Is your dog living with pain?

It is estimated that 30% of pet dogs and cats that visit a vet have chronic (long term) pain. Pain can manifest in a range of ways including changes in the animal’s movement and the way they interact with their humans and other household pets. Sometimes pain is not diagnosed but put down to the dog or cat “just getting old”.

Types of pain

While pain is generally undesirable, some types have a protective function.

• Physiologic pain is a transient pain which has a protective function. This type of pain occurs and subsides quickly in response to a noxious stimulus. An example is the sharp pain you get when you get a prickle in your foot or place you hand on a hot stove. This type of pain acts as an alarm to protect the body from tissue damage. We learn to avoid this stimuli in future.

• Another type of pain that dogs can experience is inflammatory pain. This pain accompanies tissue damage and acute inflammation. Returning to our example above, this pain is the result of the puncture from the prickle or burn from the hot stove. It this thought that inflammatory pain has a protective purpose to prevent or minimise further tissue damage. This type of pain encourages the animal to be still to aid healing and once the inflammation is resolved so too is the pain.

• Persistent or neuropathic pain is a type of pain that occurs when there is tissue damage and / or inflammation for a long period of time. Conditions where this type of pain may occur includes degenerative conditions like osteoarthritis or a significant trauma. Neuropathic pain is also observed in long term musculoskeletal conditions that have changed the way the dog’s neural system detects, processes and responds to stimuli and therefore perceives pain.

How can massage help manage pain in dogs?

When dogs are in pain they often adopt postures and gaits to avoid further insult. These protective strategy can start a pain cycle. Altering their posture and gait can overload other areas of the dog’s body and new pain points can develop. Further, pain can reduce a dog’s willingness to exercise which in turn can cause weight gain and overload joints or exacerbate an already altered gait. Inactivity can cause loss of muscle tone (atrophy) and strength which also affects the dog’s willingness and ability to exercise.

McFarlane et al states that once the dog has established a guarded posture “it is unlikely that pharmacological intervention alone will be effective in relieving the chronic pain state”. This is where massage therapy can be effective in manipulating soft tissue to reduce pain and alter mechanical stresses. Massage can maintain circulation to provide hydration and nutrients to muscles while passive range of motion and stretching can maintain joint health including promoting synovial fluid production and lubricate articular cartilage. Finally, by extrapolating the results of massage on human subjects, massage may reduce pain and anxiety in dogs also.

In human studies, there is evidence that massage produces a relaxation response characterised by lowered blood pressure and heart rate, decreased oxygen consumption and muscle tension, and lowered levels of cortisol and noradrenaline.

In a study of humans suffering from chronic lower back pain, participants had 10 massage treatments over a 12 week period. At the end of the two weeks, participants reported a 49% reduction in pain and after 12 weeks a 40% reduction in pain (from the initial baseline) was reported. The reduction in pain correlated with a decrease in heart rate in participants also.

In four studies of humans with osteoarthritis in their knee, all four studies found that following massage treatment the participants reported:

• Reduction in pain generally
• Improved performance / movement
• Increased range of motion
• Decrease in pain associated with range of movement
• Fewer sleep disturbances due to pain

Similar effects were shown in a literature review of six studies of palliative care patients. The literature review sought to investigate the effect of massage on level of pain, anxiety and depression.

Pain

Four studies reviewed showed that massage had a significant analgesic effect. Those patients with the highest pain score at the outset of the studies showed the greatest levels of pain relief from massage. The effects of massage in all four studies were measured immediately after a massage treatment.
One study included in the literature review showed that massage had no effect on pain.
Additionally, there are divergent findings about massage’s long term effect on pain. One study showed that at 16 – 18 hours after a massage treatment there were no significant effects on pain.

Anxiety and depression

The studies included in the literature reviewed showed a reduction in anxiety following a massage treatment. Similarly, those patients that received a massage also reported an improvement in their mood.
The literature review showed that factors affecting mood and anxiety include the type and duration of massage. One study found that a full body massage was more effective in producing a relaxation response which correlated with reduction in anxiety and depression than a foot massage. Longer massage treatments are also more likely to produce a relaxation response and therefore affect anxiety and depression levels.

How does massage work to relieve pain?

There are several theories about the mechanism by which massage relieves pain. It is thought that the direct mechanical pressure of massage activates the pain gate mechanism. Mechnoreceptors in the dog’s skin are stimulated by touch and transmit impulses to the spinal cord. These impulses inhibit the transmission of signals relaying painful stimuli to the same spinal segment thereby distorting the transmission of noxious stimuli and altering the perception of pain. This mechanism provides short term pain relief.

Massage, also provides longer term analgesic effect by stimulating the descending pain suppression mechanism. Massage stimulates nuclei in the mid-brain to release endogenous opiates (inhibitory neurotransmitters, like endorphin) The release of these substances diminishes the intensity of stimuli transmitted to the higher centres of the brain and in so doing reduces the perception of pain.

Finally, where pain is a symptom of inflammation, massage is effective in reducing inflammation and stimulating the healing process. After the acute phase of a trauma has passed, massage is effective in stimulating the circulatory system to “flush” fluids surrounding the trauma or injury site and removing mediators of inflammation. In removing these fluids, massage plays an important role in resolving inflammation.

Full Stride works with dog owners who want to incorporate natural treatments into their dog’s health care regime. Full Stride provides canine massage treatments in dog’s homes within a Brisbane based service area and from a clinic on the north side of Brisbane.

Until next time, enjoy your dogs.

Sources:

Adams, R., White, B., & Beckett, C. (2010). The Effects of Massage Therapy on Pain Management in the Acute Care Setting. International Journal of Therapeutic Massage & Bodywork, 3(1), 4–11.

Catanzaro A, Di Salvo A, della Rocca G (2014) Neuropharmacology of Animal Pain: A Mechanism-Based Therapeutic Approach. J Vet Sci Med Diagn 3:1

Falkensteiner, M., Mantovan, F., Müller, I., & Them, C. (2011). The Use of Massage Therapy for Reducing Pain, Anxiety, and Depression in Oncological Palliative Care Patients: A Narrative Review of the Literature. ISRN Nursing, 2011, 929868. http://doi.org/10.5402/2011/929868

Goats, G,C. (1994) “Massage-the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects”, British Journal of Sports Medicine 28 (3) p153 – 156

MacFarlane, P.D, Tute, S.A & Alderson, B (2014) “Therapeutic options for the treatment of chronic pain in dogs”, Journal of Small Animal Practice (55) p127 – 134

Matthews, K, Kronen, P.W, Lascelles,D, Nolan, A, Robertson,S, Steagall, P, Wright, B & Yamashita, K (2014) “Guidelines for recognition, assessment and treatment of pain” Journal of Small Animal Practice, Vol, 55 p10 – 68

Millis, D & Levine, D (ed) (2014) Canine Rehabilitation and Physical Therapy, Elsevier Inc, Missouri USA

Perlman, A. I., Sabina, A., Williams, A. L., Njike, V. Y., & Katz, D. L. (2006). Massage therapy for osteoarthritis of the knee: a randomized controlled trial. Archives of Internal Medicine, 166(22), 2533-2538.

Walach, H., Güthlin, C., & König, M. (2003). Efficacy of massage therapy in chronic pain: a pragmatic randomized trial. The Journal of Alternative & Complementary Medicine, 9(6), 837-846.