There is more than one approach towards pain relief for dogs that are suffering from arthritis. You know about pain medication and NSAIDs, but how many other options have you considered?
Millions of research dollars are spent annually on new and improved ways to manage pain in pets. There is no magic pill and pain management in dogs must be multimodal. Research shows that combining several treatments provides maximum effect.
This article covers pain management in arthritic dogs, and we’ll go over fourteen methods of pain relief for dogs based on available scientific evidence.
Understanding pain in dogs with arthritis
Osteoarthritis (OA) means inflammation of the dog’s joints. It’s a degenerative disease. OA is most prevalent in medium and large breed dogs. Arthritis is also the most common reason why dogs suffer pain. There’s an 11-item index for assessing the dog’s level of pain and stress, alongside a pet owner’s questionnaire (1, 2).
Arthritic dogs experience constant, long-term discomfort and pain. It’s not exclusive to older dogs. Although rare, even young canines can fall prey of this debilitating disease, especially through elbow or hip dysplasia.
But it’s often difficult to know when a dog is in pain.
Dogs can’t tell us when they are suffering from pain, and will typically do that in silence. Subtle signs of discomfort may be the only clue for the owner.
Common signs of pain in dogs include:
- Restless behavior
- Obsessive licking
- Constant whining
- Poor sleep patterns
- Lack of appetite
- Unexplained aggression
It’s possible that causes of these signs are something other than pain, but it’s a good indication of something being wrong. At that point, you need to take action.
Below are 14 options of pain relief for dogs, ranked in order of safety, efficacy and available scientific evidence. Combining several of these methods of pain treatment will provide maximum effect.
1. Exercise and Weight Loss
Studies show that the most statistically significant way to decrease chronic arthritis pain in dogs is weight loss (3, 4, 5). In particular, one clinical trial with 9 dogs has shown that decreasing body weight by 11-18% results in significant improvements (4).
A dog’s lean body condition not only means less stress on joints, but the body will be in a less inflammatory state as well (6).
Adipose tissue in a dog’s body is not inert. It is metabolically active and secretes enzymes that can increase overall inflammation. That leads to more chronic pain in dogs.
Moderate exercise is paramount. Keeping muscles strong and limber will increase mobility in dogs with pain. Simple at-home exercises and methods like stairs and ramp ascent can greatly increase the dog’s mobility and range of motion (7).
Daily controlled exercise regime, especially low impact exercises such as swimming were shown to have benefits in reducing arthritis pain (3).
2. Nutrition and Diet
Unsurprisingly, proper nutrition for dogs can have a direct impact on their condition. Research shows that diets rich in omega-3 fatty acids reduce inflammation by decreasing the amount of omega-6 available in the body, which results in pain reduction (8).
Metabolism of omega-6 fatty acids can lead to inflammatory mediators that have a role in the pathogenesis of a disease. The body breaks down omega-3 fatty acids into anti-inflamattory compounds, protectins and resolvins (9).
Studies suggest that the use of commercial dog food diets rich in omega-3 fatty acids, as well as supplementation of omega-3s such as with fish oil, can improve clinical signs associated with chronic arthritis pain in dogs (10, 11, 12, 13, 14).
Other diet enrichments, such as green-lipped mussels (perna canaliculus) have also been shown to improve conditions of arthritic dogs in pain (15).
3. Dog Joint Supplements
A popular and easily accessible form of pain relief for dogs with arthritis are nutraceuticals. Dog arthritis supplements are increase the viscosity of joint fluid. Studies show glucosamine and chondroitin sulfate to be somewhat effective.
Studies repeatedly demonstrate the use of these supplements can improve cartilage health and actually protect the cartilage from additional damage, as well as reduction of pain in dogs (3, 18, 19, 20, 21, 22). However, other studies have shown no signs of effectiveness, thus further research is required (23, 24).
You must use the supplements daily. It may take up to 6 weeks to see any effects. Research shows for these nutraceuticals to be safe for dogs with no side effects, and some generally help with mild chronic joint pain
4. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs for dogs continue to be the most common drug group of pain relief for dogs. When used appropriately, NSAIDs can be an important part of a multimodal approach to managing pain discomfort in canines (25, 26).
NSAIDs work by blocking cyclooxygenase (COX), which is increased in response to inflammation. And because inflammation is the cause of pain in dogs, when these receptors are blocked, the dog will experience significant relief from pain.
There are two problems with some NSAIDs, however.
First, side effects of giving NSAIDs to dogs occur in anywhere from 2.6% to 34% of cases (27).
