Plus-Hex CLINICAL
Introduction
Osteoarthritis( OA) is a common degenerative joint disease, which is prevalent among the canine population and can cause chronic pain and discomfort, significantly affecting the pet ' s quality of life( QoL). Present treatments for OA in dogs aim to reduce pain and lameness, and improve biodynamics, through the use of analgesia [ 1 ] and physiotherapy [ 2 – 4 ]. Canine massage is a manual therapy and a type of veterinary physiotherapy, which has gained popularity as a complementary treatment. It can be used as part of a multimodal approach to reducing pain in OA. Recently, clinically significant studies, with larger populations of patients, have been conducted in this area to gain evidence to support this method of therapy [ 1, 3 ].
Current research aims to provide evidence that canine massage helps to reduce pain and increase the wellbeing of the patient through the use of a variety of techniques, including tapotement, passive movement, friction, effleurage and petrissage [ 1, 3 ]. The advantages of implementing these massage techniques include:
• reduced pain
• improved blood circulation
• reduced muscle tension
• enhanced joint flexibility
• improved range of movement
• improved mobility
• increased relaxation
• improved wellbeing [ 1 ].
This literature review explores the benefits of massage therapy and other therapeutic techniques in reducing pain in canine OA patients and compares the different systems used to measure pain in these patients.
Benefits of pain reduction achieved through canine massage
Canine massage is thought to reduce pain by increasing the production of endorphins. These are chemicals that produce a natural form of analgesia [ 5 ], which has been shown to:
• significantly reduce levels of cortisol, a prevalent stress hormone in individuals with chronic pain [ 4, 5 ]
• improve joint flexibility
• reduce muscle tension
• enhance circulation
• promote relaxation [ 1, 3 ].
Beneficial effects in terms of relieving myofascial pain and addressing trigger points have also been highlighted [ 1, 4, 6 ]. Additionally, the systemic effect of massage on the autonomic nervous system has been found to aid relaxation by lowering blood pressure and heart rate [ 1 ]. Studies have demonstrated that massage therapy helps to reduce inflammation, promote tissue healing, and improve pain levels and QoL in animals with OA [ 1, 3, 7 ]. Muscle makes up 44 – 57 % of a dog ' s bodyweight and can be a source of pain, particularly when myofascial trigger points are present; this highlights the further benefits of canine massage, which targets this discomfort [ 6 ].
Fuentes Beneytez [ 3 ] conducted a small-scale study to investigate the impact of Tuina( TN) massage, in combination with conventional medication( CM), on reducing pain levels in dogs with OA. The study enrolled 47 dogs with OA that were already receiving CM, and the dogs were assigned in a random manner to either a control group or a treatment group. The treatment group( which received TN massages on a weekly basis) demonstrated a significantly greater improvement in all outcome scores, including range of motion( ROM), walking frequency / duration, QoL, pain and weakness. The results of this study indicate that incorporating regular massage as a supplementary method within a treatment plan significantly benefits dogs with OA [ 3 ]. Although the results for pain reduction in dogs with OA were significant, using a larger sample size would improve validity.
Riley et al. [ 1 ] conducted research on the impact of massage therapy on pain and QoL in dogs with signs of pain. The cross-sectional study involved 527 dogs, and the results revealed a significant reduction in pain scores and improvement in QoL following massage therapy, suggesting that the treatment is highly effective.
It is important to note potential biases in both studies: the authors were personally involved in conducting the massage techniques and were owners of the massage institutes used in the studies. Fuentes Beneytez ' s [ 3 ] study reduced this bias by having a blinded assessor for the test of ROM, which was one of the indicators of pain used in the study. Having a double-blinded assessor and randomised control group would have increased the validity of Riley et al. [ 1 ] in terms of statistical and clinical significance. The strengths of this study were that it was randomised and the owners were blinded to their dog ' s assigned group. Riley et al.' s [ 1 ] study used a large population and showed a statistically significant reduction in pain in dogs with OA receiving regular massage, and shows valid results.
The use of massage as a manual therapy for treating OA in humans has resulted in similar findings to those of canine massage. A study by Atkins and Eichler [ 8 ] in humans highlighted a reduction in pain due to improvements in gait pattern and mobility. This study conducted a clinical trial on human patients with
Volume 41( 4) • August 2026
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