Laurie's Blogs.

Question:

Hi Laurie,

I hope you don’t mind me asking you a question directly about a case. But it is my own little dog so I was hoping for some treatment technique ideas. I have a sub 4-pound Chihuahua who has a very painful neck. This has happened before and took about 6 months to clear up with massage and occasional meds and such. It is pretty bad this time. I’m not sure why it started, but a week ago he was lying on the couch and my brute of a husband just moved his hips backwards on the couch, the little guy was lying behind him and his neck may have been jammed? Totally hypothesis. Anyway... the gist of it is, that he can’t look up and to the left. Up and to the right seems okay. He now has radicular pain in his L foreleg. Not wanting to put weight on it, limping. Neck muscles are all in a bunch and he screams and screams when he has been lying down and then goes to move. Drugs: I have been trying a combo of tramadol, valium, methocarbomal, rimadyl, &/or metacam (at different times to see what helps). Nothing is making much of a difference. I can’t really get to him manually because he is so sensitive :(. I watched your C7 video and tried to work a little on that last night, but it just made him worse I think. It is hard to be specific due to him being so little and my hands being so big in comparison. Treatment ideas?

Thanks so much!

M

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Answer:

 Hi M!

Poor little guy.

So, I’d traction (gentle), do some gentle mobs in the opposite direction as painful / limping side, and laser the living daylights out of it (same side as pain / restriction / limb non-use.

If you can only mob adjacent ones, then do that.  If you have limb involvement then you’ll be thinking its C5 - T1...

Tiny little neck movements following a treat... slightly up & down & side to side.

No massage.

Your drug selection sounds good... keep up with some kind of combo along with the therapy.

Let me know how it goes!

Laurie

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Hey Laurie,

Thanks, that is basically what I did last night (except I did do some light massage), and he does seem some better today. I have not done laser yet. The place that I treat animals has a laser, but I am only there on Thursday and Friday. I will take him with me this Thursday and laser him all up! It won’t take long as he is sooo tiny!

Curious, was there any reason you suggested not to do massage, other than that I had told you that he was worse the day after I did it last time? Is this something you have found with yucky neck pain? Hold off on massage until it is starting to feel better? 

Anyhoo, I know you are a busy lady keeping up with this new website and such!

Thanks for your advice! 

M

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Hey M!

So, my comment regarding massage stems more from my findings on humans.... when the muscle spasm is ’reactive’ to an underlying nerve / spinal cord pain, then the muscle spasm is facilitation (vs primary)... and as such, to massage it requires messaging to go through - to and from - the irritated nerve roots... which do not pass the messages along properly.  Subsequently, you end up with more muscle spasm.  It can alternately be explained by pain science:  whereby the increase in pain in the area causes allodynia, and hyperalgesia (pain signaling resultant from stimuli of non-painful stimuli & an exaggerated pain response to a noxious stimulus.)  Either way you want to explain it... I have always advised against massage in acute nerve / disc pain scenarios.  (Before I actually had as much of a grasp of the background science of it all, as a new grad, I simply noted how many of my disc patients stated to be worse when they had gone for a massage prior to trying physical therapy as a treatment...)

Laurie

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Laurie,

Ha! Yes, of course, and when I treat humans, I do exactly that! I do not massage an acute back. Don’t know why I tried massage in my little guy. I think that at first, before I could see the radiculopathy, I thought maybe he had an impinged facet ( do you see this in dogs?) and I was thinking massage to relax the muscles, plus some SNAGS (Mulligan mobilization technique) aught to do the trick. But, once radiculopathy reared its ugly head, no massage! I think I forgot to tell you that at first it was just yelping and pain with looking up and to the left. But then after a couple days of meds and rest he was much better until he went running through the yard again and then wham! Much worse. 

M

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M,

I have seen some dogs where I think that impinged facets were the problem... but I tend to think disc first... and even with impinged facets, I also think Nerve Root impingement...and not just articulation.  Of course when you pinch a nerve and it becomes inflamed and/or release an impingement... things can often get worse before better.  So that may have been what happened with your little guy.  

Laurie

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L,

As far as my little guy goes. He has been much better since the work I did on him the other night. I have not had to do laser yet, and I am keeping the drugs going. But I think the work done made a big difference. Bulging disc, nerve impingement, facet impingement, whatever it is, it did seem to help! 

Thanks as always!

M