The use of electrotherapies is a large controversy within the veterinary physiotherapy sector. Owner perception is a large driver for this, some owners love them, some hate them. I am writing here today to hopefully bust some myths around the whole electrotherapy debacle!
During my studies one of my respected lecturers said to me “Nothing is more effective than manual therapies getting deep in that tissue and making a change”. At the time I did strongly agree with him and at this stage I was also very against the use of them. During my clinical hours I felt, especially canine therapist, that physios would hide behind the electrotherapies and let them do all the work for them. I remember feeling immense guilt for sending any customers away after just receiving electrotherapy. My brother is a Human sport and exercise therapist (ZRL sports therapy) and he was also very against the idea of electrotherapies and as veterinary medicine is vastly based on human evidence, I believed I was on the right thought path!
However, as I progressed through my education, I started to conduct my own research around electrotherapies and gained valuable exercise around when, and when not to use them and realised that no, they are not essential, however in some cases they are a very valuable tool to have in your tool kit! The evidence base provides solid foundational evidence on the effectiveness of 3b LASER:
- Low-level LASER first stimulates cells to trigger change, which in turn stimulates surrounding tissue promoting normal cell functioning. This promotion of normal cell functioning aids in immune, hormonal and nervous system signalling to reduce inflammation, promote tissue recovery, increase blood flow to that localised area and provide pain relief (Moskvin and Yagupov, 2020).
- Reduce inflammation, promote repair to damaged tissues and provide pain relief. On a subcellular level interacts with mitochondria (powerhouse of every cell) to produce ATP (body’s form of energy) providing a surplus of energy for tissue repair, inflammatory response and pain control (Paterniani and Grolli, 2018).
- A study investigating 61 Quarter horses with back pain, 68% ridden Western and 32% ridden English- after 3 sessions of low-level LASER therapy a significant difference (P=0.05) was noted within veterinarian derived visual analogue scale concluding improved function from baseline of spinal and pelvic function. Additionally low-level LASER also produced a significant decrease in severity of epaxial (back muscle) pain (p<0.01) (Haussler et al., 2020).
- 15 horses were used to assess the short-term effects of low-level LASER on active pain thresholds of muscles in the back and hindquarters in relation to firing rates at different gaits. Findings concluded that post low-level LASER the examined muscles shown improved muscle function at different gaits providing a more efficient and coordinated contraction (Ahmed et al., 2021).
My own personal experiences have also driven my change in perspective. During my clinical rotations we would visit certain horses and even during light palpation they would have excessive muscle spasm, large proportions of increased tone and a very shut down dementor. In these cases, even light manual therapy may be too much for them to handle and would make very little difference in the short sessions we would have with them. Therefore, having that LASER in the tool kit allowed us to provide them with some pain relief and healing promotion in hopes next time we see them we can use manual therapies to help them further.
Additionally, some older horses may have degenerative conditions such as osteoarthritis. For them to cope with this condition they may have developed some compensatory mechanisms such as increased tone at the base of neck from loading more weight on their fore to offset pain in their hocks. If we used deep massage to reduce the increased tone this would break down their coping mechanism and ultimately make them not able to cope with any daily stressors! Therefore superficial massage can help provide pain relief coupled with LASER between joint spaces of the hocks to reduce any arthritis associated pain to enhance older horses’ quality of life.
Finally, after seeing several canine patients of various breeds it become known that they are not the best at sitting still (especially spaniels, I know from my own personal experience!). Therefore, quite a vast majority of them don’t tolerate massage too well weather this be the round bottoms, the pressure of the massage, the increase in skin temperature or just generally not able to tolerate the pain. With having accessibility to the LASER, they are still able to receive pain relief and a healing aid to speed up the rates of recovery!
To conclude, I have promised myself that I will never hide behind my LASER. I make it my mission to only use my LASER as a complementary therapy to help heal those tissues that need an extra boost or help provide that one patient with pain relief they so desperately need as they are unable to cope with any form of manual therapy. I will always listen to what owner’s feel is best for their animal and I will always provide my professional opinion- Manual therapies are superior, however LASER is a very beneficial complementary therapy alongside manual and remedial exercise prescription.
Electrotherapies have earnt their right of place in my tool kit, however they will never be my superior modality.
References
Ahmed, W., Elbrønd, V.S., Harrison, A.P., Hart, J.O. and Williams, R.E., 2021. An investigation into the short-term effects of photobiomodulation on the mechanical nociceptive thresholds of M. longissimus and M. gluteus medius, in relation to muscle firing rate in horses at three different gaits. Journal of equine veterinary science, 98, p.103363.
Haussler, K.K., Manchon, P.T., Donnell, J.R. and Frisbie, D.D., 2020. Effects of low-level laser therapy and chiropractic care on back pain in quarter horses. Journal of equine veterinary science, 86, p.102891.
Moskvin, S.V. and Yagupov, N.A., 2020. Low-level laser therapy for sports horses.
Paterniani, V. and Grolli, S., 2018, April. Approach and potentiality of low level laser therapy in veterinary medicine. In Laser Florence 2017: Advances in Laser Medicine (Vol. 10582, pp. 16-33). SPIE.
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