Chiropractic care for horses is a form of manual therapy commonly used in veterinary treatment protocols for lameness. Chiropractic treatment focuses on joint mobilization and manipulation to reduce pain, improve symmetry, and increase range of motion. [1]

Many owners use chiropractic treatment as part of routine care and maintenance for their horses to improve performance and reduce the risk of injury. Chiropractic is safe when performed by a trained professional.

Equine chiropractic treatment may reduce back pain, neck pain, and some types of limb lameness. Currently, treatment of back and neck pain in horses has the most research supporting the use of joint mobilization and manipulation.

Studies also show these treatments can increase flexibility, which may benefit performance.

Equine Chiropractic

Chiropractic care for horses is a therapeutic approach that focuses on addressing misalignment and dysfunction of the musculoskeletal system.

Chiropractic treatment involves moving a joint through its range of motion for therapeutic benefit. [1] Moving a joint into different zones within its normal range of motion can stretch surrounding soft tissues or treat reduced range of motion within the joint itself. [1]

Range of Motion

Joints in the horse’s body have three possible ranges of motion: active, passive, and anatomical limit.

Active range of motion refers to the range of movement occurring in the joint as the horse’s muscles move normally. [1] Typically, this is a small range of motion, as the tissues surrounding the joint naturally prevent it from extending or flexing excessively. [1]

Passive range of motion is the range possible when a chiropractor places gentle pressure on the joint during flexion or extension, pushing it beyond the active range of motion. [1] The practitioner can feel an elastic resistance to further movement in a normal joint, whereas an abnormal joint may show abrupt resistance. [1]

The anatomical limits are the absolute maximum degree of movement a joint can tolerate without injury. [1] Excessive force or abnormal movement patterns can force a joint beyond its anatomical limits, resulting in damage to joint cartilage and soft tissues. [1]

Chiropractors performing joint manipulation push the joint up to, but not beyond, its anatomical limits as part of treatment. [1] Due to the risk of tissue damage, only trained professionals should conduct chiropractic manipulations.

Chiropractic techniques

There are two major components to veterinary chiropractic treatments in horses: joint mobilization and joint manipulation. [1]

Joint mobilization refers to repetitive movement of the joint through its passive range of motion to stretch the connective tissues and ensure symmetry of the joints. [1] The goals of these treatments are pain reduction and improved mobility. [1]

Joint manipulation refers to the application of rapid, controlled force to manipulate a joint beyond the passive range of motion, up to its anatomical limits. [1] These treatments address local pain and joint stiffness. [1]

It is important to note these techniques can damage tissues if performed improperly, which underscores the importance of working with a qualified practitioner. [1]

Musculoskeletal Examination

Chiropractic treatment involves an evaluation of the entire horse’s musculoskeletal system to determine the range of motion of their joints and guide treatment. [1]

Areas that may benefit from treatment typically show symptoms such as: [1]

  • Weakness
  • Asymmetry
  • Reduced or excessive joint motion
  • Muscle spasms when moving the joint

Practitioners typically start at the head, then move towards the tail during evaluation. [1] Specific locations of focus include: [1]

  • Movement of the jaw and hyoid bones (bones attached to the tongue)
  • Flexion, extension and bending of the joints between the neck vertebrae
  • Movement in the thoracic spinal column
  • Bending, flexion and extension of the lumbosacral (lower back) area
  • Movement in the pelvis
  • Movement of the limbs in all directions

Spine

To assess the spinal column, practitioners may watch the horse performing normal activities such as lying, standing, and moving to examine active range of motion. [2] Carrot stretches can also help with evaluating motion of the head and neck. [2]

Additionally, veterinarians use spinal reflexes, stimuli that trigger bending of the spine, to evaluate the spine’s movement and identify any evidence of spinal pain. The main techniques for triggering spinal reflexes are: [3]

  • Pressure on the ventral sternum
  • Simultaneous girth and croup pressure
  • Pressure at the junction between the sacrum and the caudal vertebrae
  • Gentle traction on the tail

Passive range of motion in the spine is evaluated by palpating each vertebra (spinal bone) individually, moving them side to side one at a time. [2] To accomplish this, the practitioner must use blocks or a stool to elevate themselves above the horse’s back so they can place downward pressure on either side of each vertebra. [1]

