Write an article based on this "Understand what physiotherapy refers to. Massage your dog to help relieve pain caused by arthritis. Learn some specific massage techniques. Try passive mobilization. Apply heat to your dog’s arthritic limbs. Talk to your vet about transcutaneous nerve stimulation (TNS)."
Physiotherapy is the treatment of pain based on physical manipulation and non-pharmaceutical means. Massage, passive exercise, transdermal electrical stimulation (TNS), and heat therapy are all physiotherapy techniques that can be used at home. Massage therapy stimulates the muscles around an arthritic joint and increases pressure within the tissue. This pushes fluid out into the blood and lymph vessels, and replacement interstitial fluid is drawn into the vacuum.  This helps remove toxic irritants to the nerve endings that have built up as a result of injury and inflammation. In return, new nutrients soak the area and encourage repair of inflamed joints and sprained muscles. An animal with sore joints has tense, stiff muscles and the tension in the muscles further compresses the joint, making inflamed surfaces rub together, and causing more pain. Massage helps the muscles to relax and stimulates the release of endorphins - a natural painkiller with a similar chemical composition to morphine. If, for example, the hip joint is painful, to massage the hip you should work from the extremity upwards (imagine massaging fluid back towards the heart).  Move the flat of your palm in a rocking motion, applying pressure with the heel of the hand to the thigh muscles, working upwards towards the heart. Slow and gentle movements are soothing, whilst hard and fast movements are stimulating, so for pain relief, one motion every five seconds is ideal. Massage the affected limb for 10-20 minutes, two to three times a day. Mobilization is the act of passively extending a limb with the aim of keeping the muscle conditioned, and the joint mobile. The theory behind mobilization is to stop the cycle of pain that restricts joint movement, which leads to a further loss of movement, and a downward cycle of limb under-use.  Again, taking the example of an arthritic hip, passive mobilization involves gently stretching the affected hind leg backward, away from the head. The owner can do this with the dog in a standing or lying position. If both hips are sore, it is better to lie the dog down since it will be uncomfortable taking extra weight on the opposite hip when one leg is raised. To passively stretch the left hip, lay the dog on its right side, with the left leg uppermost. Slide the left hand in front of the thigh halfway down the thigh bone, and cup the cranial muscles in the left palm. Apply gentle but firm pressure in order to push the thigh backward so that the dog's paw moves backward. Do not force the movement, and stop if the dog gets uncomfortable. Hold this extended position for around 40 seconds and then release. Try to do a 10 minute session twice a day. This helps to keep the joints supple and is pain relieving. The application of heat helps to dilate blood vessels and stimulate the circulation. In turn, this helps to remove noxious toxins that irritate pain receptor nerves.  A simple method is to use a wheat bag, the sort you heat up in a microwave. Follow the manufacturer's instructions to heat the bag, and with the dog lying down with the arthritic joint exposed, rest the warmed wheat bag over the joint. Leave it there for 10-15 minutes, and then follow with some passive movement exercises. Transcutaneous nerve stimulation (TNS) can be performed at home by an owner, provided they have access to basic training and the appropriate equipment.  This involves the application of a small electrical current to the skin in order to numb sensory nerves and block pain transmission. This is achieved by stimulating delta fibers which release enkephalin in the spinal cord, which in turn reduces sensitivity to pain. One 20 minute session can reduce pain for up to 24 hours. The TNS machine is a small handheld battery-powered box attached to two electrodes, which are placed in contact with the dog's skin. Pain is blocked downstream from the electrodes, so to treat hip pain, place one electrode either side of the spine approximately 15 cm (5.9 in) higher than the pelvis.