No Pain, All Gain: The Benefits of Equine Acupuncture
By Mary Masterson, DVM
Bend Equine Medical Center
2105 NW Black Pines Dr
Bend, OR, 97701
Email: bemc@bendnet.com

For as long as humans have been experiencing pain, we have been ingenious at finding ways to alleviate it.  From simply rubbing where it hurts to “biting the bullet” we have empirically discovered that physical interactions with the body can have profound therapeutic effects.  It was observed 3000 years ago that using a needle (acus) to pierce the skin (puncta) in a specific location could provide relief to a variety of human ailments and veterinary acupuncture has been practiced for nearly as long. Because of their historical importance in agriculture, transportation and military operations horses were some of the first of the animal kingdom to be treated with acupuncture. 

Now it seems that the western medical community has discovered what ancient Chinese “Horse priests” knew 2500 years ago:  that stimulation of certain points on the body can dramatically reduce pain, provide relaxation and improve circulation.  In the last 10 years, acupuncture has been receiving greater acceptance in western medical professions.  Health organizations such as the National Institutes of Health, the American Medical Association, and the American Veterinary Medical Association (AVMA) all recognize acupuncture as a valid modality for a variety of diseases in human and non-human animals.  The AVMA has stated that veterinary acupuncture is now considered an integral part of veterinary medicine in line with other medical and surgical procedures performed on animals. A greater awareness and acceptance of acupuncture as a treatment modality has resulted in increased research and improved understanding of acupuncture’s applications and mechanisms of action.

Acupuncture provides therapeutic effects by neuromodulation.   Specifically, a needle placed into a certain site on the body communicates with the nervous system and acts to modify its function. The specific effects of acupuncture needling are mediated through stimulation of the peripheral nervous system (nerves under the skin at the site of needling) which in turn communicate with the central nervous system (nerves within the spinal cord and brain).  Via these pathways, substances are released in the brain and spinal cord that have wide ranging therapeutic effects on the body.   Such biochemicals include endorphins and serotonin, two compounds that are well documented to relieve pain and provide relaxation.  Interestingly, brain scanning techniques have linked acupuncture to changes in blood flow to areas of the brain that are associated with pain reduction. While the efficacy of acupuncture has long been established anecdotally, a fundamental scientific understanding of this modality allows us to move away from the historical descriptions of acupuncture in terms of “energy” and into a more modern explanation how this modality is achieving its therapeutic effects via stimulation of the nervous system.

 Acupuncture is useful for treating a variety of conditions in performance horses. It is particularly useful for the treatment of back pain in horses. Chronic back pain is a common affliction in sport horses that presents most often as poor athletic performance.  Other symptoms seen with back pain are changes in behavior or temperament such as becoming sour, bucking or rearing.  Clinical studies have shown that electroacupuncture (acupuncture needles connected to light electrical stimulation) is more effective for treating thoracolumbar (lower) back pain in horses than conventional non steroidal anti-inflammatory medication such as phenylbutazoneÒ (bute).   The primary benefits of acupuncture for back problems are pain relief, increase in blood flow, relief of muscle tension and systemic muscle relaxation. Numerous studies have shown that simply providing pain relief will allow the body to heal itself from an injury more quickly than when pain goes unmanaged.  Acupuncture is not only effective at treating the horses’ thoracolumbar area, but is also helpful in treating pain in the pelvis and sacro-iliac regions.  This is rewarding because these areas are often resistant to more conventional treatment modalities such as cortisone injections.

Performance training often requires a series of demanding repetitive motions from the horse.  The physiologic strain of this type of exercise, frequently results in symptoms such as decreased stride length, generalized body soreness and increased stiffness.  These horses are often sound but exhibit substandard performance or increased resistance to activities that were not previously problematic.  These horses typically respond very well to acupuncture treatment and resolution of these symptoms before they progress into actual lameness is ideal.
 
Pain relief provided by acupuncture is often immediate but may have a variable duration of effectiveness depending on the type and severity of musculoskeletal dysfunction. Acute injuries tend to respond rapidly, and require fewer treatment sessions, while chronic musculoskeletal conditions often require longer term treatment. Acupuncture can be used successfully in treating a plethora of musculoskeletal conditions as a primary treatment or as an adjunctive therapy to more conventional veterinary techniques.  For example, horses with primary distal hock joint arthritis (spavin) frequently suffer from significant compensatory lower back pain due to muscle spasm in the longissimus dorsi muscle.  Intraarticular injections are typically the best way to manage the spavin, but if the back pain is left untreated the response to hock treatment is less rewarding. Using acupuncture to treat back pain can result in a greater response to therapy and return to maximum performance.  Most importantly, a thorough examination and workup of the presenting performance complaint is always necessary to determine what the ideal therapy will be.  Frequently, this treatment plan includes a combined approach of acupuncture and conventional veterinary therapy.  
 
Acupuncture involves the insertion of fine needles into specific predetermined locations (acupuncture points). The pattern of points used depends upon the specific problem being addressed.  Chosen acupuncture points are often within local tender or painful sites, as well as proximal or distal to the affected sites. Acupuncture needles are very fine and flexible and there is typically very little if any reaction to placement of the needle- much less than the reaction observed with a hypodermic needle used to give a vaccination.  Most horses are remarkably tolerant to acupuncture.  Some horses are very relaxed and become naturally sedated as endogenous endorphins are released during treatment, while others are more guarded and require tranquilization for treatment.  Sedation is usually necessary if a sensitive area of chronic pain such as the back is being treated.  Initial therapy is typically once a week for three weeks, then as needed based on the horse’s response to treatment. 

This article has been mainly limited to the discussion of acupuncture’s application to the treatment of musculoskeletal issues. It is important to realize that the therapeutic effects of acupuncture are far reaching and it can be used successfully in a variety of medical conditions. These conditions include medical colic, respiratory disorders, neurologic conditions, allergic conditions and immune dysfunction to list a few.  The most important factor to knowing whether acupuncture can be useful in your horse is to have a thorough veterinary work up to diagnosis the problem so that the appropriate treatment modality can be chosen.   To find out more about acupuncture and whether it would be an appropriate choice for your horse find a certified veterinarian acupuncturists who can articulately discuss your specific case.  Someone who has undergone the education and practice necessary to be competent at performing acupuncture will be happy perform a thorough evaluation of your horse to answer any questions you may have about using this exciting therapy.