Joint trauma can severely limit performance and seriously affect the quality of your horse's daily life. Owners want and need to know how best to manage equine joint disease. The most important factor in successful treatment is early detection and diagnosis.

Any of the components of joints--the joint capsule, synovial membrane, synovial fluid, cartilage, bone, and ligaments--can be affected by disease or injury. A thorough lameness examination is the only way to accurately diagnose joint disease, and it should be the basis for any therapy recommendations.

Treatment goals for joint injury are reduction of inflammation and healing of injured tissue. These goals are often reached by a combination of therapies that might include rest or reduced training, non-steroidal anti-inflammatory drugs (NSAIDs), intra-articular (within the joint) injection of corticosteroids, intra-articular or systemic injections of hyaluronic acid (HA) and polysulfated glycosaminoglycan (PSGAG), physical therapy, acupuncture, and/or oral nutraceuticals.

Over the past decade, much has been learned about the pathophysiology of joint disease, which has led to improved veterinary treatments. Add in today's over-the-counter supplements to the treatment options, and many owners soon find joint therapy a bewildering subject! How do you decide what's best for your horse? We discuss with owners what prescription medications might be indicated for the problem(s) being treated. While an owner or trainer can administer some medications, a veterinarian must administer others by systemic or intra-articular injection. Following are the most commonly used joint disease medications:

NSAIDs--When used judiciously, these medications (e.g., phenylbutazone, ketoprofen, flunixin meglumine) help reduce orthopedic inflammation to an acceptable level while healing begins.

PSGAG--This is considered to be a chondroprotectant (cartilage-protecting) drug. Given by intramuscular or intra-articular injection, it is used to prevent the development of osteoarthritis and to slow its progress.

HA--This is an essential element in normal joint fluid and cartilage. Administered by intravenous or intra-articular injection into an affected joint, HA minimizes damage from inflammation within the synovial membrane and cartilage.

Corticosteroids--These powerful anti-inflammatory drugs are often combined with intra-articular administration of HA. Research strongly suggests that, when properly used, select corticosteroids exert a chondroprotective effect and enhance the healing process within the injured joint.


Any decisions regarding "over-the-counter" (OTC) oral joint supplements (nutraceuticals) should be made after diagnosis by a veterinarian and prescription of appropriate drugs. It is important to realize that oral supplements inhabit a very different world from prescription medications. The supplement industry is under very little regulation or enforcement regarding manufacturing standards, marketing claims, safety assurances, and accuracy or relevance of label information. Incomplete or confusing labeling can be especially problematic if the product contains any substances that are forbidden under various competition medications rules. In other words--caveat emptor (buyer beware)! However, some nutraceuticals are reportedly effective in relieving joint pain in a significant percentage of performance horses, depending on the problem being treated.

MSM (methyl sulfonyl methane)--This compound has years of anecdotal support in the performance horse world. Recent research reports that MSM has a significant anti-inflammatory effect on joint cartilage samples in a laboratory setting.

Chondroitin/glucosamine/manganese combination products--Two products have been specifically evaluated in peer-reviewed, blinded studies presented at the annual conventions (1996 and 2002) of the American Association of Equine Practitioners. We have also seen rewarding results with a third such product for which published data does not exist.

Herbal supplements--While it is likely that certain herbal products can play a role in the management of joint pain, we are unaware of any with published clinical trials performed in the horse. The added concerns of non-compliance with medications rules and potential drug interactions are significant.

Finally, never forget that the injured or diseased joint is part of a bigger picture--your horse! If training is inappropriate, trimming and shoeing inadequate, or athletic goals unreasonable, no veterinarian, prescription drug, or supplement will solve the problem.

About the Author

Harry Werner, VMD

Harry W. Werner, VMD, is a Connecticut equine practitioner with special interests in lameness, purchase examinations, wellness care, and owner education. Dedicated staff, continuing education and technological advances enable his practice to offer high-quality patient care and client service in a smaller, general equine practice environment. A committed AAEP member since 1979, Dr. Werner is has served as AAEP Vice President and, in 2009, as AAEP President, and he is a past president of the Connecticut Veterinary Medical Association.

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