{"id":127212,"date":"2024-08-30T20:39:44","date_gmt":"2024-08-30T20:39:44","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=127212"},"modified":"2024-08-30T20:39:44","modified_gmt":"2024-08-30T20:39:44","slug":"small-animal-muscle-function-and-pain-management","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/rehabilitation\/small-animal-muscle-function-and-pain-management\/","title":{"rendered":"Muscle Function and Pain Management"},"content":{"rendered":"
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Abstract<\/b><\/p>\n

The muscular system is a major contributor to pain and discomfort in veterinary patients. Knowing the physiology of how muscle functions when healthy and when injured and being able to recognize patients\u2019 signs of pain and discomfort will help veterinary nurses communicate their observations to the veterinarian, thereby ensuring optimal care and pain relief for the patient.<\/p>\n

Take-Home Points <\/b><\/p>\n

    \n
  • Knowing muscle physiology and how muscle functions to achieve movement will help with patient assessment and treatment plans.<\/li>\n
  • Patient examination and evaluation for pain and discomfort should include evaluation of the musculature.<\/li>\n
  • Many manual therapies and physical modalities are available to treat patients for muscle pain and discomfort.<\/li>\n
  • Referring a patient to a certified rehabilitation specialist can help achieve a more tailored plan.<\/li>\n<\/ul>\n<\/div><\/div>\n

    A<\/span>lthough muscle makes up much of the body, the muscular system is often neglected during assessment of a patient for pain and discomfort. The complex muscular system, which is responsible for complicated movements, cardiac and respiratory function, and even some gastrointestinal function, can be compared to a spider web. When the muscular \u201cweb\u201d is intact (i.e., the body has no muscle pain or injury), signals (i.e., the \u201cspider\u201d) can travel from the muscle to the central nervous system (CNS) without difficulty. When the \u201cweb\u201d is healthy and completely intact, it can function at optimal capacity and serve the \u201cspider\u2019s\u201d needs for catching food and protecting itself. Similarly, when muscles are healthy and pain free, they can properly communicate signals to the CNS and surrounding musculature to complete necessary functions (e.g., maintaining posture, providing stability, sensing pain, creating movement). Much like a spider web, if the muscle is damaged, it cannot send appropriate signals to the CNS, which affects sensory input and motor output. If the musculature \u201cweb\u201d is disrupted, the patient displays abnormal movement, which can lead to pain and discomfort. This article describes how to identify painful patients, the physiology of muscle pain, and therapeutic modalities for treating muscle pain.<\/span><\/p>\n

    Identifying Muscle Pain<\/h2>\n

    When patients arrive at the clinic, thorough physical and visual examination is needed to properly assess them for muscle pain. Observing a patient\u2019s walk in the exam room can provide valuable preliminary information. Before the physical examination is completed, visual assessment can help indicate if the patient is experiencing underlying muscle pain (<\/span>BOX 1<\/b><\/span>).1-4<\/sup><\/span><\/p>\n

    BOX 1 Questions to Ask Yourself While Visually Assessing a Patient<\/div>
    Positive (yes) answers indicate that the patient is experiencing muscle pain\/discomfort.<\/p>\n
      \n
    • Is lameness apparent?<\/li>\n
    • Is muscle atrophy apparent?<\/li>\n
    • Does the patient have worn nails (indicating knuckling or paw dragging)?<\/li>\n
    • Does the patient shift weight on or off a certain limb when it stops moving?<\/li>\n
    • Can any paw pads be seen from behind the patient (indicative of uneven weight bearing)?<\/li>\n
    • Does the patient lie down quickly after standing for short periods?<\/li>\n
    • Does the patient have difficulty going from a sitting to standing position or vice versa?<\/li>\n
    • Does the patient sit squarely with both legs tucked underneath the pelvis, or does 1 leg go out to the side?<\/li>\n
    • Does the patient seem to guard a certain area of the body or act uncomfortable in the room?<\/li>\n
    • Are muscle fasciculations seen?<\/li>\n
    • Does the patient hold its head low when walking?<\/div><\/div><\/li>\n<\/ul>\n

      During the physical examination, veterinary nurses can assess heart and respiratory rates, which are elevated in animals experiencing pain.5<\/sup> Placing hands on a patient and gliding them over body structures may help detect areas that feel warmer or may be swollen, possibly indicating local inflammation. A complete orthopedic examination includes evaluating the gait<\/a>; checking joint range of motion during flexion and extension; adducting and abducting the shoulder and hip joints; listening for sounds of crepitus (clicking or popping) during joint manipulation; assessing resistance when manipulating a joint past its normal resting position; and looking for signs of joint thickening, buttressing (scar tissue buildup at the joint capsule), effusion, and\/or instability (e.g., cranial cruciate ligament disease, patellar luxation, hip dysplasia, shoulder). <\/span><\/p>\n

      If indicated based on the presenting complaint, special tests should be completed (e.g., checking for cranial drawer, tibial thrust, Ortolani and other joint stress tests).1-3,6<\/sup> <\/span><\/p>\n

      The muscular system should be palpated for myofascial trigger points (areas in the muscle and surrounding tissue where disrupted muscle fibers have led to taut bands that are associated with pain and discomfort).7 <\/sup>Patients with myofascial trigger points<\/a> often exhibit muscle fasciculations or will try to move away from palpation of those tender areas (<\/span>VIDEO 1<\/b><\/span>).7<\/sup> Postural evaluation of weight distribution can be checked by lifting individual limbs while the patient is standing still. If the patient is compensating by weight shifting to another area of the body, that limb will be easier to lift, indicating that the patient is not willing or able to bear the appropriate weight on the lifted leg.1<\/sup> <\/span><\/p>\n