Intramuscular Stimulation (IMS) vs. Acupuncture

Can physiotherapists do acupuncture? What physiotherapists do is not traditional acupuncture, but a technique called intramuscular stimulation (IMS) or “dry needling”.

To ensure you are receiving the best possible care it is important to differentiate between what a physiotherapist can offer and traditional acupuncture.

What is IMS or “Dry Needling”?

IMS, or dry needling, is a procedure used by physiotherapists who are not licensed to practice acupuncture. Dry needling is the placement of acupuncture needles into trigger points or knotted muscle fibers to elicit a “twitch” response which then releases muscle pain.

Registered acupuncturists are trained in IMS as just one technique among many to help bring the body in balance and relieve pain long term.

Risks and Concerns of Physiotherapy-Based IMS

It is validating that other practitioners see the benefits of acupuncture and want to use it in combination with their own therapies! Unfortunately, while physiotherapists are incredible practitioners and are essential to the healthcare community, there are some issues with the adoption of acupuncture practices in a physiotherapist setting.

Read on to learn more about the common concerns and risks associated with physiotherapy-based dry needling.

Trust in Treatment:

Not only does a bad IMS experience affect treatment goals, it can impact a patient’s trust in the competency and efficacy of their physiotherapist. It might also prevent them from seeking out treatment from a registered acupuncturist who might better treat their specific concern.

To best reach your health goals ensure that you are seeking treatment from the appropriate professional instead of taking a “one stop shop” approach to your health.


IMS training typically takes place over a weekend. No regulatory agency controls the training, licensure, or supervision for this procedure so the skill and abilities of physiotherapists can vary drastically.

Registered acupuncturists in BC must complete three years of education, receive a license, and complete examination through The College of Traditional Chinese Medicine Practitioners and Acupuncturists of BC. Acupuncturists are regulated by the provincial government in training and practice.


IMS involves longer, often thicker needles and forceful manipulation. When performed by someone other than a registered acupuncturist, you are at risk of injury, pneumothorax (collapsed lung), unnecessary pain, and bruising. Seek treatment from an acupuncturist who has gone through the training and licensure needed to safely apply dry needling techniques.

Qi (Chi) Disruption:

From an energetic standpoint, IMS can cause an imbalance in your overall healing energy (Chi, pronounced “chee”). Acupuncture seeks to remove these blockages and return your energy flow to a state of balance.

Because dry needling is the insertion of acupuncture needles, it can have a powerful effect on your Chi. Physiotherapists are not trained to understand the complex theory behind acupuncture. Incorrect needle placement, direction, length, or manipulation can leave you in pain, feeling exhausted, scattered, and could potentially exacerbate other symptoms or conditions.


IMS is designed to help orthopedic complaints, generally muscle pain. In contrast, acupuncture is a complete medical system designed to treat a chronic disease systemically.

Lasting Results:

Patients often experience only temporary relief with IMS. This is because it operates on the symptom-based approach of Western medicine. Eastern medicine is holistic in its approach, meaning it treats the whole body and not just the symptoms. IMS, like prescriptions for pain medication, address a specific symptom but does not seek to put the body back into balance, and therefore is rarely as long-lasting as an acupuncture treatment.


If I believe that acupuncture won’t work for your condition or if acupuncture alone is not enough to solve your health concerns I will refer you to the appropriate healthcare practitioner. I believe in an integrative, holistic approach to medicine and with consent I often communicate with patient’s medical providers to ensure continuity of care.



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