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Topic:Pain Management

Pain management in horses involves various strategies and interventions designed to alleviate discomfort and improve the well-being of equine patients. It encompasses pharmacological approaches, such as the use of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and other analgesics, as well as non-pharmacological methods like physical therapy, acupuncture, and environmental modifications. Effective pain management aims to address both acute and chronic pain conditions, which can result from injuries, surgeries, or diseases such as laminitis and arthritis. This page aggregates peer-reviewed research studies and scholarly articles that explore the mechanisms, efficacy, and safety of different pain management techniques in horses, contributing to the understanding and advancement of equine veterinary care.
Assessment of Blood Profiles and Pain in Sport Horses Undergoing Intrarectal Ozone Therapy.
Veterinary medicine and science    March 7, 2026   Volume 12, Issue 2 e70678 doi: 10.1002/vms3.70678
de Luna Paiva TD, de Melo Lopes AR, Silva ÁJC, Figueiredo MAF, da Cunha Nogueira SS, Nogueira-Filho SLG.Medical ozone is used in various treatments due to its oxidising properties. Objective: We aimed in this study to evaluate the impact of intrarectal ozone therapy on haematological and biochemical parameters, as well as the pain induced by the procedure in sport horses. Methods: In vivo experiment with 12 Quarter Horses (3 males and 9 females) used as their own controls to assess the effects of ozone therapy. Methods: Blood samples were collected before treatment (Control), 24 h after ozone therapy (24 h post-treatment), and 7 days after the last day of ozone therapy (7 days post-treatment). ...
The effect of botulinum toxin injection into the deep digital flexor muscle on foot biomechanics in healthy horses.
American journal of veterinary research    February 26, 2026   1-10 doi: 10.2460/ajvr.25.12.0452
Slavik K, Underwood C, Lowndes C, Skelton G, van Eps A.To examine the effects of botulinum toxin inoculation into the deep digital flexor (DDF) muscle on foot biomechanics. Unassigned: 6 healthy horses were injected with botulinum toxin in the DDF of 1 forelimb. The opposite forelimb was untreated. Ground reaction forces (GRF) were measured using a pressure sensor in regions of interest, including the dorsal hoof wall (toe). The location of the center of pressure (COP) was measured relative to the dorsal hoof wall during static standing and at peak stance during walking. Repeat measurements 3, 7, 14, 28, and 42 days after injection were compared t...
Equine lameness detection and monitoring during diagnostic anaesthesia with an instrumented hoof boot.
Veterinary journal (London, England : 1997)    February 25, 2026   Volume 317 106614 doi: 10.1016/j.tvjl.2026.106614
Keller J, Hassenstein MJ, Jung K, Geburek F.Ground reaction forces are accepted as gold standard for objective assessment of weightbearing lameness but measurements at the hoof are limited to experimental devices. This study aimed to evaluate whether innovative instrumented hoof boots (IHBs) could detect and monitor lameness in horses during diagnostic anaesthesia. Twenty-six horses referred for lameness examination (15 front limbs, 17 hindlimbs) were equipped with IHBs and body mounted inertial sensors. Data were collected simultaneously before and after diagnostic anaesthesia until objectively considered positive. Recorded IHB data i...
Vaccination-associated lameness in warmblood horses after intramuscular injection.
Journal of equine veterinary science    February 23, 2026   Volume 159 105820 doi: 10.1016/j.jevs.2026.105820
Lenarz J, Smit IH, Rhodin M, Lischer C, Fugazzola MC.Intramuscular vaccination is a routine component of equine medicine, but local muscle soreness may transiently affect gait symmetry. Objective data on vaccination-associated gait changes in horses are lacking. Objective: To investigate whether intramuscular vaccination induces measurable gait asymmetries depending on injection site, to inform recommendations on vaccination site selection and short-term exercise management. Methods: In this prospective, randomised, blinded, placebo-controlled study, eighteen clinically sound Warmblood horses were enrolled and received an intramuscular vaccinati...
