Research Update: Effects of electrostimulated acupuncture in dogs with elbow arthritis

In this controlled clinical trial from a university hospital, nine dogs with chronic forelimb lameness and radiographic evidence of elbow osteoarthritis were treated with electrostimulated acupuncture. The authors hypothesized that electrostimulated acupuncture would decrease pain and reduce lameness as measured by force plate analysis and owner assessment of each dog's pain (by using a visual analog scale) and activity levels (based on written comments).

During a two-to three-week acclimation phase, all dogs were familiarized with the force plate, and baseline ground reaction force data were obtained. Dogs were then randomly assigned to one of two groups. The first group received electrostimulated acupuncture once weekly for three weeks followed by a sham treatment (one unstimulated dermal needle was placed at the top of each dog's head and away from any recognized acupuncture point) once weekly for three weeks. The second group received the reverse protocol: sham treatment followed by electrostimulated acupuncture. Gait analysis was performed before each treatment. The dogs did not receive analgesics or nutraceuticals during any phase of the study.

The study results showed that electrostimulated acupuncture had no significant effect on ground reaction forces in any limb. The visual analog scale pain scores showed no significant interaction between treatment and visit number. However, eight of nine owners correctly identified when their dogs received electrostimulated acupuncture rather than sham treatment, and this finding was statistically significant. Weekly written comments from owners indicated that the dogs improved during the acupuncture and sham treatment phases of the study compared with during the acclimation phase. The authors concluded that in this small clinical trial electrostimulated acupuncture failed to objectively relieve lameness associated with degenerative joint disease of the elbow, although subjective improvement was noted based on owner comments.

COMMENTARY

Elbow arthritis is a common clinical problem in dogs, and medical therapies typically involve anti-inflammatory and analgesic agents, nutraceuticals, weight control, and physical therapy. Treatment with electrostimulated acupuncture has been proposed to block pain pathways by stimulating central nervous system release of endorphins. This study was designed to objectively and subjectively measure this effect by using objective and subjective lameness and pain assessments; direct measurements of endorphin concentrations were not performed. The lack of benefit, using force plate analysis, from electrostimulated acupuncture in this report is similar to that seen in a previous study evaluating gold bead acupuncture in alleviating lameness in dogs with hip dysplasia.1 However, the authors note the positive subjective assessments by the dogs' owners and the statistical limitations of their study. Additional studies from different clinical centers are needed for practitioners to objectively confirm or deny the efficacy of acupuncture in alleviating arthritis-induced pain in dogs.

Kapatkin AS, Tomasic M, Beech J, et al. Effects of electrostimulated acupuncture on ground reaction forces and pain scores in dogs with chronic elbow joint arthritis. J Am Vet Med Assoc 2006;228:1350-1354.

REFERENCE

1. Bollinger C, DeCamp CE, Stajich M. Gait analysis of dogs with hip dysplasia treated with gold bead implantation acupuncture. Vet Comp Orthop Traumatol 2002;15:116–122.

The information in "Research Updates" was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS, DVM, DACVS, Veterinary Surgical Specialists, 21 E. Mission Ave., Spokane, WA 99202.

Joseph Harari, MS, DVM, DACVS