Neuromuscular Electrical Stimulation

What is Neuromuscular Electrical Stimulation?

Neuromuscular Electrical Stimulation (NMES) uses electrical stimulation to cause contraction of muscle.  Electrical impulses are applied through electrodes that are attached to the skin over the target muscle.  Repeated impulses increase muscle strength and patient awareness of the muscle.

Who can benefit from NMES?

NMES helps increase muscle strength when the patient is unable or unwilling to use the muscle normally.

This is particularly useful in dogs with spinal injuries that can not walk, and in dogs with post surgical orthopedic conditions that are not using the affected leg.

How often should it be done?

NMES is usually used early in the recovery process.  It is typically repeated two or three times a week in the first few weeks after injury, but can be applied multiple times daily in hospitalized patients.  Treatment is discontinued when the patient begins actively using the muscle.

Are there any side effects?

Involuntary muscle movement can be scary, especially for nervous dogs.  Most dogs tolerate treatment well, but it can be painful at higher intensity settings, so the level is gradually increased until muscle movement is observed.  NMES should not be used in dogs with an implanted pacemaker.

Prolotherapy

What is Prolotherapy?

The word Prolotherapy is a contraction of Proliferation Therapy.  It involves the injection of an irritant into tissue to stimulate the body’s inflammatory response.  This response is useful in weakened or damaged tissue because the inflammatory response results in the creation of new fibrous scar tissue that strengthens and stabilizes the affected area.  The irritant solution usually contains both hyperosmolar dextrose (sugar) and lidocaine (local anesthetic).

Who can benefit from Prolotherapy?

Prolotherapy is helpful for acute ligament injury as well as chronic musculoskeletal weakness and pain.  This includes traumatic patellar luxation and cruciate ligament injury, arthritis/degenerative joint disease, tendons and cartilage injury.

It is used most commonly in middle aged to geriatric dogs, especially those for whom anesthesia and surgery are considered high risk.

How often should it be done?

Prolotherapy treatment sessions are usually performed at two to six week intervals over several months.  The total number of treatments required depends on the condition being treated.

Are there any side effects?

Mild to moderate pain during and immediately after the injection is the most common side effect.  This means that some dogs may require mild sedation for the procedure.

Laser Therapy

What is Laser Therapy?

Low Level Laser Therapy (LLLT) uses laser light to alter cellular function.  A focused beam of laser light is directed into an area of damaged or painful tissue to stimulate the body’s response, relieve pain, and increase healing.

Laser light penetrates deeply into the body, where it transfers energy into the tissue.  Specific wavelengths of light have been shown to dilate blood vessels, increasing oxygen delivery, and also to increase the rate of absorption and use of oxygen by the cells. 

Who can benefit from Laser Therapy?

LLLT has been shown to help with a variety of conditions.  At PetPT we use this modality primarily for pain management.  Both acute and chronic pain respond well to laser therapy, and commonly treated conditions include muscle pain, disc (spinal) pain, arthritis, nerve injury, and postoperative pain management.

How often should it be done?

A typical course of treatment requires 4-6 visits, but frequency of treatment depends on the condition being treated and how long the condition has been present.  There is usually noticeable improvement after the first session, but the effects are cumulative and the frequency of treatment can be decreased as the condition improves.  Chronic conditions can benefit from periodic maintenance treatments.

Are there any side effects?

Laser therapy is very safe when performed by a trained therapist.  Class IV lasers feel warm at certain wavelengths, and the sensation can (rarely) be unpleasant for dogs with hyperesthesia or allodynia (altered nerve function).

Dry Needling

What is Dry Needling?

Dry needling is a manual pain management technique where sterile acupuncture needles are inserted directly into myofascial (muscular) trigger points to relieve pain. Trigger points are composed of  tightly contracted knots within the muscle that cause pain within the body.  Trigger points are located by palpating the muscle, then needles are inserted into the center of each trigger point. Research studies have shown that inserting such needles into trigger points causes biochemical changes within the body, which relax the contracted muscle and help reduce pain.

Who can benefit from Dry Needling?

Trigger points occur in dogs with either acute or chronic muscle overload.  Dogs with orthopedic or neurologic injuries that change their posture, as well as canine athletes training for competition, can develop muscle pain that is relieved by dry needling.

How often should it be done?

Frequency of treatment depends on the condition being treated and how long the condition has been present.  Typically there is a noticeable improvement by the second treatment, and two treatments may be enough for some patients. Others, with more chronic conditions, will benefit from continued weekly treatments.  As the condition improves, the frequency of treatment can be decreased.

Are there any side effects?

There is often some muscle soreness, and occasionally bruising at the needle insertion site.  The soreness is mild, and usually resolves within 24 hours.  Canine athletes should not undergo dry needling immediately  before competition.