Update on Idiopathic Trigeminal-Mediated Headshaking.
The Veterinary clinics of North America. Equine practice    February 20, 2026   S0749-0739(25)00071-9 doi: 10.1016/j.cveq.2025.12.003
Aleman M, Morales CJ.Idiopathic trigeminal-mediated headshaking is a painful neuropathic disorder characterized by sudden, violent, predominantly vertical head movements of unknown etiology. Clinical signs may be seasonal or persistent and triggered by light, sound, exercise, or tactile nasal stimulation. The pathophysiology is multifactorial, involving abnormal trigeminal nerve excitability influenced by hormonal, environmental, and dietary factors. Treatment is challenging and typically multimodal, aiming to reduce trigeminal hypersensitivity and improve quality of life.
Effect of palmar digital perineural analgesia (as a model for “nerving”) on forelimb loading over varied surfaces at the walk and trot – a pilot study.
Journal of equine veterinary science    February 17, 2026   Volume 159 105812 doi: 10.1016/j.jevs.2026.105812
Zimmerman-Cameron SR, Colbath AC, Caruso MA, Hoffman RM, Logan AA.Navicular syndrome is characterized by palmar foot pain and is a common cause of lameness in horses. Palmar digital neurectomy (nerving) removes sensation to the heel region of the hoof and may serve as a treatment for navicular-afflicted horses, while analgesia (blocking) results in temporary loss of sensation. Objective: The purpose of this pilot study was to examine the effect of loss of sensation in the heel on the forelimb area and force while tracking on soft and hard ground at the walk and trot. Methods: Three horses that scored a 0 or 1 on the AAEP lameness scale were fitted to Tekscan...
Acquired and Degenerative Conditions of the Cervical Vertebral Column in Horses.
The Veterinary clinics of North America. Equine practice    February 12, 2026   S0749-0739(25)00078-1 doi: 10.1016/j.cveq.2025.12.010
Schmidt S, Swagemakers JH, le Jeune SS.The cervical vertebral column in horses plays a crucial role in movement, posture, and performance and disorders affecting it can cause pain, ataxia, or lameness. This review discusses major acquired (traumatic, infectious, neoplastic) and degenerative (osteoarthritis, foraminal stenosis, intervertebral disc disease) conditions. Acquired lesions often arise from trauma, bacterial infection, or neoplasia, with clinical signs ranging from neck pain to neurologic deficits. Degenerative disorders, particularly osteoarthritis of articular process joints, are common in the caudal cervical spine and ...
Survey describing the perspectives and practices of Australian veterinarians to pain management in horses.
Australian veterinary journal    February 5, 2026   doi: 10.1111/avj.70059
Whitelock A, Goodwin W, Dryburgh L, Mshelbwala PP, Rae L, Marwedel L, Lok T, Kemp K, Stewart AJ.To describe Australian practices and attitudes regarding equine analgesia. Methods: Cross-sectional anonymous, voluntary survey of Australian veterinarians treating equine patients. Methods: Australian veterinarians in equine or mixed practices completed a six-section, 60-question survey between November 2019 to August 2020. Information was gathered on demographics, analgesia prescription, pain assessment and attitudes surrounding specific analgesics. Respondents assigned a pain score ranging from 0 to 10 for various conditions; these were averaged to give each respondent an "average pain scor...
Riding with care: A review of factors that influence the welfare of the ridden horse and a case for the application of the precautionary principle in equestrian pursuits.
Journal of equine veterinary science    February 4, 2026   Volume 158 105801 doi: 10.1016/j.jevs.2026.105801
Copelin C, Merkies K.Equestrian sport's social license to operate has come under scrutiny due to concerns surrounding the well-being of ridden horses. Inappropriate equipment use, such as harsh bits or overtight nosebands, can negatively influence well-being by generating inescapable pressure or pain on the sensitive structures of the horse's head and limiting natural behaviours. Restrictive equipment may also be used to generate exaggerated, stressful and uncomfortable head and neck positions such as hyperflexion. Saddles must be properly fitted to both horse and rider to ensure appropriate distribution of kinema...
