Intramuscular Stimulation (IMS), Dry Needling, Functional Dry Needling (FDN)
Release Trigger Points. Ease Muscle Tightness. Move Better.
If you’ve been dealing with persistent muscle tightness, trigger points, or nagging musculoskeletal pain, IMS and dry needling may be able to help. At Divine Care Physiotherapy in Langley, our physiotherapists use these needling techniques as part of a broader, personalised treatment plan aimed at reducing pain, easing muscle tightness, and helping you get back to moving comfortably.
What Is Dry Needling, IMS, and Functional Dry Needling?
These three terms are closely related, although each approach has a slightly different emphasis:
- Dry needling is a broad term used to describe techniques that involve inserting a thin, sterile, solid filament needle into specific areas of muscle and soft tissue, often including trigger points or tight bands of muscle. No medication or other substance is injected — hence the term “dry” needling. It is generally used to address areas of muscle tightness, pain, or dysfunction identified during a physical assessment.
- Intramuscular Stimulation (IMS) refers to a specific approach to intramuscular needling that is based on the relationship between the nervous system, muscle tightness, and pain. It may involve treating muscles and areas identified during a physiotherapy assessment rather than simply focusing on the location where pain is felt.
- Functional Dry Needling (FDN) is an approach to dry needling that considers functional movement and movement impairments. The goal is to address areas of muscle dysfunction that may be contributing to pain, tightness, or restricted movement.
In practice, all three approaches use fine needles to target specific areas of muscle and soft tissue, with the treatment approach selected according to the individual’s assessment, condition, and treatment goals.
Dry Needling vs. Acupuncture: What's the Difference?
This is one of the most common questions we get, since dry needling uses a similar type of fine needle to acupuncture. The techniques share a similar tool, but they are based on different treatment frameworks.
Dry needling and IMS are generally based on musculoskeletal anatomy and are used to target specific muscles and soft tissues identified during a physical assessment. Acupuncture, meanwhile, is traditionally associated with Traditional Chinese Medicine and follows its own diagnostic and treatment framework.
How Does IMS / Dry Needling Work?
When a needle is inserted into a tight or irritated area of muscle, it may produce what’s called a local twitch response — a brief, involuntary contraction of the muscle fibres. This response may be associated with several changes in the treated area:
- May increase local circulation to the treated area
- May help reduce muscle tightness in the treated area
- May influence the body’s natural pain-modulating mechanisms
- May be used as part of a broader rehabilitation plan that supports recovery
Some people may experience reduced muscle tightness or pain following treatment, although responses vary depending on the individual, the underlying condition, and other factors.
What to Expect From Your Treatment
Your physiotherapist will start with a proper assessment of your movement, muscle tightness, and pain pattern to determine whether dry needling or IMS may be an appropriate part of your treatment plan — it isn’t used for every condition or every patient.
During the session, you’ll be positioned comfortably, and your physiotherapist will assess and palpate the area to identify the specific muscle or tissue to be treated before inserting the needle. You may feel a brief prick as the needle enters the skin, followed by a deep ache, cramp, or twitching sensation depending on the technique used and the area being treated. These sensations can occur during treatment and are not necessarily a sign that something is wrong.
The treatment is generally intended to be tolerable, although some people may experience brief discomfort during needle insertion or muscle stimulation. Because everyone responds a little differently, your physiotherapist typically starts conservatively — with fewer needles or a gentler approach — and adjusts based on how your body responds.
It’s common to experience some muscle soreness for 24–48 hours afterward, similar to how a muscle may feel after a hard workout. Mild soreness can occur as a response to treatment. If you experience severe, worsening, or unusual symptoms, contact your healthcare provider for advice.
Conditions We Treat with IMS / Dry Needling
Dry needling and IMS can be a useful part of a treatment plan for a range of muscle and joint-related conditions, including:
- Rotator cuff injuries and shoulder tightness
- Tennis elbow and golfer’s elbow
- Neck and back pain, including low back pain
- Headaches related to muscle tension
- Sciatica
- Osteoarthritis of the hip and knee
- Patellofemoral pain syndrome
- Muscle strains and general muscle tightness or tension
- Shin splints
- Fibromyalgia-related muscle pain
- Tendinitis, tendinopathy, and tendinosis
- Ligament injuries
Many of these overlap with injuries we see through our musculoskeletal physiotherapy program, where dry needling and IMS may be used alongside other physiotherapy approaches, such as manual therapy and exercise, when appropriate.
For athletes dealing with sports-related injuries, overuse injuries, muscle tightness, or rehabilitation needs, dry needling or IMS may also be considered as one component of a broader sports physiotherapy treatment plan, alongside assessment, exercise, and rehabilitation when appropriate.
Safety and Who Should Be Cautious
Dry needling and IMS are not suitable for everyone. Your physiotherapist will assess your medical history, current condition, medications, and other relevant factors before deciding whether needling is appropriate as part of your treatment plan.
Let your physiotherapist know during your assessment if you have any relevant health conditions, take medication that may affect bleeding, are pregnant, have a skin condition or infection near the treatment area, or have significant anxiety or fear related to needles. Your physiotherapist can then determine whether the treatment should be modified, postponed, or replaced with another approach where appropriate.
As with any treatment, your physiotherapist will consider your individual circumstances and discuss the most suitable options with you before proceeding.
Benefits of IMS / Dry Needling
Depending on the individual and the condition being treated, IMS and dry needling may:
- Help reduce muscle tightness and pain in some people
- May help improve range of motion when muscle tightness is contributing to restricted movement
- May influence the body’s natural pain-modulating mechanisms
- May help address areas of muscle dysfunction identified during a physiotherapy assessment
- Work well as one part of a broader physiotherapy plan, rather than as a standalone treatment
Your physiotherapist will determine whether IMS or dry needling is appropriate for you based on your assessment and overall treatment goals.
Frequently Asked Questions
Do I need a doctor's referral for IMS or dry needling?
No, a doctor’s referral is not required. If your physiotherapist identifies something during your assessment that needs a physician’s input, they’ll refer you at that point.
Does dry needling hurt?
Most people find it uncomfortable rather than painful. You may experience a brief prick when the needle enters the skin, followed by temporary discomfort, aching, cramping, or a twitching sensation depending on the technique used and the area being treated. Your physiotherapist starts gently and adjusts the treatment based on your response.
Is dry needling the same as acupuncture?
They use similar types of fine needles, but the underlying treatment frameworks are different. Dry needling and IMS are generally based on musculoskeletal anatomy and are used to target specific muscles and soft tissues identified during an assessment, while acupuncture is traditionally associated with Traditional Chinese Medicine and follows its own diagnostic and treatment framework. See our acupuncture treatment page for more on that approach.
How many sessions will I need?
This depends on your individual needs and the nature of your condition or injury. Your physiotherapist will build a treatment plan aimed at helping you return to your normal activities as efficiently as possible and will adjust it as you progress.
Can dry needling be combined with other treatments?
Yes. Dry needling and IMS may be used alongside other physiotherapy approaches, such as manual therapy and exercise therapy, when appropriate. Depending on your condition, your physiotherapist may combine needling techniques with treatments from our musculoskeletal or sports physiotherapy programs.
Ready to Get Started?
If muscle tightness or trigger point pain has been slowing you down, our physiotherapists can assess whether IMS, dry needling, or functional dry needling makes sense as part of your individual treatment and recovery plan.