Treating Equine Back Pain with Modern Holistic Modalities

Once thought of by many as being “a bit out there,” some holistic modalities are now recognized as valuable adjuncts to conventional back pain treatments, even among veterinarians. Three of the most popular – massage therapy, chiropractic adjustment and acupuncture – are widely believed to be able to help many horses get relief from back problems, and they may thus be worth considering if your horse is dealing with such issues.

EQUINE BODYWORK/MASSAGE THERAPY

When we think of massage, most of us probably envision a general process of rubbing and kneading designed to loosen up tight muscles. Modern equine massage therapists, however, often apply a number of different techniques when it comes to treating back pain in horses, and some will, therefore, refer to what they do as “bodywork,” which is a more comprehensive term than “massage.” As Lexi Jones, a bodyworker with Fluidity Equine Therapy in Abbotsford, B.C., explained, “It is incredibly valuable to have a variety of bodywork options in your treatment arsenal, as the equine back contains many different kinds of tissue, and every approach has its own strengths addressing specific tissue problems.

“To treat back pain, I typically start with myofascial massage, which increases blood flow, stimulates the fascia (the connecting tissue of the entire body), and enhances oxygenation of the muscles, which, in turn, helps restore range of motion. This is sometimes accompanied by deep tissue massage and acupressure, depending on the case. Deep tissue massage stimulates blood flow and oxygenation, releases and relaxes muscles, and helps muscles return to their normal shape and function, while acupressure releases muscle tension and can assist in reprogramming muscle memory.”

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Jones also uses Kinesiology taping (or K-taping) as an adjunct to the previous approaches. K-taping employs a special kind of elastic tape with an adhesive on one side. Applied to specific parts of the back, the tape lifts the dermal layer above the fascia, thereby promoting faster healing, reducing swelling and associated pain, and promoting quicker muscle recovery by promoting healing and enhancing the effects of the other modalities. “K-taping is relatively new to the equine world,” said Jones, “but while it was initially developed for human athletes, we have collected proven results with equine athletes as well.”

Jones pointed out, however, that in addition to knowing a number of different techniques to address back issues, a good equine massage therapist (EMT) or bodyworker will also know when it is not appropriate to use specific modalities. “For example,” she said, “acute injury, nerve damage or significant scarring may eliminate
the use of deep tissue or acupressure, as these approaches could actually increase the pain.”

Equally important is for the therapist to work with the owner and veterinarian to try to determine the cause of a horse’s back trouble, whenever possible, as this can be key to preventing recurrence. It is sometimes quite difficult, however, to pinpoint the root cause of equine back pain, and in many cases, the problem doesn’t actually originate in the back at all. “Certain lameness issues can affect the back through compensation efforts,” said Jones. “For instance, a stifle injury can show up as a sore back because the horse is compensating for the stifle, thereby straining the back muscles. Even something as simple as an unbalanced hoof trim can affect the back, as no part of the horse is separate from the whole.”

Benefits of equine massage therapy include:

Pain relief
Reduction or elimination of muscle spasms
Decreased anxiety
More balanced and efficient movement
Increased flexibility and range of motion
Release of endorphins (relieves pain and promotes a sense of well-being)
Immune system support
Injury prevention
Improved recovery time

Case Study: Horse with Spinal Misalignment Gets Lucky
Jones dedicates a considerable amount of time to helping horses at an equine rescue. One horse named Lucky didn’t seem very lucky at all when he first arrived. “Lucky came to the rescue after a series of flips, sales and trades – five in under two years,” she said. “It was clear that he had some physical issues, but no one had taken the time to determine the extent or nature of his disability, which turned out to be a simple misalignment of his spine.

“Over time, Lucky had compensated for this condition by hollowing his back and overusing his shoulders to take pressure off his back. When a horse does this, it results in overdevelopment of the trapezius, the muscle that is responsible for movement of the scapula (shoulder blade). In Lucky’s case, his condition had persisted for so long that he lost much of the muscle tone in his back, causing the spine to sway downward. This made saddle fit virtually impossible, and it also complicated treatment.”

Jones knew that helping Lucky would require a team effort, so she consulted a chiropractic colleague and brought her on board. “I then took the first hands-on step,” she said, “using myofascial release to loosen the tension in his muscles. This was critical, as without that initial release, any subsequent treatments would not have yielded results because Lucky’s muscular tension would simply not allow any alignments to take place.

“I was present for the first adjustment, after which I bolstered that treatment with a concentrated approach of kinesiology taping. K-taping enhances most chiropractic adjustments by increasing blood flow to affected areas, which speeds the remedial effects of adjustments. In this instance, the results of combining these three modalities were dramatic. Lucky lifted his back almost immediately, and after subsequent sessions combined with a prudent conditioning regimen, he regained strength in his back, and his muscle tone improved significantly. This eventually progressed to increased abdominal strength to help maintain his back, and it also made it much easier to fit him with a saddle.”

