The Similarities in treating Osteoarthritis in humans and dogs - written by Liz phelps (2021)
Introduction
Osteoarthritis (OA) is the most common musculoskeletal disease in both humans, currently estimated to affect over 600 million people globally, and dogs, where estimates in the late 1990’s were 20% of dogs over the age of one year old being affected. However, newer information suggests that it is almost double that. In a recent study using a canine OA screening checklist, close to 40% of dogs screened had clinical signs of OA. It is, in many respects, a quiet epidemic as it is often under-diagnosed. (Lascelles, BDX. Et al 2021)
Arthritis is a degenerative joint disease, causing deterioration of the articular cartilage with in the joint. The tissues around the joint start to become inflamed and sore and the joint becomes thicker and stiffer. It develops slowly and can affect humans and any breed of dog but certain large breeds of dogs, including German Shepherds, Golden Retrievers, and Labradors, are more prone to develop it than others. (Home Counties Massage 2020)
Although there is currently no cure for this progressive condition, identifying the problem early is key and instigating appropriate management in the form of pain relief and physical therapy can help keep you and your dog active and improve quality of life. (AKC 2022)
Osteoarthritis symptoms can usually be managed, although the damage to joints can't be reversed. Staying active, maintaining a healthy weight and receiving certain treatments might slow progression of the disease and help improve pain and joint function.
An international team of researchers, led by the Royal Veterinary College, (RVC) have identified for the first time key similarities between osteoarthritis (OA) in dogs and in humans. (rvc.ac.uk 2019)
Their findings, (published in Nature Reviews Rheumatology), suggest the similarities are partly due to the shared lifestyles and environments of dogs and humans, however their similar anatomies and disease physiology also contribute. (rvc.ac.uk 2019)
This article aims to highlight similarities and effectiveness between risk factors, effects, treatment and management of OA for dogs and humans as part of a multi modal approach.
“Animals are non-verbal beings. They can’t tell us that they hurt in a verbal way. They can only tell us by their behaviour, their unwillingness to socialise, their unwillingness to play ball and so forth. If we don’t treat that pain of arthritis, we’re taking all of that away from them. And that’s really sad, because then they’re not going to have a fuller life that they really deserve.”
(Mike Petty, DVM, CVPP, CVMA, CCRT, CAAPM ((Lascelles, BDX. Et al 2021)
What is Osteoarthrits?
Osteoarthritis, also known as Degenerative Joint Disease (DJD), is often seen as a ‘normal’ part of the ageing process. It is a progressively worsening inflammation of the joint caused by the deterioration of cartilage. In a healthy joint, cartilage acts as a cushion allowing the joint to move smoothly and freely through its full range of motion. In cases of osteoarthritis, this cartilage cushion begins to break down, due to factors such as genetics, age, injury, repetitive stress, or disease. The loss of this protective cushion results in pain, inflammation, decreased range of motion, and eventually the development of bone spurs, causing pain and loss of range of
movement. While any joint in the body can develop osteoarthritis, this condition most commonly affects the limbs and lower spine. (AKC 2022)
Dogs hide signs of pain and pet owners often overlook these signs, attributing them to “old age” Or ‘normal wear and tear’. This may lead pet owners to only start to recognise the signs of osteoarthritis very late in the disease when the signs are obvious and dramatic. (Lascelles, BDX. Et al 2021)
Comparitive reasons for OA
There is no single cause for the development of OA and we are now more aware that just ‘getting old’ is not accepted as the cause.
Body conformation - this is how the body is built. Both humans and dogs, if they have skeletal abnormalities have increased risk of OA.
Genetics - some humans inherit a tendancy to develop OA. Some dog breeds have a predisposition to OA. These tend to be larger breeds such as Labradors, German Shepherds, Newfoundlands.
Body weight - there is an increased chance of developing OA in humans and in dogs. The increased body weight adds stress and load bearing to the joints. Fatty tissue in the body also produce proteins that can cause inflammation around the joints.
Bone deformities - some humans and dogs are born with malformed joints or defective cartilage. Also, especially in dogs, there is an increase to developing OA if the joints develop abnormally. For instance if a dog develops hip dysplasia, elbow dysplasia or has a luxating patella.
Repetitive activity - in both humans and dogs there is an increased risk of OA if the joints undergo large amounts of repetitive movement. For instance sporting activities will have repetative movements which overworkl the joints and break down the cartilage.
Injuries - if there is a history of injury to a joint then there is an increased risk of OA in humans and dogs. Even if the injury has healed there is still an increase to the development of OA.
Orthopaedic surgery - in both humans and animals there is an increased risk of development post surgery.
Nutritional history - a poor diet can contribute to the onset of OA.
Gender - in humans a female is more likely to develop OA, however in dogs it is the male that research would suggest is more likely to develop OA, especially male dogs that have been neutered.
Metabolic diseases - diseases such as diabetes can contribute to the development in humans and dogs.
Age - in both humans and dogs there is a higher risk of developing OA in older age. Humans and dogs have different lifespans however the development of things such as OA will happen in the same ranges of their age ranges.
Comparative anatomy and lifespan of humans and dogs (RL Meeson. et al., Nat Rev Rheumatol. 2019) (rvc.ac.uk 2019)
The effects of osteoarthritis pain in humans and animals
There is now a much greater understanding of the negative impact of OA pain, both in humans and dogs. In 2017 The Pain in Animals Workshop (PAW) focused on chronic pain in companion animals associated with osteoarthritis, cancer and neuropathic pain. Bringing together leading advocates in the areas of government, academia, industry and pain management to discuss and work on improving our ability to recognise and measure chronic pain – a fundamental prerequisite to being able to treat OA pain (Lascelles, BDX. Et al 2021) and also to highlight the multiple dimensions impacted by OA pain. (See Fig 1) (Lascelles, BDX. Et al 2021)
Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:
(https://www.veterinaryirelandjournal.com/focus/211-osteoarthritis-pain-and-inflammation-the-new-science)
Pain - Affected joints might hurt during or after movement.
