Companion Animal Chiropractic and Physical Manipulative Therapies
Allen Schoen United States
Chiropractic and manipulative therapies have recently been integrated into conventional veterinary medicine. These therapies include: Chiropractic, Osteopathy, Myofascial Release (soft tissue only), and Massage. Chiropractic is derived from the Greek “cheir” meaning hand and “praxis” meaning practice, implying that it is a practice done by hand. It is defined as the art and science of diagnosis and correction of dysrelationships between the nervous system and the spinal column through manual spinal manipulation.(1) The AVMA policy on chiropractic states that a licensed veterinarian must be involved in diagnosing, prescribing, and supervising chiropractic treatment of animals. Referrals must be made to a veterinarian with post-graduate training or who is a licensed chiropractor, and in conformance with state practice acts. Chiropractic care is a holistic approach to many of the health and performance problems of the horse and dog. Chiropractic does not replace traditional veterinary medicine and surgery, but provides an alternative method of care. Chiropractic focuses on the health and proper functioning of the spinal column.
The spinal column consists of a complex structure composed of bones, ligaments, muscles, nerves, blood vessels, and lymphatics. It provides a framework of support, protection of the central nervous system, and protection of internal organs.
One of the major challenges in integrating chiropractic in veterinary medicine is the terminology used in human chiropractic, which is foreign to veterinarians. For example, the definition of a subluxation is completely different to a veterinarian and a chiropractor, leading to numerous misunderstandings and debates. One needs to look at current definitions in order to better understand chiropractic concepts. These definitions and concepts are evolving as well. The Chiropractic Motor Unit is defined as two adjacent vertebrae and their associated structures, including ligaments blood vessels, joints, muscles, and the contents of intervertebral foramen. From a chiropractic perspective, a vertebral subluxation complex is defined as a disrelationship between a vertebral segment in association with contiguous vertebrae, resulting in disturbance of normal biomechanical and neurologic function. Two main disturbances result from this disrelationship. One is a kinesiopathic component resulting in pathology of movement of the motor unit (hyper or hypo mobile). The second is a neuropathic component resulting in pathology of the neural component (facilitation or inhibition of neural function).
Causes of subluxations include traumatic injury, postoperative complications, conformation, excess weight, hereditary, or congenital defects. Another concept that is challenging for veterinarians to understand is an adjustment or manipulation. An adjustment is defined as a “short-lever, high-velocity, quick thrust” with specific force applied in a specific direction to a specific vertebra and designed to deliver maximal force with minimal tissue damage. Manipulation distributes the force to multiple segments via “long-lever, slow velocity, non-thrust” techniques. These are all based on Wolf’s Law that “structure follows function.” In other words, that functional problems precede actual structural defects.
The pathophysiology of subluxation complexes includes compression of spinal nerve roots or the spinal cord, vertebrobasilar arterial insufficiency, somatovisceral dysfunction, and decreased mobility. Veterinary chiropractic research is limited. Most recent research has been conducted by Dr. Kevin Hausler at Cornell Veterinary School, where he documented mobility of the equine spine and demonstrated equine spinal movement following a chiropractic adjustment.
Chiropractic examination techniques include static palpation, motion palpation, and gait evaluation. Static palpation evaluates the symmetry of both dorsal and transverse spinous processes. Symmetry is evaluated from left to right, cranial to caudal, dorsal to ventral, as well as looking at symmetry of the musculature, looking for any muscle atrophy, kyphosis (roach back), or scoliosis. Evaluation also includes checking for heat, pain, muscle tone, and spasms. Motion palpation includes evaluation of active and passive range of motion in vertebral motor units. Lateral flexion, axial rotation, flexion, and extension are all evaluated.
After the examination, adjustments and manipulations are applied to appropriate areas. Ancillary care may include acupuncture, muscle relaxants, rest, massage, stretching exercises, laser therapy, ultrasound, or magnetic therapy.
Chiropractic Care may be integrated into a conventional companion animal practice for preventive health care, sports medicine for agility trial dogs, working dogs, as well as others. It may be used as an adjunct for the treatment of back and neck pain or to treat secondary compensation to primary problems such as hip dysplasia. Further research is needed to document the mechanisms of action, indications and limitations and contraindications of veterinary chiropractic. Additional training programs need to be developed. Colorado State University College of Veterinary Medicine is offering the first program of this kind at a U.S. veterinary school. The future of chiropractic is to include it in a professional manner as an integral part of veterinary medicine.
1. Willoughby, S., Chiropractic Care, In Schoen, A.M., Complementary and Alternative Veterinary Medicine, Mosby, Inc., St. Louis, MO., 1998. 185.
WSAVA Contact Information