Ultimately, Lucky went on to compete in dressage, a testament to what a dedicated, knowledgeable team of holistic practitioners can accomplish.

EQUINE CHIROPRACTIC ADJUSTMENT

Chiropractic work has also seen a huge upswing in popularity for treating back pain in horses. Results certainly vary, but some horse owners report seeing dramatic improvements in their horses with as little as one adjustment.

“To clarify terminology, the term ‘animal chiropractor’ is reserved for practicing Doctors of Chiropractic (DC) that are certified to work on animals. Veterinarians take the same certification to work on animals, but they are legally required to avoid the use of the terms ‘chiropractor’ or ‘chiropractic treatment.’ Subsequently, veterinarians refer to their practice as ‘spinal manipulation therapy’ or VSMT. The training and subsequent treatment is the same, whether it is from a chiropractor or a veterinarian, however, the terminology should be clear,” explained Dr. Tovah Caldwell, of McKee Pownall Equine Services in Campbellville, Ontario.

As with massage therapy, the success or failure of chiropractic treatment can depend on correctly identifying the cause or causes of the horse’s pain. “In my experience, it is rare to identify just one clinical sign and one underlying cause for back pain – the signs and symptoms are often intertwined to create a complex clinical picture,” said Dr. Caldwell.

“If the horse doesn’t respond to treatment, or the response is very short-lived despite repeat treatments, it doesn’t necessarily mean that the treatment didn’t work. Poor response just indicates that the restrictions and chiropractic issues identified are likely not the primary problem. This is when it’s important to revisit the case with your veterinarian, identify the primary cause, and institute other treatments that will work in conjunction with the chiropractic care.”

That said, Dr. Caldwell finds that most types of back pain respond positively in some way to spinal manipulation. “This is particularly true for those with secondary back pain (provided the underlying cause is addressed), general stiffness, mild arthritis, conditioning issues, or some form of dysfunction causing poor performance under saddle,” she said. However, she pointed out that horses with acute or traumatic injuries, overt lameness in one limb, or horses in severe pain are not good candidates for chiropractic care initially. “These horses need to be assessed by a veterinarian for primary medical care,” she said. “Once the primary issues have been addressed, spinal manipulation may be beneficial as an adjunct to treatment.”

Benefits of chiropractic/VSMT include:

Improved joint mobility
Increased range of motion
Reduction of muscle spasms
Pain relief
Improved attitude/behaviour
Increased energy
Greater endurance
Improved athletic performance
Improved muscle balance and postur
Improved self-carriage
More fluid movement, especially through transitions and lead changes
Improved rideability

Case Study: The Transformation of a Sway-backed Bucker
Dr. Caldwell has seen chiropractic techniques work wonders for many horses. One that particularly stands out was a horse that a client was given to use in her school program. “The horse,” recalled Dr. Caldwell, “is a teenaged Canadian gelding who had a weak topline and sway-backed appearance when the client first got him. Because of this, his back was sore, and his baseline movement was stiff and uncomfortable looking. He was completely unable to canter under saddle and was not suitable as a school horse as he would routinely buck.

“With regular treatment over the course of two months and a dedicated owner willing to do the exercises I recommended, the change in the topline of this horse was absolutely amazing. The sway-backed appearance has remarkably reduced, his baseline movement is more comfortable and fluid, and he can now canter easily in both directions. He is even jumping small jumps! The horse didn’t receive any other form of veterinary treatment, only spinal manipulation and a rehab program.”

EQUINE ACUPUNCTURE

While the practice of acupuncture is still poorly understood by many people, Dr. Caldwell, who is trained in medical acupuncture as well as VSMT, said, “Western medicine is beginning to embrace acupuncture as a valid treatment due to an increase in the number of published, peer reviewed, good quality scientific studies that are showing the effects acupuncture with proper needle placement has on the nervous system. These include functional MRI studies (Hui, K. K., Napadow, V., et. al. Monitoring Acupuncture Effects on Human Brain by fMRI. J. Vis. Exp. (38), e1190, doi:10.3791/1190) that show how various parts of the brain stem respond to point placement.”

Acupuncture can be especially beneficial for horses with serious back pain, as other treatment modalities, both holistic and conventional, might be too uncomfortable, at least in the beginning. “I tend to default to acupuncture in cases of moderate to severe chronic back pain,” said Dr. Caldwell. “Often, these horses resent being touched or having their spine manipulated, and even traditional western approaches and therapies may not work well for them. What happens with any type of chronic pain is that the nervous system becomes highly sensitized to the discomfort leading to a state of ‘wind up.’ This causes the perception of pain to be amplified, even if the area is not actually that painful anymore.