Congenital malformations of the thoracic vertebral column in a mature competition pony.
Journal of equine veterinary science    February 4, 2026   Volume 158 105800 doi: 10.1016/j.jevs.2026.105800
Hoogelander B, Frippiat T, Bergman HJ, Vanderperren K, van Veggel ECS.Thoracolumbar congenital abnormalities are considered rare in mature, performing horses. This case report describes a 14-year-old Welsh pony presented with marked epaxial muscle atrophy, mid-thoracic spinal pain, and stiffness, most pronounced during canter. The thoracic spine exhibited scoliosis, centered at T9-T10, and kyphosis. Radiography and postmortem computed tomography revealed complex congenital malformations of the thoracic vertebral column, including abnormal morphology of the T10-T12 vertebral bodies, partial vertebral fusion, a malformed spinous process, a malformed rib with assoc...
Ocular Causes for Undesired Behaviors in the Horse.
The Veterinary clinics of North America. Equine practice    January 28, 2026   S0749-0739(25)00069-0 doi: 10.1016/j.cveq.2025.12.001
Knickelbein KE.Numerous ocular diseases cause visual impairment and induce ocular pain that may be associated with undesired behaviors in horses. Horses with ocular pain, indicated by the presence of blepharospasm, blepharoedema, ocular discharge or rubbing the eye, should be rested from work to avoid worsening the ocular disease and to avoid undesired behaviors associated with pain or vision impairment. Horses with ocular disease are frequently head shy. Some stoic horses may not have obvious outward clinical signs despite significant visual impairment, and as such, undesired behaviors such as spooking, bal...
Parasympathetic tone, cardiovascular variables, and behavioral alterations in conscious horses before and after castration and during anesthesia: A pilot study.
Journal of equine veterinary science    January 9, 2026   Volume 158 105781 doi: 10.1016/j.jevs.2026.105781
Mendoza Flores JE, Terrazas A, Lara Sagahon AV, Aleman M.Parasympathetic tone activity (PTA) and its association with behavior in conscious versus anesthesia in horses are unknown. Objective: To study PTA, heart rate (HR), minimum alveolar concentration (MAC), and mean arterial pressure (MAP) during castration under anesthesia. To study PTA, HR, Horse Grimace Scale (HGS), locomotor activity (LA), and behavior in conscious horses before and after castration. Methods: Pilot study including seven healthy adult horses. After habituation (days 1, 2, and 3), PTAm, HR, HGS, LA, and behavior were investigated during pre-surgery (days 4-, 5-, and one-hour pr...
The Effect of Magnetotherapy on Back Pain Sensitivity and Muscle Tension in Recreational Horses-A Pilot Study.
Animals : an open access journal from MDPI    December 26, 2025   Volume 16, Issue 1 77 doi: 10.3390/ani16010077
Jastrzębska E, Dobbek D, Pawłowska A.Back pain in horses is a frequent musculoskeletal issue that affects performance and welfare. Magnetotherapy has been proposed as a complementary, non-invasive treatment to reduce pain and support soft tissue recovery, but studies in horses remain limited. This pilot study aimed to evaluate the effects of low-frequency pulsed magnetic field therapy on horses with hypersensitivity to palpation along the longissimus dorsi muscle. Four recreational horses participated in a 10-session magnetotherapy program, with changes assessed using palpation, neck flexibility tests, heart rate measurements and...
Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse.
Veterinary surgery : VS    September 11, 2025   Volume 55, Issue 2 491-497 doi: 10.1111/vsu.70017
Marques GF, Moorman VJ, Ellis KL, Perlini M, Edwards VL.To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
Oral cannabidiol increases thermal threshold in horses without physiologic adverse effects.
