How does dry needling work? Benefits of Gunn IMS/Dry Needling for Chronic Pain
Gunn IMS, also known as dry needling or trigger point dry needling, is incredibly effective for the treatment of chronic pain and tension.
In fact, that’s exactly how it was developed by Dr. Chan Gunn when he was “working with patients 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 (1)”.
So how does dry needling work and what are the benefits of dry needling?
I always like to explain dry needling as a ‘control, alt, delete’ for the muscle fibres (if you are a millennial or older and that reference means anything to you haha).
It helps to release a myofascial trigger point or knot in a muscle fibre/muscle tissue that then takes the muscle from it’s shortened position and lengthens it. By lengthening the muscle it offloads the region that it’s been compressing! This can improve range of motion and reduce pain.
Any time an acupuncture needle is used and crosses the skin membrane, an electrical action potential is induced and it stimulates the trigger point. It’s really cool because when that happens, an actual biochemical change occurs in the muscle, which is why it’s actually effective at creating lasting changes in the tension of the muscle.
The number of dry needling sessions needed is dependent on the chronicity of the injury and how many regions of the body are affected.
When using Gunn IMS or dry needling in a treatment, if the affected area is in the periphery, like the forearm or calf, we will always investigate and assess what’s happening up the chain in the spine. I’ve explained this analogy in a previous blog post, but I always equate the spine to the electrical panel in your house. The cervical spine is the electrical panel for the upper extremity and the lumbar spine is the panel for the lower extremity.
When dysfunction occurs down the chain, more often than not, the corresponding nerves that innervate that muscle up the chain are compressed in some way. This is why our treatment plan often includes needling at the root (the spine) and in the periphery (the effected muscle).
The physiology behind dry needling
For the physiology enthusiasts in the crowd, let me explain the science behind what's happening.
When a muscle is shortened or contracted for a prolonged time, changes occur in the muscle fibre. A muscle contraction starts at something called the neuromuscular junction between a motor neuron and a muscle fibre. Acetylcholine is a neurotransmitter released from the motor neuron that binds to receptors on the outside of the muscle fibre. Once it binds, the muscle fibre is depolarized and causes a cascade of events that results in a muscle contraction.
When a muscle has been chronically tight, more acetylcholine binding sites form, making it much easier for a muscle contraction to occur. So, in essence, the muscle is ‘on’ or firing a lot of the time, which results in constant tension in the muscle and trigger point formation.
When the needle is inserted, an electrical action potential occurs and the twitch contraction that IMS induces flushes acetylcholine (a neurotransmitter) from the muscle fibre. We explain it as a reset for that muscle fibre which takes it from a shortened position to it’s resting length. To summarize, because an actual biochemical change is taking place, you can get an actual lasting change in the tone of the muscles. In a recent umbrella review of the literature regarding the ‘Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain’ by Chys et. al, they found that ‘Several studies have shown an additional effect (in managing MSK pain) when combining dry needling to physiotherapeutic interventions compared to these interventions in isolation.’
The review also found that ‘For chronic pain, several peripheral and central neurophysiological effects have been described as well (such as effects on central sensitization) [6,7,8,67] and needling techniques have recently been added to the treatment guidelines of (chronic) neck pain and low back pain [68,69,70].’
Central sensitization is when various physiological and psychological factors lead to the amplification and persistence of pain signals within the central nervous system (Spinal cord and brain) which results in heightened pain perception and widespread pain sensitivity which is no good. So essentially there is a large benefit in including dry needling or Gunn IMS in a treatment plan to help combat chronic changes that have occurred in the nervous system.
Read more general questions about Gunn IMS/dry needling here. Please reach out if you are interested in learning more!
Where to get dry needling treatment/gun IMS treatment in Toronto
At Resilience, we can help you with dry needling treatment in the Toronto area. You can schedule your 10-minute complimentary consultation with us today by clicking here.
Next on your reading list:
Resources:
Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain—An Umbrella Review by Marjolein Chys,1,* Kayleigh De Meulemeester,1 Indra De Greef,1 Carlos Murillo,1,2 Wouter Kindt,1 Yassir Kouzouz,1Bavo Lescroart,1 and Barbara Cagnie1 https://www.gunnims.com/what-is-gunn-ims-dry-needling.html