Pelvis

To evaluate the pelvis, pressure is applied to the points of the hip and buttock to “rock” the pelvis. Pressure on the top of the croup can also provide information to help evaluate pain in the sacroiliac joint. [1]

Limbs

To assess the limbs, practitioners move each joint through its active range of motion in flexion, extension, and internal and external rotation. [2] By applying gentle pressure, they can evaluate passive range of motion at the same time. [2]

Often, equine chiropractors repeat the musculoskeletal examination after treatment to determine the effectiveness of manipulations performed and identify any areas requiring further treatment. [1]

Mad About Horses
Join Dr. Chris Mortensen, PhD on an exciting adventure into the story of the horse and learn how we can make the world a better place for all equines.
Apple Podcasts Spotify Youtube
Mad Barn - Equine Nutrition Consultants

Effects on Tissues

Joint mobilization and manipulation techniques stimulate the skin, fascia (connective tissues), muscles, ligaments, and other soft tissues surrounding the joints. [1] These techniques also affect blood vessels and lymphatics, which are responsible for fluid drainage, potentially reducing swelling in tissues after treatment. [1]

Tissue stimulation through chiropractic treatment may improve rehabilitation outcomes such as healing time and integrity of repaired tissue. Under healing conditions, tissue repair and remodeling rely on stimulation of cells through use of the joint to restore normal flexibility and strength. [1]

For this reason, many practitioners believe chiropractic is most effective during the early healing stages, while tissue repair is still occurring. [1]

Chiropractic techniques may also stimulate nerves in the area responsible for pain [1] Mechanoreceptors, specialized sensors that respond to touch and pressure, may also be “reprogrammed” by chiropractic treatment, allowing for restoration of normal movement patterns in horses with chronic pain or stiffness. [1]

Clinical Use

Veterinarians primarily use joint mobilization and manipulation to treat musculoskeletal conditions, particularly those affecting the joints or surrounding tissues. [1]

These treatments are often recommended for recurring or long-term lameness issues, particularly if response to conventional treatments is poor. [1]

Horses with the following symptoms may benefit from chiropractic treatment: [1][4]

  • Muscle spasms
  • Poor performance
  • Pain when saddling
  • Whole body stiffness
  • Abnormal gaits not associated with obvious lameness

Common findings on physical examination in horses that may benefit from chiropractic treatment include: [1][4]

  • Inability to stand square on all four limbs
  • Back or neck pain
  • Reduced range of motion in a joint
  • Scarring or contraction of soft tissues around an injured area
  • Pelvic asymmetry

Joint Mobilization vs. Manipulation

The use of joint mobilization versus manipulation in chiropractic treatment depends on the characterization of joint dysfunction or disease in the affected horse. Factors to consider include: [1]

  • Training and skill of the practitioner
  • Risks to surrounding tissues
  • Whether the injury is new, highly painful, or inflamed
  • Location of the injury

Scientific Evidence

There are several studies and case reports on using chiropractic to treat various conditions in horses. However, there are few studies examining the effect of chiropractic treatment in comparison with other treatments or compared to horses that did not receive chiropractic treatment.

More research is necessary to determine the efficacy of chiropractic treatment in horses.

Back and Neck Pain

Chiropractic treatments are a common component of treatment for back and neck pain in horses, particularly joint manipulation methods. [1]

One study showed that spinal manipulation improved spinal flexibility and pain tolerance in the thoracic spine of treated horses. Spinal manipulation was also more effective compared to spinal mobilization techniques. [1]

Chiropractic treatment of back or neck pain in horses typically involves once weekly treatment for three weeks, but more frequent sessions may be recommended depending on the case. [3]

In human medicine, a tiered treatment guideline is often used when treating back pain. [3] Based on these guidelines, some veterinarians place chiropractic treatments in the first tier of back pain treatment for horses, alongside acupuncture, stretching, and laser therapy. [3]

If horses fail to respond to these initial treatments, then more advanced diagnostics and aggressive treatment plans are warranted. [3]

Muscle Pain

Studies on the efficacy of chiropractic in treating muscle pain in the back are variable.