American journal of veterinary research    August 25, 2025   Volume 86, Issue 11 ajvr.25.05.0185 doi: 10.2460/ajvr.25.05.0185
Carroll AT, Reed RA, Berghaus LJ, McNabney D, Knych HK.To investigate the effect of cannabidiol (CBD) on thermal and mechanical thresholds and physiologic variables in horses. Unassigned: 6 horses (3 geldings and 3 mares) were enrolled in a prospective, randomized, masked crossover design from March 18 through May 3, 2025. Horses received 3.48 mg/kg CBD oil or placebo (sesame oil) orally every 24 hours for 3 days. Thermal and mechanical thresholds were determined at baseline and 4 and 12 hours after treatment administration on each day. Physiologic variables, including heart rate, respiratory rate, and rectal temperature, were recorded at the same...
Global survey on the utilisation and experiences with different retrobulbar anaesthesia techniques in horses.
Equine veterinary journal    August 23, 2025   doi: 10.1111/evj.70082
Lieberth S, Thieme K, Dancker C, Merle R, Eule JC.Retrobulbar anaesthesia (RBA) is relevant for ocular surgery in standing sedated horses. Objective: Gathering insights on experiences with RBA techniques. Methods: Cross-sectional survey. Methods: An online survey collected information on the respondents' professional background, indications, injection methods, use of ultrasound assistance, medication, and complications associated with RBA in horses. Results: Two-hundred and thirty-eight veterinarians from 25 countries contributed. 86.1% were members of veterinary specialty colleges. RBA indications were enucleation (97.8%), corneal surgery (2...
Optimizing equine standing sedation: continuous infusion of detomidine and butorphanol enhances stability but prolongs ataxia.
Frontiers in veterinary science    August 21, 2025   Volume 12 1606585 doi: 10.3389/fvets.2025.1606585
Arantes JA, Rabelo IP, Bermudes L, Lacerenza MD, Mendes RP, Corrêa RR, Yamada DI, Valadão CAA, Dória RGS.This study aimed to compare the sedation quality and cardiorespiratory and behavioral effects of detomidine administered intravenously, either in intermittent boluses or as a continuous rate infusion, with butorphanol in horses pre-medicated with acepromazine for odontoplasty procedures. Unassigned: A prospective clinical study was conducted with fifteen adult horses randomly assigned to two groups: Bolus group (BG, = 7) and Infusion group (IG, = 8). Both groups received acepromazine premedication, followed by detomidine administration (bolus or infusion). Butorphanol was administered either...
Primary Jejunal Impactions Resolved via Exploratory Celiotomy in Six Horses: 2017-2023.
Animals : an open access journal from MDPI    August 12, 2025   Volume 15, Issue 16 2363 doi: 10.3390/ani15162363
Willette J, Guinn A, Munsterman A.Impactions of the jejunum are rarely described in the literature. The current case series describes six cases of adult horses with jejunal impactions with feed material diagnosed by exploratory celiotomy. Horses underwent exploratory celiotomy based off of their degree of pain despite medical management and concerns for a primary strangulating small intestinal lesion. All jejunal impactions were relieved via manual decompression of the impaction into the cecum. None of the cases underwent a resection or anastomosis at the site of impaction. All horses were treated with gastroprotectants (omepr...
Analgesic and Gastrointestinal Effects of Methadone in Horses Undergoing Orchiectomy.
Animals : an open access journal from MDPI    August 11, 2025   Volume 15, Issue 16 2358 doi: 10.3390/ani15162358
Maldonado Moreno N, Alves Moreira J, Araujo De Oliveira L, Sanches Gontijo A, Castilho Baldi ML, Rocha Wenceslau R, Beier SL.A multimodal approach is recommended to optimize perioperative pain control in animals, although opioid use in horses remains limited due to the risks of central nervous system (CNS) stimulation and reduced intestinal motility. A group of 19 healthy, male, mixed-breed horses were divided into two groups and medicated with acepromazine (0.05 mg kg) and detomidine (10 µg kg), with methadone (0.05 mg kg) (ADM) or saline (ADS) administered intravenously (IV). Physiological variables, intestinal motility, gastric distention, and facial pain (EQUUS-FAP) were evaluated one day before (DB), before th...