Second, cyclooxygenase (COX) is also responsible for maintaining the health of many tissues in the dog’s body; for example, the lining of the stomach.
There are two types of cyclooxygenase: COX-1 and COX-2 inhibitors. COX-1 is important in preventing stomach ulcers and necessary for maintenance of canine health. COX-2 is the type that has a negative impact on the body and is implicated in the pain pathway.
Modern NSAIDs such as Deramaxx are manufactured to be as COX-2 specific as possible to spare the important functions of COX-1 on the body (28).
Other popular dog NSAIDs include:
- Carprofen (Novox or Rimadyl)
- Firocoxib (Previcox)
Out of all oral treatments, NSAIDs are most effective, but it’s not without adverse effects.
Remember that NSAIDs for dogs are by prescription only. Furthermore, never give your dog a human NSAID such as Ibuprofen (Advil) or Naxprofen (Aleve). They are very toxic to dogs and can be fatal.
5. Dog Pain Meds (Over the Counter)
Plenty of over the counter dog pain medications also exist, but they aren’t as potent as non-steroidal anti-inflammatory drugs. In cases where an NSAID alone isn’t providing enough relief from discomfort, your veterinarian might add on a different class of drug in addition to the NSAID for maximum effect.
Occasionally, the combination of more than one pain drug will work better for pain relief for dogs than either on their own.
Some of the known names of OTC dog pain meds include:
It’s often negatively associated with alternative and holistic health. However, acupuncture is a common treatment for chronic pain that has some scientific backing. We are starting to learn about its benefits in veterinary medicine as well (34).
Acupuncture works by stimulating specific points on the body to elicit a release of various neurochemicals and hormones. This in turn will decrease inflammation and associated pain. Veterinarians recommend to use acupuncture alongside other types of physical therapy for maximum effect (35).
Even though many owners believe that acupuncture has helped to improve their pet’s levels of discomfort, results from controlled studies proving acupuncture’s pain relieving properties are still mixed because it is a difficult therapy to test (36, 37, 38, 39).
Most pets tolerate the acupuncture needles well, and anecdotal evidence shows how many owners have recognized the relief it gives their suffering dogs.
7. Stem Cell Treatment
Embryonic stem cells are probably the most well-known in popular culture. But stem cells derived from adult tissues have shown a promising ability to help heal and regenerate tissue by reducing inflammation and differentiating, or becoming healthy cartilage, bone and joint cells.
The cells are harvested from the dog’s own fat cells, sent to a lab to be rendered and purified, and are then injected into the painful joint.
Studies show encouraging results, with measurable improvements in lameness scores and overall mobility (45).
8. Physical Therapy
The benefits of rehabilitation and physiotherapy, or physical therapy for dogs have been around the veterinary medicine for decades, but only recently physical rehabilitation has been getting more attention as treatment for different conditions in dogs (46, 47, 48, 49, 50, 51, 52).
The evidence is clear on how physical therapy increases joint mobility and range of motion, survival times, prevents muscle atrophy and otherwise benefits dogs with arthritis.
Physiotherapy works in two ways to relieve pain in dogs: on mobility and strength of the joints, and on a dog’s central nervous system, which is a contributor to pain perception, thus subsequently helping to manage pain. Exercises and low impact activities should be a part of your dog’s pain management program.
Physical therapy has different subsets:
- Massage therapy
- Electrotherapy (or Electrostimulation Therapy)
- Laser Therapy
Above studies show how physical therapy can be used not only to relieve pain in dogs or help with canine arthritis, but also to improve dog’s general physical and mental condition, cardiovascular system, help lose weight and reduce muscle atrophy. This results in pain relief.
9. Laser Therapy
Laser therapy aimed at reducing pain is also known as a cold, light or low level laser therapy (LLLT). Cells or tissues are exposed to low levels, or red, or near-infrared light which stimulates cellular function.
Pain treatment with laser therapy is generally fast (less than 15 minutes). Dogs tolerate the laser very well, as it is completely painless. Treatments of laser therapy need to be done regularly to see the best results. Research shows that it’s safe for dogs, but evidence on the effectiveness of LLLT for pain is mixed (57, 58, 59, 60, 61).
In small study trials, laser therapy reduces cell death, improves wound healing, speeds up the repair of damaged soft tissue, nerve, cartilage and even bone. It can provide relief from both chronic and acute pain (62, 63). While this may look promising, we need more studies, especially for pain relief for dogs.
