the spinal cord.
Once the tissue is ‘reset’ from the needle application, the tightness or resting tone of the muscle is much lessened, as well as an immediate decrease in pain from the dysfunctional tissue.
Unveiling The Science Behind E-Stim
In recent years, E-Stim has been at the forefront of IMS research, with a growing body of evidence that it is a superior way to both treat clients comfortably as well as gain added benefit of achieving more input to the bodily tissues and neural structures.
Instead of the traditional method of having to piston the needle in and out to achieve the local twitch response, we can simply apply a minimal current to the needle to achieve the motor response and reset the target tissue. Most patients find this approach much more comfortable than traditional IMS trigger point release, and we can leave the e-stim on longer as there is less micro-trauma to the tissues as well.
Another key benefit to using e-stim vs traditional IMS needling is when using e-stim, you can actually directly target the nerve that impacts the injured area you want to affect.
As an example, in a recent 2019 case study (Alvarez-Prat et al), the researchers wanted to look at using e-stim on the femoral nerve (the nerve that connects to the quadriceps muscles) and how e-stim can affect knee pathology. They evaluated their theory that e-stim would increase strength output (in patients with current knee pain) on 13 participants and tested their max isometric strength immediately before and after e-stim therapy.
The results showed that with only 1 treatment, the 13 participants on average immediately increased their quad strength by 20%. While the study did not monitor how long the results lasted, you can imagine how quickly pre-injury strength can return if we were able to instantly increase your strength 20% back and then move into harder physio exercises and daily activities!
Furthermore, e-stim needling has exhibited remarkable potential in fortifying tendon recovery post-surgery. In a 2018 study by Imaeda et al., Achilles tendon recovery in rats was assessed with and without e-stim. Over a three-month post-operation period, the group receiving e-stim displayed over 50% greater tensile strength in their tendons compared to those without the therapy.
While this study was conducted on rats, its implications for our anatomy are profound, indicating that e-stim therapy can hasten the development of robust scar tissue over injury or surgical sites, reducing the risk of re-injury.
If you are currently dealing with any painful conditions that you have been unable to get benefit from yet, or just want that extra boost, consider reaching out to your local Momentum Health nearest location to find a therapist that specializes in e-stim dry needling to help get your recovery back on track!
Alvarez-Prats, Dave, et al. “ Changes in maximal isometric quadriceps strength after the application of ultrasound-guided percutaneous neuromodulation of the femoral nerve: a case series. Journal of Invasive Techniques in Physical Therapy 2.01 (2019)
Inoue M, Nakajima M, Oi Y, Hojo T, Itoi M, Kitakoji H. The effect of electroacupuncture on tendon repair in a rat Achilles tendon rupture model. Acupuncture in Medicine. 2015;33:58-64.
FAQs on Dry Needling with E-stim
Q: Does Dry Needling hurt?
A: Most patients will feel a slight “pinch” as the needle is inserted. With e-stim, we remove the mechanical movement of the needle and decrease friction, so it is much more patient comfortable compared to the traditional way of moving the needle in and out of the tissues to elicit the reset response.
Q: Is this acupuncture?
A: The tool we use (the needle) is an acupuncture-style needle, but the location, depth and e-stim applied time is completed different versus acupuncture therapy. Acupuncture is a traditional therapy involving holistic treatment of the body’s ‘Chi’ and energy, while e-stim Dry Needling is based on the physical anatomy and mechanical assessment of the presenting individual injury.
Q: How long does it take to see results?
A: Many patients find symptom relief to be immediate from an IMS treatment. Recovery from injury can vary significantly, depending on many factors that your practitioner will review with you.
Q: Does this work for everything?
A: Dry needling with e-stim works for many conditions (sprain/strain, overuse injuries, sports injuries, car accidents, post surgical + post fracture) but there are some conditions and patients that it can be contraindicated (ie. During first trimester of pregnancy). Your qualified practitioner will screen your individual injury for appropriateness to dry needling.
Q: Is the whole treatment needling?
A: No – and this is the critical part to rehab! We use the dry needling with e-stim to reset the target tissues, lessen the muscular tension and subsequently pain in the area. Then rehabilitative exercises are prescribed based on your specific injury to take advantage of this reset and correct the underlying dysfunction – allowing patients to move pain-free much faster.
- Written by Jason Douglas, PT, MSc.PT, IMS Certified
Jason graduated with his Bachelors of Physical Education in 2008 and his Masters of Science in Physical Therapy in 2011, from the University of Alberta. He worked for the Canadian Back Institute for one year, working with patients rehabilitating from spinal injuries, chronic pain and musculoskeletal sprains/strains. Jason opened Momentum Health West Springs and has worked as clinical lead and managing Clinic Director there since 2014. As well, Jason works as a Lead Instructor for Evidence in Motion – teaching other physical therapists, chiropractors and Medical Doctors how to perform Intramuscular Stimulation (IMS) – a speciality dry needling technique. Jason focuses in the treatment of sporting injuries, rotator cuff rehabilitation, whiplash, post-surgical rehab, as well as tension headaches and lower back dysfunction. Jason is also involved with high level athletics, working as the physical therapist for the Canadian National Professional Boxing welterweight champion (Steve Claggett) UFC Featherweight (Hakeem Dawodu), many of the Calgary Gymnastic Clubs Provincial and National level gymnasts, as well as mixed martial artists competitors and coaches from local gyms in Calgary. When not helping patients to rehabilitate from their injuries, Jason enjoys snowboarding, mountain biking and boxing.