In a previous article, I discussed the effects of physical therapy on rehabilitating animals after spinal cord injury. This article reviewed a study involving rats with spinal cord injury to their T10 vertebrae. The study investigated the effects of stretching on the animal’s locomotion. For more details please see Spinal Cord Injury: Does stretching help recovery?

The objectives of rehabilitation programmes for animals and humans with spinal cord injury are to restore function and address pain and in so doing improve the patient’s quality of life. While the previous article indicated that starting a stretching protocol during the acute phase of the injury had an adverse effect on restoring locomotion function, this article will discuss other treatments to restore function and address pain.

Massage therapy – effect on pain in patients with spinal cord injury

A study of human patients with spinal cord injury assessed the effect of acupuncture and massage therapy on neuropathic pain of patients. Both treatments have been shown to activate pain inhibiting pathways but there are limited studies on their effect on pain in SCI patients. Participants in this study had SCI for two years or more and were diagnosed with neuropathic pain. They were split into two groups: acupuncture and massage.

Both groups received treatments twice weekly for six weeks. The acupuncture treatment comprised 13 – 15 points each session with the points chosen based on the areas of pain. The massage treatment focussed on areas of pain and preserved sensation.

Few adverse effects were reported for either acupuncture or massage. One participant from the acupuncture group reported being tired after the treatment and one reported an increase in pain. In the massage group, two participants reported soreness after the treatment, one participant reported an increase in pain and one reported feeling cold.

Participants in both groups reported positive effects from acupuncture and massage. In the acupuncture group the following results were reported immediately after the treatment:

• Improved sleep

• Improved bladder and bowel function

• Decreased muscle spasms

• Decreased allodynia

• Increased energy

• Decreased pain medication

• Feeling calm and relaxed

Similar positive effects were reported in the massage group as follows:

• Improved function and less stiffness

• Improved sleep

• Improved relaxation

• Fewer muscle spasms

• Improved circulation

• Decreased allodynia

• Fewer painful attacks

• Decreased pain medication

In terms of pain and pain relieving effects of the treatments, 8/15 acupuncture patients and 9/15 massage patients reported minimally improved to very much improved pain relieving effect at the end of the treatment.

While both treatments had positive effects immediately after treatment, these effects diminished by two months after the treatment period.

Massage therapy – effect on muscle strength and joint range of motion in spinal cord injury patients

Another study assessed the effect of massage versus exercise in patients with injury to their C5 – C7 vertebrae. The aim of the therapy was to investigate the effects of massage and exercise on improving muscle strength and joint range of motion. The study hypothesized that improving muscle strength and range of motion would improve patients’ function and reduce depression and anxiety.

In this study, participants in the massage group received a 40 minute treatment twice weekly for five weeks. The exercise group were taught an exercise routine to perform twice weekly for five weeks.

Participants in the massage group reported decreased anxiety and depression scores and improvements in muscle strength at the end the treatment period compared to the baseline. In both the exercise and massage group, increased should abduction range of motion was reported. In the massage group, there was also an increase in wrist flexion and extension.

The study concluded that massage resulted in an improvement in muscle strength and fine motor range of motion compared to the exercise group. The improvement in function may also be a contributing factor in the massage group’s decrease in anxiety and depression scores.

Benefits of massage therapy for patients with spinal cord injury

These two studies indicate that massage therapy can benefit patients with spinal cord injury in the following ways:

• Massage therapy has few adverse effects on patients with spinal cord injury.

• Massage therapy has a pain relieving effect however this effect is not sustained for more than two months after the last massage treatment. For sustained pain relief, patients require regular massage treatments.

• Massage therapy has a positive effect on patients regaining muscle strength and joint range of motion. Improvements in musculoskeletal function may contribute to improved anxiety and depression scores in human patients.

Massage therapy for dogs with spinal cord injury or disk disease

Like humans, dogs suffering from spinal cord injury or disk disease may benefit from massage therapy to address the effects of paralysis, loss of function and pain – neuropathic and / or musculoskeletal. Dogs with SCI or disk disease can also experience muscle strain from altered gait and abnormal loading, complications from voiding dysfunction, side effects from some medication such as constipation and psychological effects of their physical condition such as being withdrawn and not wanting to interact with their caregivers.

While dogs with these conditions may benefit from massage treatments and physical therapy special care is required. General guidelines for treating dogs with SCI or disk disease would include:

• Avoiding any direct pressure over the spine.

• Keeping treatment sessions short initially to avoid tiring the dog or causing any additional discomfort.

• Assessing the dog’s condition and capabilities and setting up the treatment area accordingly. This may include providing additional matting or support for the dog’s body during the treatment, taking special care when re-positioning the dog for treatment and providing assistance to the dog in regaining their footing when the treatment is complete.

A massage treatment programme for dogs with SCI or disk disease would initially start with 1 – 2 short sessions for the first 2 -3 weeks. The focus of these short sessions would be to acclimate the dog to the treatment, address neurological function and assist in improving body awareness.

Treatments would use only moderate pressure and avoid any areas where the skin is broken or sensitive. The treatments would aim to address muscle contractures, release adhesions in the fascia and work on restoring limb proprioception. For dogs suffering from constipation, abdominal massage may be indicated.

In addition to massage treatments, home exercises to aid muscle strengthening, balance and co-ordination may benefit dogs with spinal cord injury or disk disease.

Full Stride provides remedial massage treatments for dogs with muscle strains and joint disease. My aim is to offer natural treatments to relieve pain and restore dogs’ mobility. Full Stride operates on the north side of Brisbane.

Until next time, enjoy your dogs.

Sources:

Diego, M. A., Field, T., Hernandez-Reif, M., Hart, S., Brucker, B., Field, T., & Burman, I. (2002). Spinal cord patients benefit from massage therapy. International Journal of Neuroscience, 112(2), 133-142.

Hagen, E. M., & Rekand, T. (2015). Management of neuropathic pain associated with spinal cord injury. Pain and therapy, 4(1), 51-65.

Norrbrink, C., & Lundeberg, T. (2011). Acupuncture and massage therapy for neuropathic pain following spinal cord injury: an exploratory study. Acupuncture in Medicine, 29(2), 108-115.

Robinson, N.G & Sheets, S, 2015 Canine medical massage: techniques and clinical applications. American Animal Hospital Press, Colorado.