Which Type of Therapy for my horse?

WHICH TYPE OF THERAPY  WILL MOST BENEFIT MY HORSE? ... Veterinary, chiropractic,Massage, Magnetic field ....?


There are a variety of  therapists, treatment regimes and machine modalities available. Making a choice between these is often most confusing. It is natural of course that different therapists will expound upon the virtues of their own methods / machines over other forms of therapy. I will now endeavour to present some simple guidelines which may assist  you in making your choices.


Question:-

1) Does the injured site / complaint respond well to anti-inflammatory medication? Bute!

2) How long since the accident / injury?...  3-4 weeks, months, years.

3) Is the horse lame? (head bobbing) or just awkward (altered gait).

4) Have symptoms of laminitis or heel pain developed?


  .....1)       The first thing to do is to try and differentiate between (i) muscle / tendon / ligament and joint injuries     VERSUS  (ii)  conditions where Neuropathic Pain is evident. One assumes that in both cases ‘pain’ is involved. The difference is that (i) most often have some degree of inflammation associated with them and thus will respond to anti-inflammatory medication.   In the case of (ii) there is usually little to no inflammation and thus the opposite occurs. i.e..... no response to ‘Bute’!

   With (i) these horse should really undergo a veterinary examination as medication may be of use and there is also the possibility that other musculoskeletal conditions are primary and muscle ‘sensitivity’ is secondary. If the condition involves ‘soft tissues’ (tendon/ muscle....etc) then massage, magnetic field, poultice...etc can be utilised to aid healing.


....2) Next how long since the injury. If it is a case of (i) spinal (joint complex) trauma with evidence of ‘neuropathic pain”, that occurred 2 months (or less) ago then there are a variety of treatments carried out by qualified therapist which should lead to a useful outcome. Acupuncture, massage standing mobilisation, trigger point therapy.... are a few that come to mind.

If however the ‘initial trauma’  ( there may have been several incidents since) was 2-6 years ago then one could expect some degree of serious reduction in some spinal joint ROM range of movement. Translated that means ‘stiffness’ (like a wrist that no longer bends) that may well require some ‘extended pressure’ (pressure applied over 5-10 minutes) to restore full or useful range of joint movement. Having treated many thousands of horses like this (particularly cervical / neck injuries) I can assure you that in general the only way to achieve this is with the horse anaesthetised. I still find it quite an effort in the anaesthetised animal and thus fail to agree with those who declare that “I can do all that without a general anaesthetic!”

The simple rule is then that early treatment opens up the choice of treatment modalities.

Later treatment when physical (joint) stiffness has become significant ‘reduces’ the effectiveness of many forms of standing treatment. i.e. there well may be a change with treatment but it is either not complete and / or short lived.


WARNING. If your horse shows any signs of ‘incoordination’ ...legs everywhere, falls over, hindquarters move independently then a veterinary examination is paramount as joint instability or a fracture may be present. Any evidence of ‘swelling’ about the spine is also often indicative of a fracture. These horses should always be examined by a veterinarian first. Some treatment modalities could lead to further trauma  even death.


3) If the horse is lame .... the lameness will either respond dramatically to anti-inflammatory medication... or it wont! If it does then a lameness work up should be carried out.

If there is little to no response then a neurological (spinal) examination may well be indicated. Altered gaits again either respond to medication Anti-inflam or they don’t. If they don’t ....? neurological?


4) In humans with ‘neuropathic pain’ it is not unusual to get changes in blood flow to the extremities hands / feet. In horses there also appear to be changes particularly in the fore feet. This may then exacerbate laminitis which has occurred through other circumstances.

In these circumstances the lower cervical (neck) spine appears to  be often involved.

The best way to treat the lower neck in a horse ...except for recent trauma.... is under general anaesthesia.  The reason for this is that the lower neck is so well protected by a huge mass of muscle and associated soft tissues.


The outcome of treatment will depend mostly on 2 factors.


(A) The extent to which joint range of movement can be restored by the therapy / therapist.

(B) The extent to which secondary degenerative processes (joint and soft tissue) have progressed prior to therapy.  e.g........ Arthritic change may have already occurred.


The length of time since trauma seems to be less important as regards the outcome. It may well however dictate the type of therapy utilised!


In other words if the initial injury  is recent and not too severe then more gentle and less invasive therapies may well be successful whilst the more severe and the longer standing complaint may require more heavy handed approaches. We must remember that we are not dealing with rabbits. These are animals with very large anatomies.