One study in Western performance horses with sudden onset back pain showed an increase in muscle pain after several spinal manipulation treatments over 3-5 days, suggesting that their symptoms were aggravated by treatment. [4]

Similarly, another study showed no improvement in pain scores after three spinal manipulation treatments. [4]

However, other studies indicate that chiropractic treatment can improve back pain. One study showed that a single spinal manipulation treatment relieved the pain reaction to pressure on the back in treated horses for up to three days after treatment. [9]

Another study showed an increased pain threshold along the back in horses treated with chiropractic methods compared to untreated horses. [5]

Flexibility and Range of Motion

Most studies on spinal manipulation in horses show improvements in flexibility and range of motion of the spine after treatment.

Two studies showed a 15% improvement in spinal flexibility, measured by the degree of vertical movement achievable, after spinal manipulation treatment. [14] Horses receiving once weekly spinal mobilization sessions had a 40% improvement in vertical movement after three weeks of treatment. [4][6]

Gaits and Movement

Most studies show no significant effects of spinal manipulation on gaits and movement in horses.

One study evaluating vertebral and pelvic motion in ridden horses with back pain showed variable changes after one spinal manipulation treatment. [4][7] The range of motion of the spine and pelvis, as well as the symmetry of pelvic motion, increased directly after treatment.

However, three weeks after treatment, these values were below the baseline measurement likely due to recurrence of back pain. [4][7] Chiropractic treatment did not have a significant impact on stride length or stride duration. [7]

A study of 38 hunter-jumper horses showed that chiropractic treatment did not affect stride length, stride symmetry, or stride rate. [8] Despite this, riders, who were unaware of which horses had received chiropractic treatment, reported improved quality of work in the horses who received chiropractic treatment compared to those that did not. [8]

Another study showed no changes in lameness scores in ridden horses after spinal manipulation treatment. [4][9] This study did show that chiropractic alters muscle function for at least 72 hours after treatment, but the significance of this change is unknown. [9]

Performance Effects

Most studies that assess the effects of chiropractic treatment through surveys of horse owners report positive outcomes. However, these studies are prone to error and may not accurately represent the efficacy of treatment.

One study reported that spinal mobilization techniques improved symptoms in 95% of horses within two weeks of treatment, based on owner responses. [15] Similar findings were reported in a longer-term study evaluating improvement at six months after chiropractic treatment. [16]

Another survey-based study reported that 90% of horses returned to work within 6-12 weeks after chiropractic treatment. [14] These findings may be of particular interest as all horses in this study previously did not show significant improvement following conventional treatment methods. [14] At 12 months after initial chiropractic treatment, 53% of horses were performing at their previous level, 31% were performing at a lower level, and 16% were unrideable. [14]

Limb Lameness

Many veterinarians use chiropractic treatment to address lameness originating from the limbs. Chiropractic may be particularly beneficial in cases that are not responding to conventional veterinary treatments, or that are recurring after treatment. [1]

There are few formal studies examining the effects of chiropractic treatment on limb lameness in horses. [10] One small study on 10 sound horses showed that chiropractic treatment can increase the range of motion in the knee and hock. [11]

More research is needed to determine whether chiropractic treatment is effective in treating limb lameness.

Selecting an Equine Chiropractor

Equine chiropractic treatment is an unregulated industry, with no official licensing or education requirements needed to perform equine chiropractic work.

Both the American Veterinary Medical Association and Canadian Veterinary Medical Association advocate that chiropractic treatments should only be performed by licensed veterinarians or Doctors of Chiropractic. [11][12] Some states and provinces require those using the term “chiropractor” to be licensed in one of these fields.

Features of an appropriately qualified equine chiropractor include: [13]

  • Licensed veterinarian or Doctor of Chiropractic
  • At least 210 hours of additional equine chiropractic training
  • Requires referral from your existing veterinarian
  • Carries their own liability insurance

Side Effects

The risk of side effects from chiropractic treatment in horses remains unknown due to lack of research in this area. However, there are very few reported adverse effects in research studies and case reports to date. [1]

The risk of soft tissue damage from chiropractic manipulation makes choosing a trained professional important to protect your horse’s health.

