Equine Chiropractic - In the Care of Your Horse
And so what is this thing called Chiropractic….? A word from the Greek, Chiro, meaning hand, and Practic, meaning practice…OK, simple enough. But what is it really…
Chiropractic is a therapeutic modality that uses controlled hand thrusts directed at specific joints in the spinal column to improve joint mobility and nerve function. Conventional veterinary treatment which has a very valid place in total horse health focuses on structural pathology while Chiropractic focuses on functional relationships that underlie pathology. I’s goal is to address the regional interactions of the body as a whole and restore balance. I am a firm believer in the integration of conventional and alternative treatments in the care of our animals.
While undoubtedly the sore ankle will benefit from an intra-articular injection of cortisone and hyaluronic acid, the underlying dysfunction must be addressed. Horses, and all living creatures, are not simplistic systems where cause and effect are cut and dried. They are complex multifaceted living systems with many inter-relational functions. The totality of the organism needs to be evaluated and treated as a whole.
If we look at the incidence of back pain in the human population the statistics are pretty staggering, 5-15% of people have chronic back pain. In a study conducted with 190 horses with chronic back pain, regardless of diagnosis or treatment, 57% recovered completely, 17% had no improvement and 38% had recurrence or continuance of back pain. I have never been a big fan of statistics….it’s nice to know that 60% of horses resolved their issues but unfortunately 4 out of 10 were still walking around with sore backs!
Chiropractic allows us to address health issues on several levels. It affords us a diagnosis and localization of the disease process which can direct us to integrative treatment and most importantly future prevention.
Now let’s talk about this process of back pain and particularly chronic back pain…
The acute injury caused by trauma, infection or overexertion presents with the classical signs of inflammation (heat, swelling, pain). These often respond to conventional treatment with non-steroidal anti-inflammatants (bute, banamine, previcox) or corticosteroids (dexamethasone) and ice and rest. The associated factors of injury intensity, structural damage, conformation and age will all impact on healing and the transition from an acute injury and pain to a chronic injury and chronic pain.
The body’s response to tissue injury is to immobilize and support that area but ongoing spinal joint immobilization can aggravate the long term healing process. Long after the original injury has healed chronic pain can exist in that site. The spinal column is composed of multiple vertebra (7 Cervicals, 18 Thoracics, 6 Lumbars, 5 Sacrals and 15-20 Tail vertebra)…that’s alotta bones!!!
Each of them functionally interacts with their adjacent partner besides being a link in the entire spinal chain. The fundamental unit of the spinal column is the vertebral joint complex composed of two adjacent vertebra. As chiropractors this functional unit is called the vertebral motion segment and includes these two bones and the soft tissues (ligaments, discs and joint capsules) that hold them together.
So what happens with back injury…and where does this pain come from? Injury to this spinal segment and the resultant immobilization and fixation of that area to allow acute healing might not resolve things. The back muscles in their contraction to protect the injured area cause muscle shortening which alters blood flow and the cellular nutrition required for healing. This increases even more the tension and stress in that area due to lack of oxygen and the build-up of waste products like lactic acid.
A hypertonic muscle (short, contracted, spasmed) has increased metabolic demands and small areas of ischemia (lack of blood flow) can cause very painful knots (trigger points) to form. This is very similar to the fibromyalgia of humans.
So how does this area look, what external signs do we see of these altered vertebral segments? Their abnormal positioning is called a subluxation which is a minute displacement or malpositioning of the coupled vertebral segment.
To us the back can look asymmetrical with loss of flexibility. The muscles running along the top line, the paraspinal muscles are very tight with point tenderness and spasm. In long standing cases even the texture of the muscle has changed. Fibrosis, almost a leather like feeling sets in.
And what about the pain…all of this spasming/contracting and swelling squeeze on the spinal nerves which exit between each vertebral pair. The most common pain fiber is the “C” fiber. These are the most numerous and oldest type of pain fibers. In the acute situation they release certain substances that cause pain. However, in chronic pain, they release something in addition to those substances called “P-factor” which can multiply pain 20-fold. The poor horse can become so worried and reactionary that even approaching him can cause these fibers to fire and pain ensue. This type of pain is called ‘allodynia’ and is an overreaction to the fear of impending pain. All of these factors, paraspinal muscle spasm and subsequent altered vertebral positioning and fixation in that position cause impingement and compression on the spinal nerves exiting between the two vertebra. This nerve root compression (radiculopathy) disturbs the functional abiity of that nerve to control the normal movement of the muscles , bones and joints downstream in the body.
With Chiropractic we can intervene at the critical stages during the initial insult/dysfunction and the resultant instability/fixation stage. We want to defuse and redirect this abnormal cycle of healing. The fundamental goal of Chiropractic is to restore mobility to these joints. Joint mobility is the cornerstone of joint health. Normal joint range of motion allows nerve function and blood flow to move unimpeded allowing our horses to perform as they should.
And so now that you know what’s underneath your horses problem let’s talk about how to resolve it…
When I evaluate a horse from a chiropractic standpoint I look at basic conformation, current and past medical history, type of work performed and the present problem that brought me there. I begin by getting to know the horse. This is one of the beauties of Chiropractic care because it allows me to form a bond through the communication of touch on a much deeper level than just human language. As a way to enhance that communication and trust and relax my patient I start with a light massage using something I call Trauma Solution. It’s a combination of calming and soothing essential oils, linament and dmso. It works as both Aromatherapy centrally and a massage vehicle locally to stimulate blood flow and muscle relaxation. It helps prepare the patient for the adjustment. During this phase, the diagnostic phase, I am checking certain Acupuncture points for tenderness as a guide to where the problems lie. I use a combination of Acupuncture and Chiropractic in my treatment protocol. This allows me to assess muscle groups influenced by these points both locally and distantly. Trigger points are often discovered in this part of the exam.
Next I begin with diagnostic motion- palpation where I assess the mobility of spinal joints. Is the range of motion of those joints restricted or even locked? What is the texture of the muscle, are there signs of heat or coldness secondary to blood circulation? Is there back symmetry or not? Level of discomfort, pain? The degree of protective guarding of painful areas?
Motion palpation itself can be therapeutic by releasing simple vertebral fixations. Cross frictional massage can allow release of certain muscles causing relaxation and enhance the ability to adjust that area. I then reassess those points to evaluate for any changes in the main areas of interest. Throughout all this I am massaging and silently talking to my patient, trying to build a rapport and get him to trust this stranger who just walked onto the ranch…
At this point I begin at the head and adjust the atlas which very commonly is affected and alters the biomechanics of the entire spine. Motion palpation is again performed after atlas release which oftentimes resolves lower cervical issues. Lateral cervical adjustments are next.
The chiropractic manipulations release vertebral subluxation/fixations of segments restoring joint motion. It is said that the weight of a dime on a spinal nerve can cause malfunction and pain, sort of an internal static which interferes with nerve impulse flow. The chiropractic adjustment removes this obstruction.
At this point I switch to standing on a stool to position myself properly to adjust the back. I once again motion-palpate each joint to see what changes have transpired from adjustment of the previous joint.
I reassess the patient after completing the adjustment and at this time choose appropriate acupuncture points to enhance the response to the chiropractic adjustment. I have found that the two modalities work syner-gistically to improve outcome.
In summary Chiropractic allows us to address issues when they are sub-clinical and without apparent signs allowing us to remove potential health issues preemptively. The nervous system controls all bodily functions and Chiropractic helps allow its free flowing function to support the animals innate healing powers in times of both physical and emotional stress. This integration of conventional veterinary care with alternative modalities complements health from both directions and offers another tool in our toolbox to care for our patients.