IMS: Treatment for Arthritis Related Muscle Pain“After 25 years of dealing with problems from the locomotor system I have the opinion that Dr. Gunn’s IMS technique is the most important contribution in the field in the last 10 years.”

-Bengt Johansson, M.D. Chairman, Swedish Society for Orthopedic Medicine

“Dr. Gunn has been a key figure in the recognition and treatment of the widespread painful condition of soft tissue rheumatism. He deserves great credit for his classical description of this syndrome.”

-Professor Patrick Wall FRS, DM, FRCP (Deceased)

“I think your paper is excellent, and very important. So many of these cases go by undetected or misdiagnosed, and the patients are accused... of being ‘crocks’…, I’ve always admired your work,...this paper is a very important contribution.”

-Professor Ronald Melzack McGill University

“Trained in traditional Western medicine, I was somewhat skeptical, but as I have seen more and more patients with chronic musculoskeletal pains that do not respond to any conventional form of therapy, I have turned to your...new ideas and solutions. I must say I have been very impressed at the results.”

-Dr. John W. Bell

“...Gunn’s Intramuscular Stimulation technique (is) most effective...there is no other pain treatment available...that can immediately predict, in an objective fashion, whether a patient will respond to (IMS) treatment.”

-Jennifer Chu-Andrew, M.D. Director (ret.), Electrodiagnosis & Rehabilitation Medicine, University of Pennsylvania

““The most important skill of a good pain physician is the ability to examine the patient, knowing what to look for. Dr. Goodman is such a practitioner...he fully understands the principles of pain. Also important, from the patient’s point of view, he has an excellent pair of hands. We are grateful and proud that he is a certified lecturer for the Institute for the Study and Treatment of Pain (iSTOP, Vancouver, B.C. www.iStop.org).”

- C. Chan Gunn, M.D. Clinical Professor, University of Washington Pain Center; Director iStop

“As a long time satisfied patient of Dr. Goodman’s, I have received many successful IMS treatments from him and am pleased to offer this recommendation for his unique medical skills. I have suffered from osteoarthritis from the early 1990’s and was referred to Dr. Goodman in August, 1995. Due to the widespread pain at that time in my neck, back, shoulder and arm, it took five IMS sessions to cure my pain completely. I have returned for a total of eight different times, including currently. These treatments have taken from two sessions to five, always resulting in complete pain recovery. I have tried other forms of medical alternatives, but IMS is the only method that provides for my complete relief!”

Jim W. Burchfield, Federal Way, WA 12/08/2004

Early-Mild Arthritis?Interested in Avoiding Drugs and Delaying the Need for Surgery?

IntraMuscular Stimulation - IMSA proven treatment for shortened muscles associated with arthritic jointsHand • Hip • Knee • Shoulder • Spine

Learn how IMS can reduce pain, slow arthritis progression and help you maintain an active lifestyle

Steven R. Goodman, M.D. is Board Certified in Physical Medicine & Rehabilitation. He has specialized in the diagnosis and treatment of musculoskeletal and soft tissue pain syndromes since

1989 and has treated thousands of patients with arthritic conditions. Since learning IMS in 1993, he has been integrating it successfully with manual therapy and exercise prescriptions for shortened muscle syndrome. He is a graduate of and Clinical Associate Professor at the University of Washington where he teaches IMS, a safe and proven non-drug, non-surgical treatment of arthritis associated muscle pain.

St. Luke’s is a division of Inland Northwest Health Services (INHS). INHS is a non-profit corporation sponsored by Deaconess Medical Center, Sacred Heart Medical Center and Valley Hospital and Medical Center in Spokane, WA for providing collaboration in health care services.

St. Luke’s Physiatry Practice715 S. Cowley, Suite 224 | Spokane, WA 99202

(509) 473-6706 | www.st-lukes.org

The Shortened Muscle SyndromeWhen an area of the body is inflamed or injured, the surrounding muscles involuntarily contract in order to splint the area, limit pain and allow healing. This occurs not only with sprains and fractures, but also with more gradual processes like arthritis. It is the body’s way to minimize joint irritation and pain.

Due to prolonged contraction, the muscles begin to develop localized areas of taut muscle fiber bands or tender knots called trigger points, which themselves become secondary sources of pain. Eventually the muscles themselves begin to shorten, and many patients report feeling stiff, ‘stuck’ or ‘out-of-place’ due to the shortened muscles restricting normal joint or spinal mobility. This further compresses the arthritic joint, increasing joint irritation and leading to a vicious cycle of continued muscle contraction and pain.

Shortened muscles develop around the hips, knees and also along the spine which then increases the pressure on the discs, nerves and facet joints.

What is IntraMuscular Stimulation?To relieve pain caused by shortened muscles, the muscle must be stimulated so that the muscle returns to its normal resting length. Intramuscular Stimulation (IMS) is an effective treatment for pain caused by the shortened muscle syndrome. IMS was developed by Dr. C. Chan Gunn of the University of Washington Pain Center.

IMS utilizes a fine flexible pin in the muscle according to neuromuscular anatomy and physiological principles.

The pin stimulates spinal reflexes causing the muscle to briefly contract and then relax, which leads to a ’resetting’ of the muscle’s resting length and decreased pain.

The effects of IMS are cumulative; each treatment stimulates additional lengthening of the muscle. Dr. Goodman utilizes manual soft-tissue therapies and exercise in conjunction with IMS to further promote muscular relaxation. Initial treatments are weekly and taper with improvement.

The number of treatments required depends principally upon the extent and severity of the shortened muscles and any associated postural abnormalities. If the pain is of recent onset several treatments may be all that is necessary. Lengthening shortened muscles can reduce pain, slow the progression of arthritis and delay the need for joint replacement surgery. It can help the patient with arthritis maintain an active and healthy lifestyle.

IMS is a scientific treatment for arthritis related pain due to the shortened muscle syndrome. It is a safe and proven treatment that offers hope to patients with early and mild joint arthritis.