Osteoarthritis

What is Osteoarthritis?

Osteoarthritis is the degradation of joints due to causes that ultimately lead to loss of function and in many cases severe pain and weakness.  Most senior cats and dogs unfortunately suffer from osteoarthritis. This can also strike young dogs that have survived trauma or have congenital malformations such as hip or elbow dysplasia.  If your dog has been diagnosed with hip dysplasia, we can teach you how to guide your dog in exercises to slow the progression of muscle loss and subsequent pain and disability from arthritis as well. 

 The constant instability in a joint that is meant to be “tight” leads to inflammation and ultimately the degradation of cartilage and subsequent pain.  Pain and discomfort from arthritis will make pets less active.  Muscles become weak and joints become stiff, limiting range of motion and thus function.  This becomes a dangerous downward spiral of inactivity and can lead to a point of no return. 

What’s the Deal with Range of Motion?

 Range of Motion is crucial to maintain for many reasons.  If a joint is immobilized either by choice or mechanics, the joint fluid doesn’t move.  Joint fluid is what feeds the cartilage therefore performing range of motion exercises will move that joint fluid to slow the onset of degenerative joint disease.  Range of motion also prevents muscle and ligament restrictions.  Animals in pain will limit their range of motion so the loss of function of one aspect of the body cascades to the loss of function in many areas as compensations place undue stress on other parts of the body.  The key is to learn these exercises in a safe manner, as our goal for physical therapy is to provide relief, not cause pain.

Multi-model Approach to Restoration/Wellness

 Rehabilitation therapy really involves an integrative approach.  Pain management is the first step to rehabilitation therapy for arthritis.  Our rehabilitation team can augment your veterinarian’s current treatment plan through the use of appropriate medications and modalities.  This will be determined first by obtaining a pain score.  Medications are commonly indicated, but as many of these patients are senior and have other health concerns as well, our team will work with your veterinarian for the best and safest alternatives to help your pet become as pain free as possible.  Contrary to popular belief, it is imperative that pain is controlled and ideally prevented for best healing before the pain pathway becomes imbedded in the body.  Medications indicated are commonly NSAIDs (non-steroidal anti-inflammatories), opiates and dorsal horn pain inhibitors (work at the level of the spinal cord pain pathways.)  However medications aren’t the only approach. 

 One of the most important aspects is weight management.  Our trained specialists can help determine the ideal weight of your friend and provide safe and appropriate exercise for them as well as diet recommendations to help them reach a goal if appropriate. Studies have shown that ideal weight can have the same effect as non-steroidal medications.

Proper diet is essential for healing and for maintaining healthy muscle.  Our evidence-based nutritional counseling can help you determine the best diet for your pet based on breed, activity and medical conditions. 

Supplements such as chondro-protectants (cartilage/joint protectants) and Omega-3 fatty acids can help with pain relief, injury prevention and restoration.  Our evidence based knowledge can help guide your selection and determine the best way and form to administer these to your pet.

 Rehabilitation therapy also includes modalities.  These can consist of simple at-home therapies such as ice and heat, range of motion exercises, stretching and specific targeted exercises. These will be taught to you by our knowledgeable staff.

Other modalities include the following:

• Massage:  Hands-on treatment helps relax muscles, increase circulation, and loosen up soft tissues, therefore decreasing pain and improving muscle and joint biomechanics.  Skilled hands focus on trigger points and sources of restrictions in muscles and joints thereby increasing range of motion and function.  Stretching is also often completed at this time to help restore normal muscle length. 
• Therapeutic Laser:  The use of light energy to affect underlying tissues thereby affecting cellular metabolism leading to lymph, circulatory, nervous system, wound/surgical healing as well as stimulation to acupuncture and trigger points.  Indicated for most conditions that require the body to repair and relieve pain.
• Under water treadmill:  Indicated for most post-surgical, osteoarthritis, neurological, muscle strength, endurance, and obesity cases.  The warmth of water relaxes muscles, decreases pain and increases range of motion, hydrostatic pressure helps reduce swelling, resistance helps promote maximum muscle movement and creates a harder work-out, buoyancy of water decreases concussion on joints and bones and provides assistance in the case of weak muscles.
• TENS or Neuromuscular Electrical Stimulation:  Most commonly used immediately after surgery or in early injury repair for pain relief and for neurological patients to help re-establish nerve pathways. Also for tendon healing/fracture repair.
• Above ground treadmill:  For specific cases to help with strength building and gait retraining also can be used for conditioning.
• Rehabilitation Room/Therapeutic exercises:  These include specific exercises to help with gait retraining/muscle strengthening for specific injuries and can also often be taught to the owner to perform at home.
• Pool:  As listed for the underwater treadmill, warm water therapy can be indicated for many conditions. As the pool is a less-controlled environment, it is utilized in more advanced rehabilitation programs and for conditioning.

 Owner Instruction

 We can teach you many modalities to do at home that can really help improve your pet’s comfort when chronic conditions exist.  Massage, range of motion exercises, stretching, appropriate use of ice and heat as well as guided exercise programs will help you facilitate and maximize the response your pet has to rehabilitation and recovery.  This is always individualized based on patient compliance and guardians’ abilities.