CAM blogs

CAM Meets David Levine

David Levine, PT, PhD, DPT, CCRP, FAPTA
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy

Dr. Levine received a Bachelor of Science in Physical Therapy from the University of New England, a Masters in Orthopaedic Physical Therapy from Boston University, and a doctorate in Physical Therapy from the University of Tennessee where he also received his PhD.

Dr. Levine is a professor and the Walter M. Cline Chair of Excellence in Physical Therapy at the University of Tennessee at Chattanooga. He is an adjunct professor at the University of Tennessee’s College of Veterinary Medicine and North Carolina State University’s College of Veterinary Medicine. In addition, he is board certified as a specialist in orthopaedics by the American Board of Physical Therapy Specialties and is also certified in dry needling. His practice in canine rehabilitation is at VCA RIVER in Chattanooga and Signal Mountain Animal Hospital.

Dr. Levine has been working and conducting research in animal physical rehabilitation since 1993 and is co-director of the University of Tennessee’s certificate program in canine rehabilitation. He is a co-editor of multiple books, including Canine Rehabilitation and Physical Therapy, Essential Facts of Physiotherapy in Dogs and Cats, and Gait Analysis: An Introduction. He has presented at over 100 conferences, and has lectured in more than a dozen countries. Dr. Levine has published in numerous peer-reviewed journals with over 100 publications. His latest research focuses on canine rehabilitation, clinical infectious disease, animal assisted therapy, and laser to improve muscle endurance.


Dr Levine kindly agreed to answer the following questions:

How do you feel we currently manage arthritis in dogs?

While we have numerous non-surgical pharmacological and non-pharmacological treatments that have been shown to decrease pain and improve function we have no known cure or proven strategies to prevent the progression of osteoarthritis. I think we can do a lot more.


How do you feel we could improve the management?

It starts with early recognition so that we are treating it in the early stages versus late stage OA. I also believe that we should be treating osteoarthritis as a serious disease and not an inconvenience that just happens. Its impact on function is tremendous and obviously it is one of the most common things we see on a daily basis. Multimodal treatment and weight loss/exercise should be more commonly used. How the patient is exercised should be looked at carefully to make sure it is appropriate. Home modifications are also sometimes overlooked.


 What do you feel the future holds for OA management?

Emerging biological therapies including regenerative medicine may play a bigger role. Molecular targets implicated in angiogenesis and neurogenesis and antibody-based therapy, growth factors, calcitonin, kartogenin, etc. all hold some promise. Of course that’s the research answer but clinically we could use a few good clinical trials in dogs that show how weight loss and regular exercise improve function and decrease pain in OA!


If you could give an owner one tip what would it be?

I think my one tip would be to treat osteoarthritis as a serious disease and to begin treating it as soon as it is noticed. Often times it is just looked at as part of ageing but this does not allow us to treat it most effectively.



We clearly know that osteoarthritis is highly prevalent worldwide and the prevalence of it has been increasing steadily. We know that it causes a significant impact on the life of those living with the disability and many years of life are lost in both people and dogs. It also has a significant impact on comorbid conditions. We don’t have much in the way of proven interventions to stop the progression and there is of course no known cure. The current therapies have a small effect on the disease and are costly and have the potential for adverse effects. In the US, the cost of OA in humans exceeds 100 billion per year!

Osteoarthritis is a serious disease in both humans and animals and it should be regarded as such.


David Levine, PT, PhD, DPT, CCRP, FAPTA
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy
Professor and Walter M. Cline Chair of Excellence in Physical Therapy
Department of Physical Therapy
The University of Tennessee at Chattanooga
615 McCallie Ave Dept #3253
Chattanooga, TN 37403

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