Integrating Veterinary Acupuncture into the Management of Canine Osteoarthritis

Author: Amanda Eldridge, DVM, CVA

Osteoarthritis (OA) is one of the most common musculoskeletal conditions we as veterinarians encounter in our aging patients. This progressive and degenerative disease leads to joint pain, inflammation, stiffness, and decline in mobility, all of which greatly affect quality of life. While OA cannot be cured or reversed, there are several methods used to slow the progression, manage the pain associated, and aid in mobility. Traditional methods include nonsteroidal anti-inflammatory drugs (NSAIDs), weight management, physical therapy, and nutraceuticals. Recently, the use of acupuncture as an adjunct therapy has been growing in popularity as well.  

Acupuncture is a traditional Chinese medicine practice which uses a non-invasive approach to pain management and functional improvement in our patients. Insertion of very small needles in specific locations around the body stimulate a variety of effects which decrease pain and inflammation, as well as promote healing. These include:

Endorphin Release and Pain Modulation 
Acupuncture stimulates the release of endogenous opioids, including endorphins, which act on pain receptors to modulate nociceptive transmission. The activation of specific acupuncture points can result in the release of these endogenous analgesics, thus reducing pain perception and improving comfort for dogs with OA.

Anti-inflammatory Effects
Stimulates the production of anti-inflammatory cytokines, such as IL-10, and inhibits pro-inflammatory mediators like TNF-𝝰 and IL-1β. These can help attenuate the inflammatory processes that contribute to the cartilage degradation and joint stiffness seen in OA patients, leading to reduced swelling and therefore pain around the affected joints.

Increased Blood Circulation
Promotes vasodilation and enhances blood flow to the affected area. This improved circulation helps deliver oxygen and nutrients to tissues, while facilitating the removal of metabolic waste products (lactic acid, carbon dioxide, urea, free radicals) that may exacerbate inflammation and pain.

Muscle Relaxation and Spasm Relief
In many dogs with OA, compensatory muscle tension and spasm around the affected joints are common. Acupuncture can help to reduce muscle hypertonicity by stimulating the release of neuropeptides such as substance P, which in turn promotes muscle relaxation and reduces the risk of secondary musculoskeletal dysfunction.

Improvement of Joint Mobility
Over time, regular acupuncture treatments may help increase joint range of motion by improving synovial fluid dynamics and soft tissue elasticity. This effect can be particularly beneficial in maintaining or restoring function in OA-affected joints, enabling dogs to maintain a more normal gait and engage in physical activity. 

Main considerations for the addition of acupuncture include chronic OA with persistent pain, patients who are not ideal candidates for long-term NSAID therapy (ie. patients with comorbidities such as hepatic or renal dysfunction), post-surgical rehabilitation, and acute exacerbations of OA symptoms. 

While acupuncture is able to be used as a stand-alone treatment, it is most effective in a multimodal approach when paired with traditional management methods. Treatment frequency typically starts weekly to biweekly with the ultimate goal being to achieve the highest effective results with the longest time period between treatments. The number of sessions needed will vary by individual, but most patients show noticeable improvement within 4-6 weeks. Once improvement is observed, maintenance treatments may be spaced further apart, often monthly. 

In conclusion, the flexibility and complementary nature of acupuncture make it a valuable adjunctive therapy in the multimodal management of canine osteoarthritis. By targeting pain, inflammation, and dysfunction at a holistic level, acupuncture can provide significant relief for dogs suffering from this chronic condition increasing comfort, mobility, and quality of life.