Arthritis therapy: Integrative approach

Many patients I see suffer from joint pain, loss of mobility, stiffness, and decreased quality of life due to degenerative joint diseases such as arthritis.

A multimodal approach is required for this very challenging condition. Usually an increase in mobility, a decrease in pain and a much better quality of life results. Key modalities are diet, acupuncture, cold-laser therapy, herbal supplements, nutraceuticals (nutritional supplements such as omega-3 EFA, green-lipped mussel extract, glucosamine,  chondroitin, MSM, antioxidants), injectable joint-support products such as Cartrophen and Adequan, Prolotherapy, non-steroidal anti-inflammatory drugs such as Metacam, and Deramaxx, and non-sedating narcotics such as Tramadol.  Sometimes steroidal anti-inflammatory drugs are used, but they are usually reserved for cases where the benefits outweigh the greater risks of that class of drug. Physical therapy such as underwater treadmill exercises and swimming in a controlled environment is helpful for improving mobility and building muscle strength lost due to inactivity. For the very difficult cases, nerve-pain drugs such as Amantadine and Gabapentin are added. Surgery is needed when there is significant joint instability leading to partial or full luxation (dislocation), bone chips in the joint space or for hip replacement. A new cutting edge modality now available is Vet-Stem Regenerative Stem-cell Therapy for dogs!

The cornerstone of diet therapy is to maintain or acheive a lean body condition. Often these pets have not been able to exercise for a very long time, and subsequently gained weight. This added weight is a serious complication for painful joints, as every extra gram the animal has to carry stresses the affected joint more. Sometimes weight loss is all that is needed for the return to full mobility, but in the majority of cases additional modalities need to be used. To determine how much weight needs to be lost and a safe rate for the slimming program, consult your veterinarian. There are prescription weight loss diets available, as well as a medication (Slentrol-for dogs only) to help acheive ideal body weight.

Acupuncture is an often-overlooked modality, but it really shines for treating chronic pain. In the hands of a practitioner trained in Traditional Chinese Veterinary Medicine, the whole body is treated, not just the affected joints, so many other issues can be addressed at the same time. The cost of acupuncture treatments is usually comparable to or even less than conventional drug treatment. Side effects are rare and usually very minor such as mild bruising at the acupuncture site.

Cold-laser therapy can be used for laser acupuncture, to stimulate acupoints without needles, or as regional therapy directly over the affected joint. The laser treatment reduces pain, increases blood flow and stimulates healing. It is usually given very frequently at first, such as 3-4 times per week, then tapered down to weekly or even monthly.

Herbal supplements are available at many pet and health-food stores, as well as online. The english name of the herb on the label is not sufficient, as many very different herbs have similar common names. The part of the plant used needs to be identified, as some plants have toxic roots but safe leaves, and vice versa. The product should be tested for contaminants, such as bacteria, mold, heavy metals and other toxins. Finally, the extraction process and amount of herb present in the product should be listed. Sadly most of the products available directly to the consumer are lacking in many if not all of the above. Another issue is the use of herbs that may be safe for people, but are toxic to pets; cats are  especially sensitive to many things that are safely used for dogs and people.  Remeber that herbs, like drugs, can have severe and even life-threatening side effects. Do not be lulled by the fact that they are “natural” products; they contain a wide range of chemical compounds that can work synergistically to help OR harm. Please consult a veterinarian trained in herbal medicine before using an herbal remedy for your pet. Listings of qualified veterinarians can be found at and

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