In general, chiropractic treatments should not be performed if there is active inflammation, infections, or bone fractures. [1] If lameness or pain worsens after treatment, the horse should be re-examined by a veterinarian and alternate treatment methods should be used in the future. [1]

Summary

  • Chiropractic for horses involves joint mobilization and manipulation techniques to address lameness and musculoskeletal disorders
  • Chiropractic treatments focus on restoring the range of motion in joints
  • Spinal manipulation has the most promising scientific evidence to support its use as a treatment for back pain
  • Currently there is limited evidence to support use of chiropractic for limb lameness

Is Your Horse's Diet Missing Anything?

Identify gaps in your horse's nutrition program to optimize their well-being.

References

  1. Haussler, K.K. Joint Mobilization and Manipulation for the Equine Athlete. Veterinary Clinics of North America: Equine Practice. 2016. doi: 10.1016/j.cveq.2015.12.003.
  2. Haussler, K.K. Review of Manual Therapy Techniques in Equine Practice. Journal of Equine Veterinary Science. 2009. doi: 10.1016/j.jevs.2009.10.018.
  3. Haussler, K.K. and Holt, T.N. Spinal Mobilization and Manipulation in Horses. Veterinary Clinics of North America: Equine Practice. 2022. doi: 10.1016/j.cveq.2022.06.008.
  4. Haussler, K.K. et al. A Systematic Review of Musculoskeletal Mobilization and Manipulation Techniques Used in Veterinary Medicine. Animals. 2021. doi: 10.3390/ani11102787.
  5. Sullivan, K.A. et al. The Effects of Chiropractic, Massage and Phenylbutazone on Spinal Mechanical Nociceptive Thresholds in Horses without Clinical Signs. Equine Veterinary Journal. 2008. doi: 10.2746/042516407X240456.
  6. Haussler, K.K. et al. Efficacy of Spinal Manipulation and Mobilisation on Trunk Flexibility and Stiffness in Horses: A Randomised Clinical Trial. Equine Veterinary Journal. 2010. doi: 10.1111/j.2042-3306.2010.00241.x.
  7. Alvarez, C.B.G. et al. Effect of Chiropractic Manipulations on the Kinematics of Back and Limbs in Horses with Clinically Diagnosed Back Problems. Equine Veterinary Journal. 2008. doi: 10.2746/042516408X250292.
  8. Lorello, O. et al. Chiropractic Effects on Stride Parameters and Heart Rate during Exercise in Sport Horses. Equine Veterinary Journal. doi: 10.1111/evj.14043.
  9. Acutt, E.V. et al. Evaluation of the Effects of Chiropractic on Static and Dynamic Muscle Variables in Sport Horses. Journal of Equine Veterinary Science. 2019. doi: 10.1016/j.jevs.2018.10.016.
  10. Haussler, K.K. The Role of Manual Therapies in Equine Pain Management. Veterinary Clinics of North America: Equine Practice. 2010. doi: 10.1016/j.cveq.2010.07.006.
  11. Guest, J. and Cunliffe, C. The Effects of Chiropractic Treatment on The Range of Motion of the Carpus and Tarsus of Horses. Equine Veterinary Journal. 2014. doi: 10.1111/evj.12267_123.
  12. Complementary, alternative, and integrative veterinary medicine. American Veterinary Medical Association. https://www.avma.org (accessed Feb. 16, 2024).
  13. AVCA Approved Post Graduate Programs. American Veterinary Chiropractic Association (AVCA). https://www.animalchiropractic.org (accessed Feb. 16, 2024).
  14. Haussler, K.K. et al. Effects of Vertebral Mobilization and Manipulation on Kinematics of the Thoracolumbar Region. AJVR. 2007. doi: 10.2460/ajvr.68.5.508.
  15. Ahern. T. J., Cervical Vertebral Mobilization Under Anesthetic (CVMUA) a Physical Therapy for the Treatment of Cervico-Spinal Pain and Stiffness. Journal of Equine Veterinary Science. 1994. doi: 10.1016/S0737-0806(06)81638-2.
  16. Colles. C. M. et al., The Osteopathic Treatment of Somatic Dysfunction Causing Gait Abnormality in 51 Horses. Equine Veterinary Education. 2014. doi: 10.1111/eve.12122.