Laurie's Blogs.

Okay… so this is a topic that likely requires a whole article, or a workshop, but it’s worth blogging about as well!  I am on several Facebook groups.  Sometimes to be helpful, and sometimes just to see what’s out there and what people are posting.  One thing that has had me banging my head against the wall is the IVDD & other Back Disorders in Dogs group, is all of the advice to crate rest.  

Okay… so DON’T allow free access to the houses or jumping off the couch, bed, or deck!  Agreed!  However, a healthy amount of targeted, careful exercise is good!  We stopped prescribing bed rest for back pain in the 70’s… and research backs up that bed rest is detrimental to healing!  So, why aren't vets and neurologist referring to rehab ASAP when a dog comes in with back pain.

I also came across this paper.  It’s for humans, but still pretty interesting!  A recent article (Suri, P. et al. Do Physical Activities Trigger Flare-up During an Acute Low Back Pain Episode? A Longitudinal Case-Crossover Feasibility Study. Spine. 2018 Mar 15; 43(6):427-433) looked at back pain flare-ups and whether or not physical activities flare acute back pain.  The article concluded:

-Prolonged sitting (>6 hours) in the past 24 hours was the only activity significantly associated with a flare-up.  There was a four-fold increase in flare up risk compared to not sitting for prolonged periods.

-Other activity involving physical exertion did not trigger flare-ups during the course of acute LBP.

-Having either stress or depression in the past 24 hours was significantly associated with twice the risk of a LBP flare-up.

-Physical Therapy was found to be a deterrent of flare-ups.

-The study focused only on flare-ups of a current acute pain episode. Discussion distinguished how triggers for a flare-up of existing LBP may differ from triggers of a new onset of LBP.

So, how do we go about amending public perception, and some old-school thoughts from other veterinary professionals about the crate rest epidemic?  Perhaps we would do better to change the terminology.  When speaking or marketing to our referring vets, perhaps we need to promote ‘relative rest’, or ‘guided rest’, or ‘active rest’.  Sometimes I think that others envision us with whips and prods making dogs exercise!  So perhaps we need to do a better job of describing what rehab can do in cases with back pain specifically.  Maybe we need to change our language about the manual therapies we can provide:  mobilizations and traction for blood flow, disc resorption, and pain relief.  Hmmm… shall we call that “therapeutic manual modulation of disc related pain”?  And then there are the modalities… how can anyone have an issue with them?  However, we likely need to sell their benefits more.

All in all… because there is no “Crate Rest Fairy”!!  She doesn’t sprinkle magic dust on dogs in crates!!  Only WE do that with our "Motion Lotion"!  (ha ha!)

On that note… have a great week!

Until next time… Cheers!  Laurie