Multimodal Pain Management.

There are multiple types of pain and multiple different ways in which pain can be targeted.

Multi-modal pain techniques aim to target pain at multiple levels of the pain perception pathway.

This is most commonly done using a combination of medications but can also involve manual therapies, therapeutic modalities as well as specific exercises to improve functionality.

Each patient is an individual so finding the right combination of therapies is essential for positive outcomes.

Pain perception

Did you know that there is not just one type of pain and there are different aspects of the body involved with the perception of pain?

For example pain at the local level for example at nerve endings at a joint can be targeted with one type of medication such as a joint injection or cold therapy.

Then, how the signal is modulated or sent as a signal before it gets to the brain can also be targeted by using different treatments such as medications that act at the spinal cord level or brain.

This is why we recommend using multiple different pain treatment techniques.

Osteoarthitic Pain

Pain and loss of mobility due to osteoarthritis is due to a complex number of factors.

It involves issues at different parts of the joint including:

  • Break down of cartilage lining due to chronic trauma and loss of hydration

  • Inflammatory cytokines acting at the joint

  • Collagen breakdown enzymes present at the joint

  • Thickening of the joint capsule

  • Increased sensitisation of nerves in the joint

  • Loss of flexibility and scar tissue forming in surrounding ligaments, tendons and muscles

  • Loss of muscle strength due to joint pain and loss of range of motion

  • Pain from bone remodelling

Pain signals are also not just transmitted by joint issues but also by the surrounding ligaments, tendons and muscles.

This is why not only medication, but also physical therapy and treating the whole joint as a ‘joint organ’ is so important for good outcomes for our patients.

Measuring Pain

Pain in animals can also be difficult to assess. Our services also includes assessment using an objective pain scale that is then reviewed after treatment to determine efficacy.

There have been different pain scales that have been developed for acute vs chronic pain and pain scales specific to cats vs for dogs.

Using pain scales helps us be as objective as possible in regards to the efficacy of treatment and to know if a pain management protocol needs to be adjusted or modified.