Rehabilitation of Intervertebral Disc Disease (IVDD)
Conservative Management of IVDD
There are many dogs diagnosed with intervertebral disc disease that do not require surgery. These dogs can be effectively managed with rehabilitation. Early intervention and support is vital as is a thorough assessment and implementation of a staged rehabilitation treatment plan.
Physiotherapy Aims
In the initial stage following diagnosis of IVDD the aims of physiotherapy will be to:
- Reduce inflammation
- Reduce pain and spasm
- Maintain soft tissues flexibility
- Improve core strength
- Stimulate sensory input
- Re-train postural responses
These above aims continue and progress with time depending on your dogs progress. Aims will ultimately develop to include the following:
- Further strengthen core stability
- Facilitate effective gait
- Increase exercise tolerance and overall cardiovascular fitness
- Return to normal function
Physiotherapy Options
Many different physiotherapeutic modalities can be employed when rehabilitating a dog undergoing conservative management of IVDD. Possible options might include – laser, or and cold therapy, massage, range of motion exercises and stretches, muscle stimulation, hydrotherapy, home exercise program and advice re injury prevention.
The following table is an example of a rehabilitation programme our chartered physiotherapists may use with your dog:
| Time Scale | Physiotherapy Aims | Physiotherapy Treatment options |
| 0-4 weeks | Reduce inflammation | Electrotherapy – Laser |
| Reduce muscular guarding |
|
|
| Improve core stability | Home exercise program | |
| Increase strength |
|
|
| Increase sensation and awareness of body position | Home exercise program | |
| Maintain soft tissue length and flexibility | Home exercise program – passive movements and stretches | |
| Management at home |
|
|
| 4-6 weeks | Continue as above | Progression of home exercise program to challenge balance, body awareness and strength |
| Advice on maintaining restricted exercise when dog feeling better | ||
| 6 – 12 weeks | Increase exercise tolerance | Increase exercise level |
| Continue to increase core stability | Home exercise program | |
| 12 weeks + | Return to full function | Progress to off lead exercise and previous exercise level |
Post-Operative Management of IVDD
Rehabilitation has a very important role to play during the recovery of a patient following surgery for intervertebral disc disease. Early intervention is crucial. The aims and treatment approach will vary depending on the level of disability your dog has and also the timescale following surgery. The key aims and treatment options are listed below. Your dogs chartered physiotherapist will constantly re-evaluate progress and adjust the program accordingly.
Physiotherapy Aims
Initial phase post op:
- Reduce inflammation
- Reduce muscle spasm
- Maintain soft tissue flexibility
- Increase sensory awareness
- Increase strength
- Advise owners of home care management requirements
Weeks 4-6:
- Activate core muscles
- Progress with the above aim
- Improve balance and coordination
- Enhance gait patterns
Week 6 ongoing:
- Increase exercise tolerance and cardiovascular fitness
- Increase core stability and strength
- Return to normal function
Physiotherapy Options
Similar physiotherapeutic modalities to conservative management of IVDD can be employed when rehabilitating a dog following surgery. Possible options might include – laser, hot and cold therapy, massage, range of motion exercises and stretches, muscle stimulation, hydrotherapy, home exercise program and advice re injury prevention. The following table is an example of a rehabilitation programme our chartered physiotherapists may use with your dog
| Time Scale | Physiotherapy Aims | Physiotherapy Treatment options |
| 1-2 weeks | Reduce inflammation |
|
| Reduce muscular guarding |
|
|
| Maintain soft tissue length and flexibility | Exercise program – passive movements, stretches, joint mobilisations | |
| Prevent bed sores (decubital ulcers) if recumbent | Regular position changes | |
| Increase sensation and awareness of body position | Exercise program – proprioceptive stimulation | |
| Increase strength |
|
|
| Improve independence with postural sets | Exercise program – Lying, Sitting, standing with support if required | |
| Improve Core stability | Exercise program – Balance challenges, baited stretches | |
| Assist Owner with Management at home | A discharge appointment with a chartered physiotherapist will be arranged to explain about keeping your dog confined, assisting to walk and to demonstrate exercises to continue at home | |
| 2-4 weeks | Progress strengthening |
|
| Improve balance and co-ordination | Exercise program – Balance challenges, baited stretches | |
| Ensure correct movement patterning | Exercises to address any movement compensations | |
| Maintain full passive range of movement at all joints and soft tissue flexibility | Exercises and stretches | |
| Improve mobility | Gait re-education | |
| 4-6 weeks | Continue as above | |
| 6-12 weeks | Increase exercise tolerance |
|
| 12 weeks + | Return to previous exercise level | Advice re progression of exercise aiming to off leadAdvance strengthening and proprioceptive training specific to dogs functional needs |
Hydrotherapy Options
Hydrotherapy is invaluable when rehabilitating patients following surgery. The buoyancy of the water supports the patient against gravity and allows effective exercise to take place. The warmth of the water provides a source of relief for any discomfort present and the hydrostatic pressure assists in swelling reduction.