3 nonpharmacologic treatment options for pain management
Dr Tamara Grubb, president-elect of the IVAPM, explains nonpharmacologic options for the multimodal approach to chronic and acute pain
Content sponsored by Zomedica
Pain management is a hot topic in veterinary medicine, and the multimodal approach to treating chronic pain in pets involves both pharmacologic and nonpharmacologic solutions. Tamara Grubb, DVM, PhD, DACVAA, and president-elect of the International Veterinary Academy of Pain Management, examined nonpharmacologic treatment options in depth during her session at the 2022 Fetch dvm360® Conference in San Diego, California.1
Here are 5 modalities Grubb discussed and how they can play a role in controlling and managing long-term pain:
1. Play, not weight loss and exercise
Grubb said that weight loss and exercise go a long way toward decreasing decreasing pain. It can reduce wear on the joint and increase muscle strength to reduce instability and better support joints. She added that some studies have demonstrated that puppies who exercise more experience decreased pain, among other health benefits.
A word of advice when communicating with clients: Grubb said she prefers to use the term play instead of weight loss and exercise. She finds it more engaging to pet parents, leading to better compliance. Psychologically, she said, it helps them conceptualize more avenues for exercise, as play can encompass a variety of activities, whereas the term exercise might sound like it requires more intensive action (such as hiking or running). They key is to get that pet moving any way possible, Grubb said.
Even though the mechanism of action is not completely understood, Grubb said she performs acupuncture and recommends it to clients. One of the key benefits, she said, is that acupuncture affects nearly every part of the pain path:
“When we stick the needle in…we get a local inflammatory response; we get more blood flow in that area and red blood cells bringing in oxygen. We also get an alteration of the transmission of impulses, which is why a lot of our points are directly over nerves. We get release of endogenous opiods…”
Grubb explained, that while research on acupuncture in veterinary medicine is limited, she believes that the evidence is there for human medicine and worth employing in animals.
3. Targeted pulsed electromagnetic field therapy (tPEMF)
Grubb also discussed the healing and pain-relief benefits of tPEMF via the Assisi Loop (Zomedica). The FDA-cleared wearable device can be use in-clinic or at home to decrease inflammation, reduce pain, and promote soft-tissue and bone healing. The ring-shaped device produces an electromagnetic signal to stimulate the body’s own production of nitric oxide. Grubb explained that nitric oxide produces anti-inflammatory, analgesic, and biotherapeutic effects (excitedly, as the topic has been the subject of her PhD thesis). This nonpharmacologic therapy can be used in conjunction with other modalities and continued at home easily.
“The best thing about the loop is that the owners can continue to do treatment at home,” said Grubb. “I don't know about you guys, but one of the most frustrating things, whether it’s acute pain or chronic pain, is what do we do to discharge the patient and continue treatment?
Grubb T. Nonpharmacologic treatment for chronic pain. Presented at: Fetch dvm360® Conference; San Diego, California. December 2-4, 2022.