Chiropractic and manual therapy in animals

What is chiropractic and manual therapy?

Manual therapy is an umbrella term for hands-on treatment techniques aimed at joints, muscles and soft tissues. In animals, three main forms are distinguished:

• Mobilisation: gentle, repeated passive movements within the physiological range of motion
• Manipulation (adjustment): a rapid, targeted thrust just beyond the passive limit of motion
• Massage and soft-tissue therapy: relaxation of muscles and connective tissue without direct joint manipulation

Animal chiropractic has been conceptually adopted from human medicine, but the anatomy and biomechanics of horses and dogs differ considerably. Specific validation for animal species is limited.

What is it used for?

Commonly used indications include:

• Back pain and reduced freedom of movement in horses (reduced performance, postural asymmetry)
• Joint stiffness and muscle pain in dogs, including after trauma or with ageing
• Recovery after sports injuries or as an adjunct to rehabilitation

What does the evidence say?

A systematic review from 2021 searched the literature from 1980 to 2020 and found only 14 peer-reviewed studies on manual therapy in animals [1]. Thirteen concerned the horse, one the dog; no studies were found for cats. Although all identified studies report positive effects, the quality of the methods was too variable to pool conclusions [1].

A major point of criticism concerns the theoretical basis: the hypothesis that vertebrae 'go out of position' and can be manually put back is not diagnostically substantiated. Measurement methods used to establish such so-called subluxations have not proven to be reproducible or reliable [2]. Optimal technique, indications and treatment frequency have not been established to date [1].

For horses there are indications of an effect on movement patterns, but the strength of evidence is low. For dogs and cats, any solid controlled research is lacking.

Safety and risks

Gentle mobilisation has a relatively favourable safety profile. High-force manipulations can cause serious damage if applied incorrectly or with incorrect indication [2]:

• Spinal cord or brain injury, particularly in animals with a hernia or intervertebral disc disease (IVDD)
• Organ rupture
• Worsening of an existing neurological problem

Absolute contraindications:

Legal framework

In the Netherlands and Belgium, chiropractic in animals may only be performed by or under the direct supervision of a qualified veterinary surgeon [2]. Treatment by unqualified practitioners is legally risky and can be harmful to the animal.

Conclusion

Manual therapy can be considered as an adjunct for certain movement problems, particularly in horses, provided it is performed by an authorised veterinary surgeon with thorough diagnostic preliminary investigation. The evidence is weak and based on few studies of variable quality [1]. Gentle mobilisation techniques are preferable to high-force adjustments. Always discuss the use first with your veterinary surgeon, especially if neurological or oncological conditions have not been ruled out.