Arthritis is a disease that affects most species.  Dogs are no exception.  It means that they start with a little inflammation and are sometimes sore, then sometimes stiff, then sometimes it hurts to do certain high-level activities AND THEN, all of a sudden, everything hurts.  What happened?

> Joint damage: secondary to wear and tear and activity that is made worse by any kind of asymmetry like, growth problems (hip dysplasia) or overuse of certain muscles (iliopsoas strain causing back pain) that creates need for joint clean up by the body.
THE PROCESS OF CLEANING UP JOINTS IS CALLED INFLAMMATION.

> Regular inflammation + continual wear >> loss of joint tissue that is painful more regularly and the muscles around the joints start to become strained and restricted.  
THIS IS CALLED MYOFASCIAL PAIN.

> Chronic inflammation causes increased sensitivity of pain receptors and drives maladaptive pain.
AND THIS IS WHEN WE START NOTICING THAT OUR DOGS CAN'T DO STUFF!

So, if we are to manage all of this gracefully, we have to reverse the process and restore the system, and then keep it running smoothly.  That is not too hard to understand, right?

Step 1: Stop the pain cycle - The War On Pain
We have to get it surrounded on all sides.  It is a tough system with many specific receptors that will continue to signal pain despite our first attempt at medications, most often, so we do this in a specific order.
> This phase involves: anti-inflammatory meds + NMDA blocking meds x 3 weeks
> Laser makes a huge difference in pain relief and progress towards healing
> We use some supplements to compliment our pain attack strategy - this is war.

Step 2: Restore tissue function
> We will need to take radiographs and do ultrasound of certain areas of the body so that our targeted therapies with shockwave, acupuncture, laser, and in the rehab gym will actually work.
> We will use shockwave to relieve myofascial pain and restriction and to stimulate healing, this is more powerful with the addition of stem cells or PRP (platelet rich plasma) if there is tendon irritation or damage.
> We will use joint lubrication by injection into the joint to restore glide and cushion for up to two years.

Step 3: We work on symmetry and strength
> Without pain, the body can use muscles it has not been able to activate before.  We can rebuild muscles that have been atrophied and work on core strength as a start.
> Often we transition to supplements in this phase

Step 4:  We do the exercises that strengthen that specific part of the body that was suffering from weakness
> We always start with good core strength to help with transitions in getting up and down, so exercises like three-legged stands and balancing on obstacles are key!

Step 5: Stay well
> Now that we know how pain creeps up, keep it at bay with a good protocol.  Use the anti-inflammatories as meds or supplements right away and call your vet for the rest.
>DON'T LET THIS GET SO BAD THAT WE ARE LOOSING FUNCTION, IT IS EASIER TO WORK ON SMALLER PROBLEMS :)
> Most dogs will do best with annual joint injections, shockwave every 3-6 months, exercises 3 days per week and daily supplements (Just like people ... I know, you are shocked).