The 5 Principles of Pain
The 5 Principles of Pain is a really useful aid for identifying symptoms of little, or big, musculoskeletal niggles that your dog might be showing.
These Principles are:
Gait
Posture
Behaviour
Activities of Daily Living - ADLs
Performance
This Blog will explain a little bit more about each Principle.
1 - Gait
The gait of a dog can give us lots of information on how he or she is feeling; it is the most obvious sign that something might be wrong. A yelp followed by a limp out on a walk makes it really clear that something isn’t right but, on the other hand, how often do you watch how your dog moves whilst on a walk?
We are so lucky here in Aberdeenshire as we have beautiful sandy beaches and, often, snow in the winter (or lots of mud!). Looking at your dog’s paw prints in the sand or snow you can notice issues. By watching prints from walk, to trot, to run closely you might become aware that they are dragging a paw, maybe they have done this all their life and you didn’t realise! This certainly doesn’t make you a bad owner! Paw dragging is often seen in an older arthritic dogs but younger ones can do this too.
A change, or a slightly unusual ‘normal’ gait, can have repercussions. Muscles, soft tissues and skeleton work together. A niggle in one area will need to be compensated for in another. Tight muscles restrict movement and blood flow, which then means that those muscles cannot be fed properly causing further tightness and a never ending cycle begins with pain being the most obvious outcome.
Here are a few things to look out for:
- Limping or carrying a leg or paw
- Stiff when moving
- Slowing down on walks
- Throwing a leg - inwards or outwards
- Pacing
- Hopping or skipping
- Lack of drive
- Crabbing (back legs not in line with front)
- Reduced range of movement
2 - Posture
Ideally your dog wants to have equal weight on all four legs and a nice straight back with their head up. This way all limbs, and muscles, are probably working normally.
If you have ever had an older arthritic dog you may have noticed that if they are stood for a while their back legs will start to lower to the ground. A younger dog should be able to stand for a longer period of time. If they find this difficult they may lay down quickly, to reduce pressure on their limbs.
Perhaps one of your dog’s back legs doesn’t seem to be taking a lot of weight? This might be because of a problem with the cruciate ligament, which sits behind the knee cap and attaches the thigh and the shin bones (femur to tibia).
Another issue is when a dog’s spine isn’t straight, perhaps the spine humps like a hill or dips like a bowl. This is sometimes called roaching (hill) or swayback (bowl); more technically it is kyphosis or lordosis.
Some changes may not be so obvious; whilst cutting your dog’s nails you may never have noticed that your friend has uneven nail wear. Uneven nail wear can reveal poor posture or gait caused by a muscular issue.
Here are a few things to look out for:
- Coat changes such as flicking up of fur
- Back like a hill or bowl (kyphosis or lordosis)
- Twitching or 'shivery’ skin
- Not able to stand for long
- ‘Hopping’ from one foot to another
- Changes in tail carriage (such as swimmers tail)
- Not all limbs taking equal weight
- Low hung head, looking ‘sad’
- Uneven nail wear
- Hip or knee rotation so that your dog sits will a knee pointing outwards
3 - Behaviour
Everyone is allowed to have a grumpy day, but could this be based in pain? Like us your dog can get cranky or wish to hide away if they are feeling unwell.
Let’s use the analogy of the filling bucket. If you haven’t heard of it here is the premise: every day, every minute, things happen or you come across things that add water to your bucket. This might be being late to meet someone, your kid annoying you, banging your hand on a cupboard door, a headache, any infinite little annoyances that happen throughout the day. All of these things keep topping up your bucket and at some point your bucket is going to overflow; it is then that you might get angry, scream, cry, seek isolation, or all of them!
Now imagine you start the day with your bucket already half, or more, because of chronic pain.
Here are a few things to look out for:
- Reluctant to be petted
- Reluctant to be groomed
- Not wanting harness or collar to be fitted
- Disinterested in life
- Looking depressed or loosing their spark
- Isolating themselves
- Self mutilation - such as nibbling
- Excessive licking of a certain area
- Snapping or growling when touched
- Snapping at other dogs to tell them to stay away
- Anxiety
- Frequent rolling on the back
4 - Activities of Daily Living (ADLs)
Dogs are known to be stoic so how can we know if they are in pain or discomfort? One way is by looking at the their everyday life; how they perform their activities of daily living. One of the first things an owner might say to me is that their dog seems to be having a little difficulty getting up onto the sofa or bed, that they need a running jump or they sometimes miss with their back legs. These, and others, are little tale tell signs that something is going on.
Sometimes these changes are so small you don’t even noice them happening. Maybe your dog goes out for a lovely walk, then settles down to sleep. Perhaps when they wake up they look stiff and have to stretch to get moving again? Maybe this stiffness lasts a few minutes, maybe for the rest of the day, but by the morning they are right as rain and ready for a walk again!
Some changes may be mistakenly identified as your dog just showing their age, such as slowing on a walk or walking behind you, or just a wee quirk, like making a meal out of coming down the stairs.
Here are a few things to look out for:
- Struggling to get up onto the sofa
- Having difficulty getting up and down stairs
- Not settling or pacing at night
- Weakness in the back legs
- Struggling or slowing on walks
- Difficulty standing from lying down
- Slipping or being unbalanced
- Lying down to eat
5 - Performance
This principle may be more useful for working dogs or those that enjoy ‘extra curricular activities’ such as agility, flyball or scent work.
Changes in the way your dog ‘performs’ may reveal that they are in pain. These changes may not be obvious, it could be as simple as they are getting fatigued quicker than you think they should. I am sure you also find that you get more tired quicker if you are sore; there is nothing better than curling up in a warm bed if you’re not feeling quite right - and the same goes for your dog.
If sore your dog will always go for the less painful option. For example, in agility this may mean they come out of the weaves early, or stop doing them at all, perhaps they start turning wide or start to pole knock. Maybe they are becoming reluctant to work at all or it seems to take them a while to get going.
As much as we think our dog is just being stubborn or having an off day, maybe they are actually trying to tell you something?
Here are a few things to look out for:
Gun / Working Dogs:
- Early onset fatigue
- Retrieval issues
- Reluctance to work
- Stiffness after a long day
- Takes time to ‘get going’
Agility:
- Pole knocking
- Weave issues
- Contact issues
- Lack of drive
- Measuring
- Turning wide
Flyball:
- Turning wide on box
- Missing jumps
- Measuring
Rally Obedience:
- Taking a long time to get into position
- Reluctant to sit
- Reluctant to down
- Wide turns
Some of the symptoms of the 5 Principles of Pain may cross-over with symptoms of other diseases that are not of musculoskeletal origin so please do seek a diagnosis from your vet.