Can Dogs Help Reduce Pain and Anxiety?
Hospital emergency departments can be stressful, and typical wait times can worsen feelings of pain and heighten anxiety. Researchers wanted to find out if a therapy dog team could increase comfort.
STORY AT-A-GLANCE
Researchers from the University of Saskatchewan examined whether therapy dogs could help reduce pain in adults visiting an emergency room, with promising results
In all, 48% of those who met with a therapy dog experienced a reduction in anxiety, while 43% had reduced pain, 46% had improvements in depression and 41% experienced improved well-being
Participants in the therapy dog group rated pain significantly lower than those in the control group at the post-intervention follow-up
It’s possible that therapy dogs improve patients’ pain via distraction, such that it may not necessarily address the cause of the pain but rather the patient’s perception of pain
Therapy dogs may also have a more direct effect on pain relief by influencing biological markers that correspond to pain, such as cortisol, or via indicators of stress like blood pressure and heart rate
Petting an animal triggers the release of beneficial hormones and neurochemicals like oxytocin, and decreases stress hormones like cortisol
Pain is the No. 1 reason why people visit hospital emergency departments, with 80% of visits made to address pain.1 The environment of the emergency rooms, which frequently have long wait times, can make the pain experience worse and heighten anxiety, which further exacerbates pain.
In 2016, a therapy dog team visited an emergency department at the Royal University Hospital in Saskatoon, Saskatchewan, Canada, for the first time, in part to offer a distraction for patients from long wait times. Since then, therapy dogs have increasing been used to offer comfort and anxiety relief to patients in emergency departments in Canada and the U.S., with studies suggesting the animals helped to relieve patients’ distress.2
Patients also expressed interest in visiting with therapy dogs to reduce anxiety and frustration, increase comfort and satisfaction, and, to a lesser extent, to reduce pain. Researchers from the University of Saskatchewan looked specifically at whether therapy dogs could help pain in adults visiting an emergency room, with promising results.
Therapy Dogs Reduce Pain, Anxiety in ER Patients
In a controlled trial, 211 patients visiting an emergency room with some form of discomfort were allocated to an intervention or control group. Those receiving the intervention spent 10 minutes with a certified therapy dog and its handler in addition to usual care. In all, 48% of those who met with a therapy dog experienced a reduction in anxiety, while 43% had reduced pain, 46% had improvements in depression and 41% experienced improved well-being.3
Overall, participants in the therapy dog group also rated pain significantly lower than those in the control group at the post-intervention follow-up.4 "The emergency room is a hectic place, and as an ER doctor myself, I know that anything we can do to improve the patient experience is welcomed," said study author Dr. James Stempien.5 The researchers further concluded:6
"Clinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients’ experience of pain, and related measures of anxiety, depression and well-being."
In separate research testing whether therapy dogs reduce anxiety specifically in ER patients, significant reductions in anxiety were noted after dog exposure, and the need for pain medication also decreased. Only 1 in 40 of the ER patients who spent time with a therapy dog needed pain medication, compared with 7 out of 40 in the control group.7
How Therapy Dogs Relieve Pain
It’s possible that therapy dogs improve patients’ pain via distraction, such that it may not necessarily address the cause of the pain but rather the patient’s perception of pain. However, some researchers have suggested that therapy dogs may have a more direct effect on pain relief by influencing biological markers that correspond to pain, such as cortisol, or via indicators of stress like blood pressure and heart rate.8
It's also known that petting an animal triggers the release of beneficial hormones and neurochemicals like oxytocin, and decreases stress hormones like cortisol. "Central nervous system mechanisms may be involved through activation of endogenous pain inhibitory processes, and release of pain-relieving neurochemicals such as endogenous opioids and oxytocin," the researchers noted in PLOS One.9
Among patients struggling with chronic pain, dogs also have a beneficial effect, facilitating improved sleeping patterns, bringing joy and encouraging physical activity and community engagement.10
Therapy Dogs Benefit ER Workers, Too
It’s interesting to note that dogs in the ER can benefit not only patients but also ER workers, who often face significant cognitive stress during their shifts, which can quickly lead to burnout. Researchers with the Indiana University School of Medicine found that even five minutes of interaction with a therapy dog is enough to lower stress levels in physicians and nurses working in a stressful ER environment.11
Salivary cortisol levels, a measure of stress, tended to be highest at the beginning of each provider’s shift, then significantly decreased in the therapy dog and coloring groups compared to the no-intervention control group. "This randomized controlled clinical trial demonstrates preliminary evidence that a 5‐minute therapy dog interaction while on shift can reduce provider stress in ED [emergency department] physicians and nurses," the researchers noted.12
The fact that even five minutes with a therapy dog led to improvements shows how powerful the healing effect of animals can be. However, despite the demonstrated benefits, there are some risks to bringing an animal into the ER, such as zoonotic infections, allergies or fear in those afraid of dogs. Dogs should undergo pet therapy certification prior to entering into any animal therapy program.
Fortunately, research has also shown that adverse events are rare when animal-assisted therapy protocols are followed,13 and most people view therapy dogs in emergency rooms favorably. In one survey of therapy dog visits to a university hospital ER, 87.8% of patients and 92% of staff approved of their presence.14
While health care professionals often focus on finding the right medication for treating all patient ills, therapy animals represent an effective "nonpharmacological intervention" that could be increasingly used in hospital settings, not only to reduce pain and anxiety but to increase patients’ motivation to become more active, even in intensive care unit settings.15
As Johns Hopkins rehabilitation psychologist Megan Hosey put it, those puppy dog eyes are hard to resist — "Once you have a dog in the room staring up at you expecting a treat or a pat, it's hard for a patient to avoid engaging."16
Healthypets Disclaimer: This information is for educational purposes only and is not intended to replace the advice of your own veterinarian or doctor. Dr. Karen Becker cannot answer specific questions about your pet's medical issues or make medical recommendations for your pet without first establishing a veterinarian-client-patient relationship. Your pet's medical protocol should be given by your holistic veterinarian.