If there is a potential lameness problem, a detailed musculoskeletal examination will be undertaken, including palpation and mobilisation of the different structures, followed by a complete gait evaluation. A gait evaluation is likely to include examination in a straight line, on the lunge on both soft and hard surfaces, in trot and sometimes in canter. A ridden examination is very important, as many lameness or poor performance problems look different under saddle.
Lameness occurs when a horse is either experiencing pain during locomotion or there is a physical limitation to demonstrating a normal gait. For subtle lameness, the horse may only show a loss of performance or resentment of a particular type of activity. As horses are usually required to be an athlete in some capacity, many of the lameness problems that we see are subtle.
Equine back pain may be primary in nature or secondary to lameness or gait change, especially of the hind limbs. Clinical signs range from poor performance to resistance, rearing and bucking. These horses usually require diagnostic imaging including scintigraphy and computerised radiography if primary in nature. Secondary back pain may be alleviated by treatment and resolution of the primary issue, with concurrent physiotherapy treatment.
Nerve blocks are used to identify the site of pain either around a nerve (perineural analgesia) or into a joint (intra-articular analgesia). This can be useful for identifying where a horse is painful if a lameness is eliminated following a specific nerve block.