Hydrotherapy, or aquatherapy, is another popular subset of physical therapy with the use of water, and in the last decade in particular it’s become more popular as another option of pain relief for dogs with arthritis (64, 65). Two most common practices in hydrotherapy are swimming and aquatic treadmills.
During this therapy process, a dog’s body weight is reduced in water. The therapy improves blood circulation, strengthens muscles and joints, helps with increased flexibility and reduces pain.
Many studies have demonstrated the safety of hydrotherapy for a variety of treatments in dogs, and its effectiveness for arthritis related pain reduction in humans, but research on dog pain management is scarce (66, 67, 68, 69, 70, 71, 72).
Note that bringing your dog to a water pond will not result in the same effects. Hydrotherapy needs to be performed in a controlled setting by a trained professional on a consistent basis. Achieving long-term positive results may be difficult.
Electrotherapy employs principles of electrostimulation where a dog would experience muscle relaxation and strengthening through an electric current. In the most basic sense, electrotherapy stimulates the body’s ability to deal with pain.
Two of the most common methods of electrotherapy are NMES (Neuromuscular Electrical Stimulation) and TENS (Transcutaneous Electrical Nerve Stimulation).
This is a relatively new method of pain relief for dogs and animals in general, and barely any research is available at the moment. However, some human studies do show its effectiveness, particularly for muscle relaxation and pain reduction (73, 74, 75).
Cryotherapy (cold) is an old method for recovery from arthritis, cancer, skin and other diseases in dogs. New technologies now allow for this old school approach to become more effective and popular in veterinary medicine (76, 77).
There are different ways of cryotherapy: ice baths, specific gels, ice packs or circulating ice compression units. There are specific time periods when it’s most effective.
Dogs with chronic pain and inflammation should stay away from cryotherapy, and use thermotherapy instead.
Thermotherapy (heat) has many different approaches as well: hot water bottles and compresses, infrared lamps, and chambers, to name a few.
This type of superficial heating may be effective for relieving chronic pain in dogs, but is not advisable for acute inflammation. There’s no research of thermotherapy for pain management in dogs, but studies with humans suggest its effectiveness (79, 84, 85, 86).
Pet owners attempting to use either cryotherapy or thermopherapy for pain relief for dogs must be aware of possible adverse effects when done incorrectly or in unsafe environment. Those may include frostbite, slow wound healing, and skin burns (87).
13. Therapeutic Ultrasonography
It’s one of the oldest rehabilitation therapies in human medicine. Ultrasound or therapeutic ultrasonography can also serve as pain relief for dogs with different conditions.
This approach uses sound waves applied directly onto the dog’s body area and produces intensive vibrations that later turn into heat. The concept is similar to thermotherapy.
Deep heat produced through high frequency ultrasound can be beneficial for muscle spasms, increasing blood flow and reducing stiffness in the dog’s joints. A few studies with humans show therapeutic ultrasonography therapy to be effective for pain, but more research is needed (88, 89, 90).
Ultrasound is well-studied with dogs with different conditions, and it’s been shown as safe to use for canines. However, there’s no conclusive evidence specifically related to using ultrasound for pain management in dogs.
14. PEMF Therapy
Pulsed electromagnetic field (PEMF) therapy is used specifically for pain relief and healing. Magnetic fields used with PEMF assists with improving cell metabolism and healing.
This method used mostly for dogs with arthritis, hip dysplasia and orthopedic injuries. Battery-operated products such as PEMF beds, pads and jackets exist to supply the electromagnetic field therapy to canines.
Vets and other professionals used it with success, and there’s a lot of scientific literature available for PEMF being safe and effective for bone healing, inflammation, wound healing and some diseases (91, 92, 93).
That said, there’s currently very little research available to clearly validate or invalidate the effectiveness of PEMF therapy for pain relief for dogs specifically. Studies do show PEMF being effective for pain management in people (94, 95, 96, 97, 98, 99, 100).
Take Home Message
Arthritis is the most common reason dogs suffer from stress and pain for prolonged periods of times. There are many options of pain relief for dogs and ways to assist them, mostly by reducing joint inflammation, improving mobility and blocking pain receptors.
A lot of studies are available for these approaches, some showing more promise than others. Going the natural route is not only the safest way with little potential side effects, but also most effective for long-term pain management. Exercise your dog, plan for weight loss, and adjust the diet.
Combining several methods to relieve pain in dogs will produce maximum effect. This means including supplements in the diet, trying any of the physical therapy treatments, and safely using NSAIDs and/or over the counter pain meds.