“Horses with this type of pain can become very challenging to treat because the nervous signal passing between the painful stimulus and the brain is inappropriately firing and needs to be interrupted. This is where acupuncture really shines, as the entire point of acupuncture is to modulate the nervous system to work more appropriately. So, when horses are in too much pain to tolerate other manual therapies, or I’m not having much luck with spinal manipulation or traditional treatments, acupuncture is my modality of choice. It can really do amazing things for pain control.”

In many cases, it isn’t even necessary to put needles in the painful areas in order to successfully treat those areas, which is another reason why very sore horses often tolerate acupuncture well. “Because we are modulating the nervous system, which is connected throughout the entire body, we can treat pain and stress reduction points that may not actually be near the painful area,” she said. “These points will still cause a significant decrease in the pain signals travelling to the brain from any part of the body, leading to the desired effect.”

Dr. Caldwell utilizes a modality called Medical Acupuncture, which is not based on Traditional Chinese Medicine (TCM) but rather on neuroanatomy and neural and hormonal modulation. “While the underlying principles of Medical Acupuncture are similar to those of TCM,” she said, “the theory that dictates needle placement and treatment protocols is very different. In this modality, the goal is to stimulate some part of the peripheral nervous system at that point. The point locations are precise and defined based on neuroanatomy and access to the various nerves at each location. In some cases, Dr. Caldwell applies mild electrical stimulation by attaching small electrodes to the needles, which creates a gentle pulsing sensation and can increase the effectiveness of treatment.

“When you insert a needle, the aim is not to touch the nerve itself, but to cause local stimulation to the surrounding tissues to affect the function of the nerve in that area. Once the nerve is stimulated, there is a cascade of stimulation that runs from the nerve, to the spinal cord, to the brainstem and ultimately to the cerebellum. The outcome of this is neuromodulation, or a change in the function of the nervous system that ultimately results in improved nerve function and decreased pain right at the level of the spinal cord and central nervous system.”

Benefits of acupuncture include:

Overall stress reduction
Pain relief
Increased production of endorphins and other pain-relieving substances within the central nervous system
Improved nerve and muscle function, especially if a particular nerve has been damaged
Muscular trigger point release
Hormonal regulation
Immune system support
Drug-free treatment suitable for competition horses
Improved mobility and more fluid movement due to improved overall comfort

Case Study: A Tense Mare Gets Relief
Dr. Caldwell was recently was called to evaluate and treat a 10-year-old jumper mare. “The mare’s owner requested spinal manipulation,” she said, “as the horse just seemed ‘not quite right’ and stiff under saddle. On exam the mare was showing signs of moderate to severe back discomfort, and her entire topline was tight, tense and sore to touch. Her stride was short and choppy and she appeared generally uncomfortable, despite not showing overt lameness on any one limb.

“I attempted to adjust her, but her muscles were so tight that I was unable to successfully adjust any part of her back. Additionally, due to her discomfort, she wouldn’t stand still, was pinning her ears when I touched her, and was trying to bite my assistant. Spinal manipulation was clearly not the right choice at that moment, so I decided to try acupuncture.

“I placed about 10 needles in her, mostly in calming and pain reduction points, none of which were in her actual back. I applied a current across the pelvic points and the mare instantly became more comfortable. She stopped dancing around, stopped biting, and despite summer camp activities happening in the barn, she lowered her head and stood perfectly still for 20 minutes. Near the end of treatment, she was licking her lips and yawning, which are often signs of stress release and enjoyment.

“We rechecked the mare the following week, as I wasn’t convinced that acupuncture would be enough to control her discomfort. To my pleasant surprise, she was moving significantly better on the lunge line: striding out, lowering her head and stretching down, and showing significant bounce and movement through her topline. Exam showed a reduction in muscle tension and she was much more tolerant of being touched. Even I was impressed at the dramatic change just one treatment had accomplished. As much as I believe in acupuncture and spinal manipulation, sometimes the results still surprise me!”

If your horse is suffering from back pain, it is always best to consult with your veterinarian before initiating any kind of therapy, but you may want to ask about including massage, chiropractic/VSM, and/or acupuncture in your horse’s treatment program. “If you’re ever facing a problem that you haven’t been able to solve, or you’re looking for drug-free alternatives to maximize your horse’s comfort and improve performance, I would encourage you to give these modalities a chance, regardless of your horse’s breed, age, or use,” said Dr. Caldwell. “In the right case and with the right practitioners, the outcomes can be life-changing for horse and rider.” Holistic offerings might, in the end, be just what the doctor ordered.