Over the past 30 years, and even more so over the past 10-15 years, there has been an increased interest in complementary and alternative therapies both by the veterinary community as well as the clients they serve. These modalities are known as complementary because in most cases they are not and should not be used as primary and sole therapies. Instead when employed they are usually used either in conjunction with traditional western medicine or they are used in conjunction with each other. These therapies include acupuncture, chiropractic, massage therapy, herbal treatments, magnetic field therapy, nutritional therapy, homeopathy and others. This article will focus on chiropractic and acupuncture therapy. A brief discussion of the basic principle of each modality will be followed by a discussion of the use of these diagnostic and treatment methods in managing equine musculo-skeletal ailments.
Chiropractic philosophy is based upon the relationship of the spinal column to the nervous system. This relationship then extends to the role of the spinal column to the nervous system and its effects on biomechanics and movement. Chiropractic examination and palpation focuses on vertebral and muscular lesions indicative of subluxations. A subluxation is defined by chiropractics as a "disrelationship of a vertebral segment in association with contiguous vertebrae, resulting in a disturbance of normal biomechanical and neurological function." Chiropractic practice then focuses on adjustment to the specific segments involved in a subluxation. An adjustment is a specific physical action designed to restore the biomechanics of the vertebral column and indirectly influence neurologic function. These adjustments also can be extended to certain other joints of the limbs such as the ankles and shoulders. There are many "styles" for the physical act of adjusting segments and joints. The styles and techniques used in equine practice, like those used in human chiropractics can vary from mild adjustment to severe manipulation. The more intense and forceful the adjustments the greater are the risks to the patient. Most veterinary practitioners utilize very safe short lever motions to effect their adjustments.
Acupuncture is one of the oldest forms of medical treatment. Acupuncture like treatment is thought to have existed in India as much as 7000 years ago. The practice is thought to have been used in China during the Stone Age approximately 3000 years BC. The use of acupuncture (acus=needle, punctura=to prick) is only one portion of Traditional Chinese Medicine (TCM). The practice of acupuncture is combined within TCM with massage, breathing exercises, nutrition, herbal remedies, and even the philosophies of life. According to TCM the function of an acupuncture exam and treatment is to discover the imbalances of life energy (Qi) within the patient's body (diagnosis) and with treatment (acupuncture) to rebalance this energy. The TCM theories of life energy and balance are well beyond the scope of this article, but it should be noted that some of these concepts are difficult to grasp as they do not relate only to the body and anatomy but also to an ancient view of life forces. Over the centuries many maps of acupuncture points have been documented. Through evaluation and study the ancient practitioners found the points on the body that elicited a response by stimulation of specific anatomic foci (usually neurologic in nature). Currently use of equine acupuncture by western medical professionals is handled in various different ways using various different techniques. The techniques employed, points selected and nature of the treatment will be guided in many cases by a combination of TCM theories and western neuro-physiologic bias. Acupuncture treatments exist for many internal ailments and therapy is not confined to musculo-skeletal issues, as will be discussed in this article. When used to address musculo-skeletal disease in the horse many of the points employed are said to have excessive activity or energy, so that much of the effects of acupuncture in these situations are due to its pain relieving qualities. Furthermore, research has shown that stimulation of acupuncture points to produce analgesia (pain relief) actually increases blood levels of beta-endorphins and serotonin, two bodily substances that are involved in pain relief as well as other functions that help the body to cope with both external as well as internal stressors. In essence even if acupuncture were not targeted at any specific ailment, points addressed in a session could be stimulated for overall pain relief and relaxation.
Both chiropractic and acupuncture examination and treatments can be quite valuable when evaluating and treating lameness and performance issues in the horse. Optimum value is derived when these two modalities are integrated with the more standard lameness detection and diagnosis. In this fashion the orthopedic needs, muscle and soft tissue needs, the spinal column and the neurologic needs are all addressed in a coordinated fashion. This integrated approach is one that is solicited by practitioners that focus mainly on western medicine as well as practitioners that have their roots and foundation in TCM or chiropractics. Although not every horse is going to need all three modalities, many or most horses would benefit from the implementation of at least two of the three methods. The easiest, smoothest and least expensive way to integrate these diagnostic and treatment methods is to work with a veterinarian that is either trained in all methods or has a chiropractor/acupuncturist that works as part of his or her lameness team.
Still several problems inhibit this integrated approach for many patients. These problems include: