Maybe there’s something in the water… but we sure are seeing a lot of dogs with back pain. Not randomly located back pain. Not Dachshunds with back pain. But large-breed dogs with pain at the base of their spine – in their low back. Dogs with presumably lumbosacral disc disease. It’s been a very interesting run of cases.
But firstly, What is Lumbosacral Disease?
It’s a disorder that affects the nerves in the low back – at the very end of the spinal cord just before the pelvis. In this region, there are only nerves left in the spinal canal before they exit out to become nerves that travel down the legs. This area is called the Cauda Equina – because there are so many nerves, the area looks like a horse’s tail.
In this region, the nerves can get squished or inflamed. This can happen with a bulging disc, with a narrowing of the spinal canal or the area where the nerves exit the spinal canal, it can be caused by a degeneration of the disc, or by bony growths that press on the nerves.
All in all, if the nerves are compressed enough, then they can become inflamed and the inflammation causes pain in the back and sometimes pain in the leg. What you might notice is your dog having a rounded back / roach-back posture or a tightly tucked tail. He or she may be reluctant to get up, do stairs, or jump up onto the couch, bed, or vehicle. We’ve had dogs that chose to go upstairs or onto a couch backwards to avoid extending their back. These dogs might have pain with squatting to defecate or pain with any movement transition. Sometimes the dogs are lame and/or the owner will note that they obsessively lick or chew at one or both rear legs. Other dogs will have one or both hind legs that shake when standing. When they’re flared up, they are worse with exercise, and in some instances (i.e. when the spinal canal is narrowed by stenosis (boney growth), then exercise in general makes them worse, regardless of whether they are flared up or not. We’ve had owners tell us stories of their dog having changes or problems with defecating or urinating (changes in frequency or ability to fully evacuate their bowels as an example).
If you bring a dog with these signs to your vet or a canine rehab-trained physio, they will look for back pain, signs of weakness in the back leg, indications that the dog is licking, biting, or chewing the leg (i.e. stained or flattened hair over the foot or leg), as well as evidence of nerve compression (i.e. dragging of the toes or slow reflexes or sometimes hyper-reflexes).
Further diagnostics would likely include an x-ray as the first step. Sometimes an x-ray will show narrowing of the disc space or bony growths. However, lots of times it doesn’t show much. More expensive diagnostics could include a CT Scan or an MRI. These will show more, but there is often a poor correlation between degree of compression and clinical signs. Also, compression can be found in normal dogs as well. So, really, all things need to match: the physical exam, the signs the dog is exhibiting, and findings on imaging.
There was a fabulous ((FABULOUS)) Facebook live interview with a neurologist in the UK on the Canine Arthritis Management page. Here’s the link… it really was brilliant.
•An MRI is not the be-all and end-all in regards to diagnosing these issues.
•There is no rush to jump into surgery.
•Surgery may not be the gold standard for all of these cases anyways.
•If other therapies are working, then stick with them.
•Inflamed nerves are painful… normally nerves can be stretched, poked, and pinched without issue. So, the pain the animal is experiencing is often inflammation-related versus damage or compression.
•Life can be good even if there is a little bit of pain.
It was honestly, one of the best things I’ve watched in quite some time.
Okay, so let’s now dive into WHAT TO DO for this! My favourite part of the interview was when the veterinary surgeon said that there is no rush to jump into surgery and that surgery was not necessarily the gold standard for these cases anyways!
If we simplify our physio management… we are either looking at treating these dogs when they are painful and inflamed. In these times, we want to reduce inflammation by any means possible. That might include laser therapy, acupuncture, pulsed electromagnetic field, mobilizations, and traction. We’d also encourage you to follow up with your veterinarian to discuss anti-inflammatories as well. Inflamed nerves are temperamental. It’s like living with a 14-year-old girl. Just the smallest little thing will set her off!!! The trick is not only to treat the inflammation, but to be SLOW in reintroducing normal activity so as not to upset the nerve as it’s healing.
The other times we see these dogs are when they are subacute (i.e. not very painful… but we know that the issue is there). At these times, our goals are to increase blood flow to the area (to continue to help with healing or MILD inflammation). So, we could still do laser, acupuncture, and magnetic field, but we might also do shockwave as well. When the dog is no longer acutely painful, it’s a good time to restore some normal movement (i.e. work on flattening the spine – not full extension, but flatter so the dog isn’t rounding the back so much.) I also think about how I can make the nerves in the ‘pinchy area’ more resilient and tolerant to a pinch, squish, or stretch. Nerves are supposed to be resilient. So, if we can ‘reset’ the tolerance, I think that is a worthy goal. There’s an exercise I’m liking that I call The Pelvic Tilt. I used this in this stage to help introduce a little bit of normal spinal posture to the back.
All in all, these dogs might have highs and lows in how they progress. There might not be a CURE, but there is a way to MANAGE the issue and to ride the good times and the bad times.
I’ve done some education on this topic on my website where I teach other rehab practitioners (vets, physios, technicians, etc.). There is a short clip I’d like to share with our Canine Fitness Centre family of clients as well that demonstrates two valuable techniques. Check it out below.
I hope this is helpful information for some of you! Thanks for reading!