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.
Phaneuf LP, Grivel ML, Ruckebusch Y.The electrical potentials were recorded from the antrum, the duodenum, the ileum and the first part of the colon of ponies under (a) normal resting conditions, (b) during nonpainful colic and (c) after intravenous morphine administration. The normal pony, at rest, had five contractions of the antrum per minute. On the small intestine, the basal electrical activity decreased from the duodenum (14-15/min) to the ileum (10-11/min). The small bowel also had three types of motility: peristaltic waves, rhythmic segmentations and random contractions. On the colon, bursts of potentials indicating inte...
Pain management in horses plays a pivotal role in the therapeutic approach to several diseases. Horses have cannabinoid receptors at the level of dorsal root ganglia, blood vessels, and synoviocytes that can be up or down- regulated by inflammatory conditions, justifying the possible efficacy of exogenous cannabinoids (i.e., phytocannabinoids) in managing several painful pathologies in this animal species. However, the current use of supplements containing cannabidiol (CBD) in equines is based on anecdotal evidence, without the support of sufficient pharmacokinetic studies. In humans, the conc...
Strugava L, Gomes ARC, Lorga AD, Bosak VL, Rossa AP, Janiszewski JDR, Machado M, Dornbusch PT, Moreno JCD.To describe anatomical references and sonoanatomy of an echo-guided injection for blocking the tibial and common fibular nerves with the use of a caudocranial midfemoral approach and to evaluate dye spreading in horse cadavers. Unassigned: 1 horse cadaver preserved in glycerin was used for the anatomical study, and 14 fresh horse cadavers were used for the dye spreading study. The experimental procedures were conducted on the first cadaver on March 25, 2021, and on the last cadaver on October 5, 2022. A glycerin-preserved horse cadaver's pelvic limb was dissected to identify anatomical landmar...
Beck AA, Paz LB, Frank MI, Pereira RCF, De La Côrte FD.To evaluate the effect of IA injections of botulinum toxin type A (BoNT-A) in horses with chronic, naturally occurring distal tarsal osteoarthritis. Unassigned: 9 horses were selected after physical and radiographic assessments. Horses also underwent an objective lameness examination and were included if they had a hindlimb impact lameness (Pmin ≥ 3 mm), which positively responded (≥ 50%) to the tarsometatarsal and centrodistal joints' anesthetic block. Horses randomly received an intra-articular injection of BoNT-A or an equivalent volume of saline solution. Horses were reevaluated at pos...
Bustamante R, Segura IÁ, Santiago I.Locoregional techniques promote multimodal analgesia and may reduce general anaesthetic requirements. However, there is limited evidence in foals. The rectus sheath block (RSB) is an interfascial plane block previously described in other species such as dogs, cats, pigs, and calves, and recently in foals, which targets desensitization of ventral abdominal midline. This block may provide an efficacious analgesic alternative for ventral celiotomies and umbilical surgeries. This case series reports the use of a bilateral RSB with 0.25-0.3 mL kg-1 bupivacaine (maximum dose of 2 mg kg-1) per hemiab...
Bacon EK, Donnelly CG, Finno CJ, Haase B, Velie BD.Multimodal analgesic administration is a promising strategy for mitigating side effects typically associated with analgesia; nevertheless, variation in analgesic effectiveness still poses a considerable safety concern for both horses and veterinarians. Pharmacogenomic studies have started delving into genetic influences on varying drug effectiveness and related side effects. However, current findings have narrow implications and are limited in their ability to individualize analgesic dosages in horses. Hydromorphone and detomidine were administered to a cohort of 48 horses at standardized time...
Cole RC, DeGraves FJ, Brown J, Schumacher J.To compare the effect of 2.5 mL 2% mepivacaine to the effect of 0.5 mL 2% mepivacaine administered over each palmar digital nerve, as an abaxial sesamoid nerve block (ASNB), to 6 horses lame because of naturally occurring digital pain. Unassigned: In a crossover study design with 3 horses in each group, the trotting gait of the horses was analyzed with an inertial sensor-based, motion-analysis system (Q with Lameness Locator; Equinosis LLC) immediately before and after treatment with either 0.5 or 2.5 mL mepivacaine administered over each nerve near the base of the proximal sesamoid bone of th...
Rodrigues APDC, Pozzobon R, De Bastiani G, De La Côrte FD, Azevedo MDS.Lameness, which arises from functional or structural changes in the limbs or axial skeleton, causes asymmetry in the movement of the equine head and/or pelvis. This study aimed to investigate the lameness patterns of horses that underwent lameness examination or monitoring during the years 2016 to 2020. This retrospective study used data from the lameness examination, evaluated using an objective assessment with body-mounted wireless inertial sensors. The lameness examination comprised clinical history, static inspection, palpation, gait evaluation (for which the animals were equipped with a w...
Quam V.Inflammation plays a role in acute and chronic equine tendon/ligament injury; anti-inflammatories are often indicated. Local corticosteroids provide consistent and profound short-term effects on pain and inflammation across species. However, there is no demonstrated benefit in the long term, and complications can occur. Alternative biologic anti-inflammatory treatments are available and should be used in horses at risk of complications. Nonetheless, corticosteroids remain an affordable and effective anti-inflammatory that, with continued research, may be indicated on a case-by-case basis as pa...
Patricio CR, Winter GHZ, Garbade P.Spinal articular dysfunction disrupts normal neural function and may lead to stiffness, pain or poor performance. Back pain is common in equine athletes, and it is a common complaint by horse owners requesting chiropractic evaluations. Objective: To describe the prevalence of spinal articular dysfunction in showjumping horses. Methods: Retrospective analysis of clinical records. Methods: Records from 3 years of examinations in horses, from beginners to high-performance levels. Each horse had 30 spinal segments evaluated for the presence of dysfunctional articulations. Exams were performed by...
Moody LM, Hicks SL, Foote BC, Hendrix DV, Ward DA.Equine corneal disease is common and painful. Current pain mitigation strategies are often suboptimal, especially early in the disease. Objective: To evaluate the effects of local anaesthetic delivery via indwelling retrobulbar catheter on corneal sensitivity, pupil size, pupillary light responses (PLRs), and ocular motility in normal horses. Methods: Randomised, controlled crossover experiment. Methods: One eye was randomly selected from seven horses. A 20-gauge catheter was placed in the retrobulbar space and injected with 10 mL of 0.5% bupivacaine or 0.9% saline. Cochet-Bonnet esthesiomet...
Calle-González N, Rivero JL, Olivares J, Miró F, Argüelles D, Requena F, Munoz A.Capacitive-resistive electrical transfer (CRET) is an endogenous non-invasive technique, used as deep diathermy. We pursue to analyze the temperature changes by applying different CRET protocols in the thoracolumbar spine of horses, between thoracic vertebrae 15 and lumbar 2. Unassigned: Ten clinically sound horses without thoracolumbar pain underwent various CRET protocols applied to a standardized thoracolumbar region (T15-L2). The protocols included sham (device off), low intensity (LIP, 5%), medium intensity (MIP, 30%), and high intensity (HIP, 40%). The HIP protocol was further divided in...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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.
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...
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...
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). ...
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...
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...
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...
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...
