Elbow osteoarthritis: medical management and laser therapy

A laser therapy study on dogs with degenerative joint disease (DJD) reveals interesting findings.

Several years ago, we initiated a laser therapy study (now known as Photobiomodulation (PBM)) to treat elbow DJD following what seemed like years of unsuccessful noninvasive, surgical or arthroscopic treatments.

Our initial PBM lower fluences didn’t provide adequate responses for elbow DJD in terms of owner-perceived lameness and functional daily activities. However, evidence from the human musculoskeletal PBM literature and success in treating neurogenic injury/chronic pain using higher fluences and power suggested that we should treat elbow DJD much like neurogenic pain — with higher fluences of light.  As such, our study was initiated.

In the initial phase (first week) of the study, several patients in both the placebo and treatment group improved drastically in a couple of the CPBI activity categories (rising movement and overall mobility).  However, from the third week onward (halfway through the entire six to seven-week treatment period), it was clear that one group continued to improve in many of the functional activities and in the owner’s perception of “lameness”, while the other group remained static or declined. A key objective outcome indicative of improvement was the reduced need for non-steroidal anti-inflammatory as the treatments progressed in the non-sham/PBM group.

Given that degenerative joint disease is so affected by environmental changes as well as concussive disease and weight, as we continue to utilize the higher dose settings to treat elbow OA one thing has become clear:  the frequency of continued ongoing treatments will vary. Many dogs will require more frequent focused joint treatments (weekly to every other week) based upon these disease-impacting variables. Also, as disease progresses, compensating soft tissue strain and sprain, as well as changed neurologic input will also affect future treatments.

Given the study outcome, we now will utilize multiple modalities, including laser therapy in the first week we see a dog in pain. Continued longer term regular PBM treatment allows for improved long-term outcomes.

Please click here to read the full manuscript of this blog that contains additional treatment recommendations and insights on treating elbow DJD.

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