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A Pain in the Neck?

Given that the neck is a very complex structure, using numerous muscles to move the seven cervical vertebrae, aiding with the balance of a 500 kilogram animal, in addition to carrying that extremely heavy head, several owners and clinicians still seem to look for neck pain only when they are running out of ideas as to why the horse is uncomfortable or not performing as well. 

Clinical signs may include: 

  • Difficultly accepting a contact. 
  • Struggling to bend on one rein or the other. 
  • Muscle asymmetry of the neck.
  • Started objecting to having his ears or poll touched.
  • Pain on palpation. 
  • Ataxia. 7% of horses with cervical arthritis become ataxic (uncoordinated). 
  • Lameness. This is extremely important to note. Neck pain can result in a significant forelimb lameness. 

It is important to note that not only arthritis of the joints themselves can cause clinical signs. Inflammation of the soft tissue structures in that area can also cause these symptoms, therefore structures around the vertebrae should also be assessed. 

Diagnosis

A clinical exam and full neurological work up will be carried out by the clinician, followed by diagnostic imaging such as ultrasound, CT and radiography (radiography not always helpful in diagnosis but we have included it nether the less). 

Treatment 

  • Non-steroidal anti-inflammatory drugs (NSAID) 
  • Good old fashioned rest (time off). 
  • Cervical facet injections (placing corticosteroids into the facet joints between the cervical vertebrae)
  • Mesotherapy (injecting small volumes of corticosteroids and local anesthetics into the mesodermal tissue under the skin
  • Acupuncture
  • Chiropractics
  • Shock wave therapy

With the correct diagnosis and treatment, many horses continue to perform extremely well for several years, however the correct management will be a major player in achieving this. 

I hope this short article helps you to realise the implications that this specific structure can have on the rest of the horse as a whole. 

Neck problems are far too easily overlooked, and we are just too comfortable focusing on the limbs, back or mouth when assessing performance issues of the horse. 

Don’t forget the neck! 
E.J. Westwood. On behalf of NVG.

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