Ultrasound-Guided Radiofrequency Ablation and Pulsed Radiofrequency Treatment for Chronic Lameness Due to Distal Forelimb Disease in Horses: A Pilot Study.
Animals : an open access journal from MDPI    August 10, 2025   Volume 15, Issue 16 2341 doi: 10.3390/ani15162341
Amari M, Brioschi FA, Auletta L, Ravasio G.Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups receive...
Cannabinoid Receptors in the Horse Lateral Nucleus of the Amygdala: A Potential Target for Ameliorating Pain Perception, Stress and Anxiety in Horses.
International journal of molecular sciences    August 6, 2025   Volume 26, Issue 15 7613 doi: 10.3390/ijms26157613
Bombardi C, Salamanca G, Tagliavia C, Grandis A, Zamith Cunha R, Gramenzi A, De Silva M, Zannoni A, Chiocchetti R.The amygdala is composed of several nuclei, including the lateral nucleus which is the main receiving area for the input from cortical and subcortical brain regions. It mediates fear, anxiety, stress, and pain across species. Evidence suggests that the endocannabinoid system may be a promising target for modulating these processes. Cannabinoid and cannabinoid-related receptors have been identified in the amygdala of rodents, carnivores, and humans, but not in horses. This study aimed to investigate the gene expression of cannabinoid receptors 1 (CB1R) and 2 (CB2R), transient receptor potential...
Comments on MacKechnie-Guire et al. (2024): Noseband type and tightness level affect pressure on the horse’s face at trot.
Equine veterinary journal    August 1, 2025   doi: 10.1111/evj.14549
Doherty O, Fenner K, Winther Christensen J, McLean A, Thomson P, Uldahl M, McGreevy P.No abstract available
Evaluation of water treadmill training, lunging and treadmill training in the rehabilitation of horses with back pain.
BMC veterinary research    July 29, 2025   Volume 21, Issue 1 495 doi: 10.1186/s12917-025-04950-2
Geiger T, Lindenhahn L, Delarocque J, Geburek F.Data about efficacy of different training modalities during rehabilitation of horses with back pain is scarce. The aim of this study was to analyze the effect of water treadmill training, lunging and dry treadmill training in horses with back pain. Methods: Eighteen warmblood riding horses referred with confirmed clinical signs of back pain including abnormal responses to passive mobilisation were randomized into three groups to participate in a 6-week water treadmill training, lunging or dry treadmill program under otherwise identical conditions. Two clinicians, one blinded to the program, pe...
Drivers of decision making in pain diagnosis and treatment: Findings from an ethnographic study of veterinary practice.
Equine veterinary journal    July 27, 2025   doi: 10.1111/evj.14562
Smith R, Perkins E, Pinchbeck G, Ireland J.Poor pain management in horses is a welfare concern. The 'diagnosis' of pain cannot be separated from the broader set of interactions through which it emerges. The interactions that take place during veterinary consultations shape the ways in which, or whether, pain management is discussed. Objective: To understand owners' and veterinarians' decision making in relation to chronic pain and its management. Methods: Qualitative ethnographic study. Methods: Data were collected from four veterinary practices in Great Britain between May 2023 and April 2024. Around 200 h of ethnographic observatio...
Clinical Effectiveness of Dry Needling on Myofascial Trigger Points in Horses: A Prospective Algometric Controlled Study.
Animals : an open access journal from MDPI    July 27, 2025   Volume 15, Issue 15 2207 doi: 10.3390/ani15152207
Calatayud-Bonilla M, Carmona JU, Prades M.Myofascial pain syndrome (MPS) is caused by trigger points (TrPs): hypersensitive spots in taut muscle bands that impair function and cause pain. Dry needling (DN) is a common treatment in humans, but evidence in horses is limited. This prospective, controlled study evaluated the effectiveness of DN in reducing TrP-related pain in the brachiocephalic muscle of horses. Of the 98 horses enrolled, 66 were allocated to a treatment group receiving weekly DN sessions for three weeks, while 32 were assigned to a control group with no intervention. Pain and function were assessed using pressure algome...
