Are Frequent Joint Injections Safe for Horses?

An owner’s doctor is reluctant to give her joint injections too often, but her horse gets them every six months. Is that cause for concern?
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are frequent joint injections safe for horses
Veterinarians use joint injection to decrease inflammation which, not only reduces the osteoarthritis-associated pain and lameness, but also temporarily stops the vicious joint inflammation cycle. | Photo: Alexandra Beckstett/The Horse
Q.My reining horse receives steroid hock injections approximately every six months. I also receive joint injections, but my doctor is reluctant to do them too frequently. If they aren’t good for me, are they good for my horse? Are there other options to manage his joint health?

—Sarah, Nevada

A.Hi Sarah,

Like your doctor, most veterinarians are hesitant to inject joints too frequently and, while what constitutes “too frequently” varies among practitioners, most prefer not to inject any one joint more than twice a year. Your questions are good ones: Are joint injections good for my horse and are there alternatives?

How Joint Injections Help

To answer the first question, it’s important to understand that veterinarians typically use joint injections to treat osteoarthritis. Osteoarthritis is a vicious cycle: It starts with damage to the cartilage or underlying bone (called subchondral bone), which leads to joint inflammation, which causes further articular cartilage degradation, and so on.

The purpose of a joint injection is to decrease inflammation which, not only reduces the osteoarthritis-associated pain and lameness, but also temporarily stops this vicious joint inflammation cycle. Additionally, researchers have shown that triamcinolone—the most commonly used corticosteroid in joint injections—protects the articular cartilage. So from these viewpoints, joint injections are “good.”

But can there be too much of a good thing? In this case, yes. When joint injections no longer have a lasting effect (i.e., they used to relieve pain and lameness for six months but are now wearing off after three), the osteoarthritis disease process has likely worsened to the point where joint injections are no longer adequate as the sole management strategy.

Additional Treatment Options

So, to answer your second question, yes, there are many other treatments that can be helpful with managing osteoarthritis. These might include systemic (oral or injectable) and/or topical low-grade non-steroidal anti-inflammatory medications, oral and injectable systemic joint support products, and/or shock wave therapy.

Additionally, certain management and husbandry techniques can have a substantial effect. In humans with knee osteoarthritis, every additional pound of body weight produces an additional 4 pounds of force on the affected joint. And a small study in dogs with hip osteoarthritis showed that they were sounder following weight loss of 11-18%. Therefore, you shouldn’t overlook the benefits of maintaining a horse in a healthy weight.

Other management techniques that could help horses with osteoarthritis include daily access to turnout and getting regular, daily exercise. If horses must be temporarily housed in a box stall (for example, at a competition), frequent hand-walking and allowing ample time for a slow warm-up might help.

Take-Home Message

In summary, in all but the most severe cases, judicial use of joint injections coupled with other treatments and management techniques allows for successful long-term management of our equine athletes with osteoarthritis.

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Written by:

Erin Contino, DVM, Dipl. ACVSMR, is an assistant professor in equine sports medicine at the Colorado State University (CSU) College of Veterinary Medicine and Biomedical Science’s Equine Orthopaedic Research Center. Contino graduated with a veterinary degree from CSU in 2010 and completed a one-year internship at Pioneer Equine Hospital in California. She then returned to CSU for a three-year Sports Medicine and Rehabilitation Residency and became a Diplomate of the American College of Veterinary Sports Medicine and Rehabilitation in 2014. Before and during her time as a veterinary student, she also completed a master’s degree in equine radiology. Her research interests include equine musculoskeletal imaging, diagnostic analgesia, lameness, and performance issues in equine athletes. In her free time, she’s a passionate three-day event rider.

2 Responses

  1. Horses doing intensive work that involves repetitive extreme turns & forceful use of the hindquarters, is the likely cause of the osteoarthritis. So the owners cause the problem. Every injection allows the horse to continue doing this work, which, obviously, is going to worsen the problem, & some horse being ‘stoic’ will work despite pain.While a person can decide for themselves if they want to work through pain & have such treatment for their own humansport ambitions, it is not kind to keep joint-damaged horses in hard work by using pain-killer injections. In the end it is a financial decision, & not in my opinion,in the horse’s best interests, except in an easy ‘retirement’.

  2. My understanding is that steroid joint injections can actually make the joint issue WORSE over time, which I think is the concern of the lady asking the question. This article seems only to say that they may not work as well over time — not that they cause damage. Is what I have been told incorrect?

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