Getting to the Point: Equine Acupuncture

A review of the existing science behind equine acupuncture

With tightening sport horse competition drug regulations, increased scrutiny surrounding horse racing, and the general public’s desire to turn toward natural alternatives to medications, many veterinarians are seeing a rising demand for equine acupuncture. In the Western Hemisphere acupuncture has become an increasingly acceptable treatment modality. In fact, a 2017 survey of 423 horse owners in the U.K. found that 81% were willing to try a complementary or alternative form of veterinary medicine.1

Even if you are open to equine acupuncture, how much do you really know about this therapy? In this article we’ll explore the scientific basis of equine acupuncture, so you can come to your own informed decision about pursuing it to treat your horse’s ailments.

A Primer on Terminology

Many people use words such as holistic, alternative, complementary, and integrative medicine interchangeably. Although each of these categories includes acupuncture, each term has a distinctly different meaning.

Holistic medicine refers to a type of practice that looks at an animal as a whole while considering its environment and nutrition. Alternative medicine uses nonmainstream practice to replace conventional medicine, while complementary medicine uses conventional medicine together with nonmainstream practice. Integrative medicine combines all forms of holistic care, wellness, and medical practice in a coordinated fashion.

The History Behind Equine Acupuncture

Acupuncture is simply the stimulation of a specific point using a sharp object, such as a needle, to create therapeutic effects. Equine veterinary acupuncture traces back to ancient China’s Tang Dynasty in 618-907.² Although its origins have not been described, many feel it might have been observational, from recording unintentional treatments from being struck with sharp objects, thus serving as the longest clinical trial in medical ­history.

Despite its popularity, equine acupuncture has limited scientific evidence behind it. Researchers have conducted only two systematic reviews of companion animal acupuncture literature in the English language, and both concluded that most scientific evidence of veterinary acupuncture’s efficacy was nonexperimental and of low quality (not randomized and controlled trials) and, therefore, inconclusive.

How Does it Work?

Western-medicine-trained horse owners and veterinarians can struggle to understand acupuncture in traditional Chinese veterinary medicine (TCVM) terms—words like qi, theory of five elements, internal and external pathogens, meridians, and yin and yang.

From a Western perspective, acupuncture works through neuromodulation, meaning it normalizes function throughout the nervous system. Acupuncture points correspond to areas of decreased electrical resistance and increased conductivity, as well as increased density of free nerve endings, small blood and lymphatic vessels, and mast cells (immune cells found in connective tissues).

From a physiology standpoint, acupuncture elicits a response at different levels of the nervous system.³ First, it causes local effects, such as increasing blood flow to a certain point and relaxing the surrounding muscle and tissue. Second, it causes segmental effects, as most meridians (pathways of acupuncture points) correlate with nerve pathways. This means stimulating an acupuncture point can cause nerve impulses to travel up the pathway and into the spinal cord. Third, it has central effects, meaning functional MRI (brain imaging) has shown different effects on the brain when an acupuncture point is stimulated. Finally, it affects the endocrine (hormone) system by changing the level of natural chemicals and opioids in the central nervous system.

Is it Effective?

As early as 1997, the National Institutes of Health concluded that acupuncture was effective in treating human nausea and dental pain and was useful for myriad medical issues ranging from osteoarthritis to low back pain to asthma.4 Since then, researchers have performed many case studies and experimental studies on the efficacy of acupuncture in horses, dogs, and cats. However, in a review of 843 references, Canadian scientists found only four hypothesis-driven (more likely to be scientifically sound) studies.5

Meagan Smith, DVM, Dipl. ABVP, assistant professor of Clinical Equine Field Service at the University of Pennsylvania’s New Bolton Center, in Kennett Square, primarily uses acupuncture “for musculoskeletal maintenance or to help musculoskeletal issues,” she says. “Trainers and riders of the horses I perform monthly maintenance treatments on truly believe their horses feel better for at least a couple weeks after treatment—more supple and freely moving.”

Indeed, the most common indication for acupuncture in companion animal literature is to alleviate pain and treat lameness conditions. Researchers have found acupuncture to be 98% effective for treating back soreness in companion animals (dogs, cats, and horses), with increased pain threshold (measured as twitching in response to heat stimulus), increased skin temperature, and increased endorphins in the spinal fluid.5


1. Thirkell J, Hyland R (2017). A survey examining attitudes towards equine complementary therapies for the treatment of musculoskeletal injuries. Journal of Equine Veterinary Science. 59 (2017) 82–87.

2. Tangjitjaroen W, Shmalberg J, Colahan PT, Xie H (2009). Equine acupuncture research: An update. Journal of Equine Veterinary Science. 29(9), p. 698-707.

3. Robinson, N. (2009). Making sense of the metaphor: How acupuncture works neurophysiologically. Journal of Equine Veterinary Science. 29(8): p. 642-644.

4. National Institutes of Health. (1997, Nov. 3-5). Acupuncture.

5. Rose WJ, Sargeant JM, Hanna WJB, Kelton D, Wolfe DM, Wisener LV (2017, Dec. 11). A scoping review of the evidence for efficacy of acupuncture in companion animals. Animal Health Research Reviews. 18(20): p. 144-185.

6. Shmalberg J, Xie H (2009). The clinical application of equine acupuncture. Clinical Techniques. 29(10): p. 753-760.

The Horse: November 2019​This article continues in the November 2019 issue of The Horse: Your Guide to Equine Health Care. Subscribe now and get an immediate download of this issueincluding this in-depth feature on the existing science behind equine acupuncture.

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