Veterinary chiropractic care is a rapidly emerging field
throughout much of Europe. Its applications have
become a daily routine in many veterinary practices
and clinics, for example in the treatment of horses with
back pain or performance issues, or geriatric dogs with
degenerative joint disease. Chiropractic therapy can be
applied as part of well-designed rehabilitation programmes
in both horses and companion animal species, post-surgically or following injury.
Because animal chiropractic is a very young field,
most veterinarians lack a thorough knowledge and
understanding of this treatment method and possible
applications. Unfortunately, in many cases, patients are still
turning away from the veterinarian, looking for the advice
and treatment of animal ‘manipulators’, who have neither a
sound veterinary nor a human chiropractic education.
Misinformation, as well as myths and prejudices
about chiropractic, are widespread within the veterinary
profession, caused by insufficiently-trained people who
claim they can put the spine or the pelvis ‘back into place’.
Trained human and veterinary chiropractic professionals
are aiming to effectively integrate chiropractic care to a
position within modern medicine.
This article aims to give a short introduction about the
principles of chiropractic care as it has developed in both
the human and animal fields, and hopefully give the reader
a better understanding as to how chiropractic applications
within veterinary practice can improve the health of our
animal patients.
Structural versus dysfunctional conditions
The very limited correlation of structural changes,
diagnosed by radiology and other imaging techniques, with
the clinical symptoms of back patients is recognised when dealing with human and animal back patients. The human
chiropractic profession has long applied a holistic approach
to the diagnosis and treatment of joint dysfunction.
It offers additional diagnostic and therapeutic means of
identifying and treating primary causes of musculoskeletal
disorders compared to more traditional veterinary clinical
approaches alone.
Combining the careful functional examination of the
individual joints of the spine and entire spine function
(often called motion palpation) with the results of
diagnostic imaging can aid in evaluating the clinical
significance of structural changes. Chiropractic examination
techniques and response to therapy can also help identify
biomechanical causes of spinal dysfunction and back pain
in patients that have no obvious structural pathologies, but
clearly suffer from musculoskeletal problems.
The Motion Palpation Institute describes the health
profession of chiropractic as follows: “Chiropractic is
concerned with the relationships between structure,
primarily the spine, and function, primarily the nervous
system, of the body, as that relationship may affect the
restoration and preservation of health. Chiropractic practice
is that discipline of the scientific healing arts especially
concerned with the aetiology, pathogenesis, diagnostics,
therapeutics and prophylaxis of functional disturbances,
patho-biomechanical states, pain syndromes and other
neurophysiological effects related to the static and
dynamics of the neuromuscular system, partially those
related to the spine and pelvis.”
Identifying the pathology
The functional unit of the musculoskeletal system is called
a motion unit. A vertebral motion unit includes two adjacent
vertebrae and the associated soft tissues that bind them
together. During the chiropractic examination, every motion
unit of the spine is evaluated for functional changes. Motion
palpation is the core of the exam. It consists of taking each
joint through its entire range of motion to determine if
there is loss of normal motion or increased resistance to
induced motion of any vertebral body. Spinal segmental
dysfunction is a lesion of a vertebral motion unit, which can
be characterised by the following criteria:
1. Asymmetrical or symmetrical loss of joint mobility in
one or more planes
2. Localised pain
3. Increased pain sensitivity to pressure on paraspinal
muscles and bony structures in the affected area
4. Visible or palpatory signs of active inflammation or
chronic tissue changes (oedema, fibrosis, hyperaemia,
altered surface temperature)
The dysfunction of a motion unit has also been described
as a disturbance in the ‘fine tuning’ of a joint’s function.
The complex neurological ‘control program’ of the joint (or several joints) is faulty. The joint may appear completely
normal upon imaging, but the range of motion is very often
changed (hypo or hyper mobile).
Reduced mobility between two vertebral bodies can
irritate the nerves exiting the spinal cord through the
intervertebral foramen, leading to a disruption in the
innervation to the tissues and impairment of proprioception.
This altered nerve function causes functional difficulties
such as pain, muscle changes such as spasms and
weakness, inappropriate loading of the limbs, unco-ordinated movements and abnormal posture.
Other consequences may be acute or chronic muscle
hypertension, increased tension of the dura mater spinalis,
altered biomechanics of the intervertebral joints, as well as
increased tension of the joint capsules and ligaments close
to the joints.
The basic principle underlying all chiropractic theories
is that the dysfunction of a joint can influence the normal
neurological balance of a healthy body.
The chiropractic treatment
The goal of chiropractic treatment is to restore normal joint
mobility, and reduce pain and muscle tension. The primary
technique utilised is specific joint manipulation (historically
often called an adjustment). The chiropractic manipulation
is typically a specifically applied short lever, high velocity,
low amplitude, controlled manual thrust. Thrusts are
applied to specific articulations or anatomic regions as
close as possible to the joint to induce a therapeutic
response via changes in joint structures, muscle receptors
and function, and neurological reflexes.
The mechanical effect of the adjustment leads to a
momentary low pressure in the joint; the joint surfaces
move apart, during which synovial adhesions and cross
linkages are disrupted.
The chiropractic treatment is thought to have a specific
influence on mechanoreceptors (muscle spindle cells,
golgi tendon organs and joint receptors) to induce reflex
inhibition of pain and re ex muscle relaxation and to correct
abnormal movement patterns.
This therapy can be very useful in alleviating pain
caused by chronic disease, but like so many therapeutic
applications, chiropractic bene ts are optimised when
performed early in disease processes.
Chiropractic research
Animal chiropractic research is still very limited, but
indicates that there is a positive effect, especially regarding
the treatment of the equine spine. Research in equine
chiropractic has focused on assessing the clinical effects
of chiropractic techniques on relieving pain, improving flexibility, decreasing of muscle tension and restoring spinal
motion symmetry.
Interestingly, and contrary to most emerging areas of
medicine, there have been many more research studies
regarding human chiropractic spinal manipulation than
have been performed in animals. Currently, veterinarians looking for evidence-based research in support of
chiropractic will find some animal studies, but extrapolation
from the human-based literature is also valuable in
understanding manipulation therapies as a whole, as well
as current and potential animal clinical applications.
Knowing how
A thorough knowledge of structural anatomy,
neurophysiology and biomechanics, as well as pathology
of the spine and the extremities, is required to understand
the principles and therapeutic goals associated with
chiropractic, and to apply its techniques properly. Medical
and specific chiropractic training are essential. Chiropractic
evaluation and treatment should only be provided by
licensed professionals (veterinarians or chiropractors
working under the supervision of a veterinarian) who
have pursued additional postgraduate training in animal
chiropractic.
Conclusion
The relatively new area of animal chiropractic offers the
veterinary profession cost-effective additional diagnostic
and therapeutic means of identifying and treating primary
causes of musculoskeletal dysfunction and suboptimal
health and performance. It represents an excellent
opportunity in both equine and companion animal practice
to benefit a significant portion of the typical patient base,
and as such, also for personal professional development
and practice growth.
