Acupuncture & physiotherapy in animals: evidence review

What is it?

Acupuncture is the insertion of thin needles at specific body locations with the aim of reducing pain or influencing physiological processes. Physiotherapy is a broader collective term: it encompasses hydrotherapy (underwater treadmill, swimming), photobiomodulation (laser therapy), exercise therapy and manual techniques. In veterinary practice, both forms are increasingly offered in combination, particularly for musculoskeletal complaints in dogs and horses.

Used for what?

The most common indications:

• Chronic pain due to osteoarthritis or muscle problems
• Postoperative recovery, such as after a cranial cruciate ligament operation (TPLO/TTA)
• Neurological rehabilitation, for example after a herniated disc
• Sports injuries in horses: muscle pain, tendon injuries, back complaints

What does the evidence say?

The available research is limited in size and quality. An RCT from 2020 on acupuncture in dogs with osteoarthritis found a statistical signal for pain reduction, but had a small sample size and limited blinding [1]. A narrative review from 2022 concludes that acupuncture has potential for pain management in companion animals, but emphasises the structural lack of standardised, well-controlled studies [2].

For physiotherapeutic modalities the picture is similar. Photobiomodulation (laser therapy) showed positive effects on pain score and mobility in two RCTs in dogs with elbow and joint osteoarthritis [3][4], but the study populations are too small for definitive conclusions. A systematic review of rehabilitation interventions after cruciate ligament surgery in dogs concluded that the evidence for most techniques is only of low to moderate quality [5][6].

Hydrotherapy via the underwater treadmill is widely used and shows improvement in joint mobility in a pilot study [7], but randomised controlled research is largely lacking [8].

Key conclusion: The evidence is weak (grade C). This does not mean that the treatments do not work — but that the scientific basis is insufficient to make clear statements about effectiveness, and about which patients benefit most.

Safety

Acupuncture is generally safe when performed correctly by a authorised veterinary surgeon. Risks are rare but real:

• Local infection or bleeding at the needle site
• Stress or pain during needling, particularly in anxious or painful animals
• Pneumothorax (rare, with needle placement close to the lungs)

Physiotherapeutic techniques such as hydrotherapy and laser therapy have a favourable safety profile provided they are performed by trained personnel. Photobiomodulation is contraindicated in active tumours, active infectious processes and direct exposure of the eyes without protection.

For horses it additionally applies that stress reactions to needle placement can be more severe than in dogs; good behavioural observation during treatment is essential.