A Multimodal Approach to Pain management 

At the Sams Clinic our focus is the diagnosis of painful conditions, acute and chronic, and their treatment, using multiple modalities, including lifestyle approaches such as diet, exercise, supplementation as well as physical therapy. Having an orthopaedic surgeon, a pain management specialist and a canine rehabilitation therapist in the same clinic gives us a great advantage in caring for our patients with chronic pain.

Chronic Pain

Because pain is a clinical symptom of an underlying condition or disease, to treat it effectively, it’s essential to accurately diagnose the underlying condition or disease before proceeding to the treatment. By far the most common form of chronic pain in small animals is osteoarthritis (OA). It’s estimated that OA affects 20% of all dogs in the U.S. Somewhere between 15 and 20 million dogs. OA is a complex disease that varies widely in its severity and clinical presentations.

We’ve listed some of the chronic pain conditions we treat at The Sams Clinic. If you don’t see your pet’s condition, please call us.

  • Osteoarthritis Pain
  • Myofascial Pain
  • Cancer Pain
  • Neuropathic Pain
  • Intervertebral Disc Disease
  • Low Back Pain
  • Chronic Ear Pain, associated with infections
  • Chronic Eye Pain, associated with glaucoma or corneal ulceration
  • Chronic Episodic Pancreatitis


Dr. Hawley’s approach to acupuncture is grounded in successful clinical results. Where traditional acupuncturists see meridians Dr. Hawley sees nerve pathways. By placing needles at specific points along these pathways, he triggers small, localized inflammatory responses that stimulate the body’s natural healing response and override pain.

Acupuncture is an ancient medical technique utilizing the body’s own homeostatic pathways to promote healing and pain relief. It has been used by practitioners in Eastern Asia for millennia and has evolved over time. Fairly recently, Western medicine has come to embrace the benefits of acupuncture as well – especially in the realm of pain control where it has been found to be particularly effective. Acupuncture can be an important part of a multimodal approach to pain control for both humans and animals.

Most veterinary patients do see significant benefits from acupuncture. Benefits experienced may be specific, such as decreased limping and improved mobility, or more general, such as appearing more content or having greater enthusiasm for life. Acupuncture sessions are usually 45 – 60 minutes and the needles remain in the patient for around 30 minutes.

Pharmacological Therapy

We realize that you may have concerns about medicating your pet. In taking advantage of the huge potential pharmacological therapy has to diminish pain, at The Same Clinic, we purposefully use a number of medications for a patient. This allows us to reduce the dosage of each medication, thereby limiting the side effects of each.

Other Modalities

  • Shockwave Therapy: Shockwave therapy (also known as extracorporeal shockwave therapy) uses sound energy to promote healing in damaged areas of the body. It is commonly used in human medicine to treat plantar fasciitis and tennis elbow. There is some evidence that, along with healing diseased tendons, shockwave therapy can help with bone healing and treating arthritis as well. The exact mechanism by which shockwave therapy works has yet to be elucidated. However, in our clinical experience, many patients have both a reduction in pain and an increase in function leading to better mobility and greater activity as a result of treatment.

  • Hydrotherapy: The Sams Clinic offers canine conditioning and post-operative surgical care through our state-of-the-art underwater treadmill. Therapy with the underwater treadmill can be particularly beneficial as our rehabilitation specialist can customize the amount of weight a particular joint bears.

  • Lifestyle Modification: A significant portion of dogs that have chronic pain conditions stemming from osteoarthritis are overweight, so losing weight may help to decrease the pain associated with OA. Additionally, specific diets and nutritional supplementation have been shown to help. Controlled exercise and environmental modifications can improve the quality of life for both you and your pet.

  • Cold Laser Therapy: When surgery or pharmacological therapies are not recommended, low intensity cold laser can be an excellent alternative. It stimulates blood flow in the treated areas, which can decrease pain and inflammation and stimulate healing.

  • Platelet Rich Plasma (PRP): (PRP) injection is a newer method of treating pain and inflammation associated with joints, tendons, and muscles. PRP injection utilizes the body’s own anti-inflammatory products to encourage healing and reduce pain. Platelets, a component of blood involved in clotting and healing of damaged tissues, are harvested from a sample of the patient’s blood using a special centrifuge. The platelets, in the form of PRP, are then injected at the specific area of damage, such as an arthritic joint or inflamed tendon, to promote healing.

  • Stem Cell Therapy: Vet-Stem®isolates regenerative cells from your pet’s own fat for treatment of tendons, ligaments and joints. It can be effective in reducing chronic pain due to conditions such as OA.

  • Transcutaneous Electrical Nerve Stimulation (TENS): This therapy can potentially reduce chronic or acute pain, especially in cases where the desired treatment does not include surgery or medications. The electrical signals from the TENS devise override pain signals going to the brain and spinal cord. This break in the cycle can reduce the pain sensation and lead to an increase in comfort.

  • Injections: Injecting medications into specific joints or the epidural space provides the opportunity to locally reduce inflammation and pain while avoiding systemic effects. Use of joint and epidural injections to relieve pain is widespread in human medicine and can also be a very effective tool to help our animal companions.
  • Myofascial Trigger Point Therapy: Massage, acupuncture, cold laser and trigger point injections can relieve painful soreness in overworked muscles. Young performance dogs or older dogs dealing with orthopaedic and/or neurologic disease can benefit from trigger point therapy.