Stiffness - Joint stiffness might be most noticeable upon awakening or after being inactive.
Tenderness - Your joint might feel tender when you apply light pressure to or near it.
Loss of flexibility - You might not be able to move the joint through its full range of motion.
Grating sensation - There may be a grating sensation when the joint is used, and a popping or crackling sound.
Bone spurs - These extra bits of bone, which feel like hard lumps, can form around the affected joint.
Swelling - This might be caused by soft tissue inflammation around the joint. (Mayo Clinic 2022)
Your dog, being unable to verbalise what they are feeling, may exhibit many different signs when they have OA, and they do not necessarily demonstrate all the same signs all the time. The most common signs dog owners may notice include:
Difficulty getting up and down
Walking stiffly or with an unusual gait
Lameness in one or more legs
Reluctance to go up and/or down stairs
Reluctance to jump up or down (onto/off furniture or into/out of a vehicle)
Stiff, swollen, or sore joints
Reluctance to be touched or groomed on some parts of the body
Loss of stamina on walks and reluctance to go on walks
Behaviour changes with unexpected aggression towards other dogs or towards humans (Downing, R. 2020)
Unfortunately we can’t yet cure arthritis, but there is lot we can do to manage the pain it causes and give dogs a better quality of life.
How can massage help as part of a multi modal approach?
Massage has long been used as part of a multi modal approach in human treatment of OA along with pain killing medication, nutraceuticals and other physical therapies. (Ather,A et al 2017) It can help to resolve or manage protective muscular splinting and areas of over compensation that arise as a consequence of painful sore joints and altered movement patterns (CMTC 2016)
Therapeutic Massage in helping to address areas of protective muscle splinting can significantly reduce the dog’s pain, because due to increased pressure on the arthritic joint the muscles crossing the joint become stressed, shortened and inflexible. And when massage is applied correctly the issues in these muscles are addressed rather than masked, resulting in an improvement in their range of motion, movement and gait, and generally a happier demeanour. (CMTC 2016)
When treating osteoarthritis the main goals are to reduce pain and inflammation, improve joint function, eliminate or control the cause of arthritis, and even halt the process. Arthritis treatment for both humans and dogs may include a combination of medication, steroid injections, assistive devices, physical therapy exercises, complementary treatments eg acupuncture and massage, lifestyle adjustments, and surgery.
Human research studies on massage and its effectiveness as a treatment for arthritis have so far only been carried on a series of patients with knee pain and it was shown to help reduce symptoms of painful arthritis. (Yin Bin Yip & Ada Chung Yin Tam 2008) (Ali, A. Rosenburger L et al 2016)
Considering this and many anecdotal experiences, there are fewer studies on dogs but anecdotally it seems likely that similar results could be accomplished for dogs with similar ailments and diseases. (Primo, C. 2022)
In a cross sectional study carried out in 2018 to determine how dogs reacted to clinical canine massage carried out by fully trained Massage Therapy Guild members, case notes from a sample of 527 dogs were shared, (with permission from the owners), by a selection of 65 practitioners. Changes in number and severity of issues for five pain indicators (gait, posture, daily activity, behaviour, performance) and quality of life score, reported by owner and practitioners, were investigated. (Riley, L, Satchell, L et al 2021)
The results of this study showed that significant reductions in pain scores were recorded for all pain indicators over successive treatments, with each treatment causing further significant reduction in pain severity. The number of pain indicators recorded over successive treatment sessions remained constant and this was in keeping with a group presenting with degenerative disease including osteoarthritis and chronic pain. It was found that all dogs and the diagnostic variables responded similarly. Post-treatment the dogs were found to be significantly more likely to have a ‘positive’ quality of life. (Riley, L, Satchell, L et al 2021)
The conclusions drawn from this cross-sectional study, indicated that canine massage therapy may effectively reduce the severity of myofascial and musculoskeletal pain reported by owners and practitioners associated with gait, posture, behavioural and performance issues and reduction in daily activities (although it was not a double-blind trial, and there was no control group). The study suggested massage therapy may be a valid treatment for myofascial and musculoskeletal pain typically shown from muscular injuries, arthritis and other orthopaedic conditions. (Riley, L, Satchell, L et al 2021)
Conclusion
‘Long ago, we accepted the power of massage for helping humans cope and alleviate the effects of stress, pain and physical and emotional imbalances. We have been massaging each other for hundreds of thousands of years. Now, we are finally using massage to comfort and help our pet animals. ‘(Rudinger, J. 2011)
Human and animal studies have found that massage is effective in relieving pain and restoring function to osteoarthritic joints. Massage therapy is gentle, safe and has few adverse effects. It can also complement pharmacological and surgical treatment of osteoarthritis. Massage treatments for both humans and dogs administered from skilled and highly trained practitioners involves a range of massage techniques, including swedish, sports and deep tissue, myofascial release,
joint mobilisation, stretching, and passive range of motion exercises. (Conlon, JL 2020)
More and more, Canine massage is becoming part of an accepted multi modal treatment plan to treat the onset and management of Osteoarthritis in dogs. Due to the similarities between the risk factors and symptoms displayed in both humans and dogs, the effectiveness of massage has been shown both in studies and anecdotally to have many benefits in managing this progressive and painful degenerative condition affecting both us and our faithful friends.
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