Regulatory Integrity and Welfare in Horse Sport: A Constructively Critical Perspective.
Animals : an open access journal from MDPI    June 30, 2025   Volume 15, Issue 13 1934 doi: 10.3390/ani15131934
Uldahl M, Mellor DJ.This commentary evaluates contemporary equestrian sport governance through the lens of equine welfare science. Drawing on evidence from the FEI Sport Forum 2025 debates, the IFHA Racing Integrity Handbook, media coverage of horse sport, recent scientific presentations, regulatory texts, and published research, we identify systemic shortcomings in how horse welfare is assessed, prioritised, and protected. Key issues include reliance on performance as a proxy for welfare, inadequate "fit-to-compete" protocols, neglect of horses' mental states, coercive tack and equipment practices (e.g., double ...
A comparison of a transdermal eutectic lidocaine/prilocaine cream and subcutaneous lidocaine injection prior to jugular vein catheterization in horses: a randomized crossover study.
Veterinary anaesthesia and analgesia    June 26, 2025   Volume 52, Issue 6 933-940 doi: 10.1016/j.vaa.2025.06.009
Amiet B, Rainger J, Zedler S, Stewart A, Woldeyohannes S, Goodwin W.To compare horses' aversive behavioural responses to the application of 5% prilocaine/lidocaine eutectic mixture of local anaesthetics (EMLA) cream versus subcutaneous infiltration of 2% lidocaine, followed by jugular vein catheterization. Methods: Blinded, randomized study. Methods: A group of 26 university-owned research horses. Methods: Each horse received both treatments at opposite jugular sites with ≥ 12 hours between procedures. One randomly assigned jugular site received 1 g cm of 5% EMLA cream 60 minutes before catheterization, while the contralateral site received 1.5 mL of 2% lido...
Indicators of mortality risk in ageing horses.
GeroScience    June 25, 2025   doi: 10.1007/s11357-025-01738-y
Kelemen Z, Vogl C, Torres Borda L, Auer U, Jenner F.Clinical care for patients with limited life expectancy often requires adjustments, prioritizing immediate benefits over long-term outcomes, as the relevance of future complications diminishes. This study identifies indicators of mortality risk in horses with chronic orthopaedic conditions to enhance individualized care and welfare. Over 3 years, 123 chronically lame horses and 6 healthy control horses at an animal sanctuary underwent regular (every 3 months) comprehensive health assessments and activity monitoring using wearable sensors. Data collected included body condition scores, muscul...
Clinical evaluation of freeze-dried secretome (lyosecretome) for osteoarthritis: a controlled trial in dogs and preliminary safety assessment in horses.
International journal of pharmaceutics    June 16, 2025   Volume 681 125864 doi: 10.1016/j.ijpharm.2025.125864
Berni P, Del Bue M, Conti V, Andreoli V, Ramoni R, Angelone M, Squassino GP, Bari E, Torre ML, Rinaldi M, Dotti S, Rossi R, Yusuf I, Mauri P....Most in vivo studies on MSC-secretome for osteoarthritis (OA) have relied on animal models, using products lacking pharmaceutical quality, not formulated for clinical use, and insufficiently characterized, limiting knowledge of its effectiveness. This study reports veterinary clinical trials on dogs and horses with spontaneous OA: in dogs (26 subjects), the trial is randomized, double-blinded, and controlled; in horses, 5 clinical cases were treated for safety assessment. Treatment consisted of hyaluronic acid with either lyosecretome - a freeze-dried, injectable MSC-secretome obtained through...
Guidelines for Formulating Rehabilitation Strategies for Equine Tendon and Ligament Injuries.
The Veterinary clinics of North America. Equine practice    June 14, 2025   S0749-0739(25)00028-8 doi: 10.1016/j.cveq.2025.04.010
Ellis KL, Giancola S.Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
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