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Dry Needling/ Functional Dry Needling Q&A

  • What is Intramuscular Manual Therapy? - Intramuscular Manual Therapy (IMT) is the use of a solid filament needle for the deactivation and desensitization of a myofascial trigger point which should stimulate a healing response in that tissue and reduce the biomechanical stress of the muscle treated. The myofascial trigger point is also related to the production and maintenance of the pain cycle. IMT is also called Trigger Point Dry Needling or Intramuscular Stimulation.
  • Is IMT similar to acupuncture? -  There are similarities and differences between IMT and acupuncture. The main similarity is both techniques use a solid filament needle for treatment application. The primary difference is that acupuncture is an ancient philosophy, and its diagnosis and practice in Traditional Chinese or Oriental Medicine are not based on modern science. What was a great approach four thousand years ago can be improved with today’s medical knowledge. IMT relies on neurology and a Western understanding of anatomy for diagnosis and direct treatment. 


  • How does IMT work? - The exact mechanisms of IMT are not known. There are mechanical and biochemical effects. Based on studies by the National Institutes of Health, we know that inserting a needle into trigger points can cause favourable electrical and biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with IMT is the first step in breaking the pain cycle. 
  • What type of problems can be treated? -IMT can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to: neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headaches including migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstring strains, calf tightness/spasms, plantar fasciitis). Often, the treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system. 
  • Is the procedure painful? - Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction. 
  • Are the needles sterile? - Yes, we only use sterile disposable needles.
  • What side effects can I expect after the treatment? - Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and a few days.                                                                                                             
  • How long does it take for the procedure to work? – Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed. 
  • Why is my doctor not familiar with IMT? - In the United States, IMT is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others about new and innovative ways to treat pain.
  • How do I know if I am a candidate? - Speak with your therapist to find out if IMT would be a good addition to your current PT management or simply schedule an appointment with Al Gesite, PT, MS, cOMT, STC or Jessie Sharp, PT, DPT.