There are many indications for acupuncture that can be successfully treated with acupuncture. In general, when the right cases are selected, around 80% will have a satisfactory response to treatment. It is always best to use acupuncture alongside conventional therapies, rather than instead of it.
Chronic pain of any origin/osteoarthritis:
(originating from hip, elbow, stifle, back, hock or wrist)
It is best practice not to use acupuncture as a last resort, especially in cases of chronic pain, or in cases where myofascial trigger points suspected; for example in chronic arthritis. The reason is that the longer you wait the harder it gets to treat chronic pain and myofascial trigger points. Chronic pain can be tricky because although it’s called chronic, the onset of chronic pain can already start as early as 20 minutes after injury.
Post op cruciate/elbow surgery:
For the same reason mentioned under “chronic pain of any origin”, it is best to start acupuncture treatment soon after surgery has been performed.
Acupuncture treatment can be started a couple of days after opioid analgesia has been discontinued. The reason is that opioids reduce the effects of acupuncture, because they have similar mode of action on the spinal cord and brain.
Myofascial Trigger points
A trigger point is characterised by a taut band in a muscle, which often has a nodule. The nodule consists of a group of muscle cells that is in a constant state of contraction, the band are the muscle cells in the same band, that are being stretched by the contracted muscles. Trigger points are often very tender and increase in size and number with age. They are predominantly found in dogs that perform repetitive and strenuous movements, such as agility or in dogs with other injuries such as osteoarthritis.
Diagnosis:Trigger points can be diagnosed only by thorough physical examination of the painful area while giving the patient time to relax. They will not show on ultrasound, x-rays or even MRI scans. You have to carefully search the painful area by palpating the muscle between your thumb and 4 fingers (called pincer grip). You feel for a taut band, and once you find it you search up and down for a nodule. Once you palpate this nodule you may elicit a muscle contraction and you can see the patient reacting in pain. There are certain areas that make it very hard to diagnose trigger points, like the gluteal muscles, since you cannot really search them with the pincer grip technique. In this case you can get a suspicion if you can feel bundles of very hard muscle that are painful to the touch.
Treatment:Mostly, myofascial trigger points don’t respond well to NSAIDS or other forms of pain relief. When left untreated, a trigger point can become very hard to treat. Trigger points can be treated by gently but firmly applying pressure, till the muscle spindle releases. If this does not help, acupuncture is indicated. Often trigger points will require repeated treatment.
Arcal lick granuloma (and other localised skin issues)
Treatment around the irritated skin lesion can release substances such as adenosine and locally reduce pain/itch due to the skin lesion itself but also treat the underlying cause, which may be a painful joint. Since acupuncture also targets the Default Mode Network in the brain (see “The science of acupuncture”) it may also reduce the memory of pain, preventing the lesion from reoccurring. Some vets say that treatment with acupuncture gives them better results than conventional methods but scientific data on this is still lacking. In the light of this, the best strategy is to refer cases that have not responded well to conventional therapy.
Behavioural problems, especially due to fear, over-excitement or pain
As described in “The science of acupuncture”, acupuncture can be a valuable tool in balancing out the sympathetic and parasympathetic nervous system, as well as reducing memory of fear, because of its effects on the amygdala. Many cases of unwanted behaviour will also have a pain component. It is recommended to refer your patient to a qualified behavioural therapist but acupuncture will make it more likely that behavioural therapy will actually work.