Pain relief is a complex topic. The role of pain is to protect the body from damage, which means it’s fundamental to health and ultimately to survival. In other words, pain is life-sustaining. It puts the body on notice that tissue damage has occurred or is about to occur. And it changes the body’s behavior accordingly, in an effort to avoid further damage and create an environment that is most conducive to healing (e.g. stillness or slow, careful movement).
Furthermore, at the biochemical level pain helps marshal the troops, so to speak. The neurotransmitters and other biochemicals involved in inflammation and the perception of pain act as beacons for the cells whose job it is to move into the damaged area, destroy any invading organisms, mop up the debris, and begin the repair process. So, in addition to its protective role, pain is integral to healing.
Does that sound like something we should be actively suppressing, just because it’s unpleasant? It is an admirable desire to want to relieve suffering. However, sometimes I think we take it to an extreme. In our culture we have such an aversion to discomfort, in whatever form it takes, that we assiduously avoid it, sometimes even to the detriment of our long-term health and well-being. I think that’s what underlies the prevailing sentiment that every animal in pain should be given some form of “pain killer.” Our guiding thought is: “Just make it go away.”
To borrow from Buddhist philosophy, there is pain and there is suffering, and the two are not synonymous. Yes, there can be a psychological component to pain (i.e. physical pain can cause emotional suffering), but it’s been my observation that most animals cope with pain much better than most humans do. In fact, your horse’s pain may be upsetting you more than it’s upsetting him. That’s not to say we should not be providing pain relief.
That’s not what I mean at all. To use another Buddhist concept, what I’m saying is that we need to do so mindfully. Know what you’re treating and why, and understand the ramifications of what you’re doing. Jumping in with the pain relievers, without fully understanding why the pain is there, is a bit like putting a strip of duct tape over the oil warning light on your dashboard, instead of making an effort to find out why the warning light is on. Remember, pain has a purpose.
Answer these three questions
The best pain relief method I know of is restoration of health. In most cases, once a damaged tissue has healed completely, it is no longer painful. So, the single most important component of pain management in horses is to correctly identify the cause of the pain and appropriately treat the cause. Pain relief, whether pharmaceutical, herbal, homeopathic, or anything else, are secondary components of the treatment plan.
Before proceeding with pain relief of any kind, three questions need to be answered:
1. Where is the pain originating?
2. Why is it there (i.e. what’s causing it)? And with chronic pain, why is it still there?
3. What, if any, intervention is needed?
Accurate assessment is the key to effective pain relief. Resolve the underlying problem and the pain resolves itself in most cases. This is where having a wholistically oriented veterinarian as an integral part of your horse’s health care team is a tremendous asset.
Pain relief options
When it comes to pain relief, there’s an astonishing array of alternatives to drugs and surgery. Some operate primarily at the biochemical or cellular level; others on a more gross scale of tissue, region (i.e. body part), or the body as a whole; and panning out even further are the therapies that primarily work on the nonphysical or energetic aspects of the body’s organizational system. Here is just a sampling:
• Biochemical/cellular: anti-inflammatory nutrients, nutraceutical, and herbs; injectable hyaluronan and polysulfated glycosaminoglycans; autologous conditioned serum (aka interleukin-1 receptor antagonist protein, or IRAP) therapy; stem cell therapy; neural scar therapy (injection of scars with local anesthetic).
• Tissue/region/body: rest, exercise, cold therapy, heat therapy, bandaging and splinting, corrective hoof care, manual and movement therapies, osteopathic or chiropractic manipulations, magnetic field therapy, and various electrical devices (e.g. transcutaneous electrical nerve stimulation or [TENS], electrical muscle stimulation, therapeutic ultrasound, cold laser and other light therapy, electromagnetic field therapy).
• Nonphysical/energetic: homeopathy, homotoxicology, acupuncture/acupressure, craniosacral therapy, Trager work, Reiki, Healing Touch, radionics, plant and gemstone essences, prayer, and love.
Of course, there’s quite a bit of overlap with many of these specific approaches, as they work at both the physical and nonphysical levels. And this list is far from complete. It simply serves to illustrate how many different ways one can approach and work with the horse’s system to help restore comfort and function. Which method or combination of methods is most appropriate will depend on the individual horse, on the cause of the pain, and on its severity and duration. This, too, is where working with a wholistically oriented veterinarian often yields the best outcome.
Pain-mollifying vs. disease-modifying
When deciding on a plan of care, it’s important to make the distinction between pain-mollifying and disease-modifying agents or approaches. Are you just wanting to mollify (calm, soothe, lessen) the pain, or do you actually want to address its underlying cause? A pain-mollifying approach is one that merely suppresses inflammation or reduces pain perception or sensitivity. With a disease-modifying approach, you’re actually working with the body’s healing processes to resolve the problem causing the pain. As you might imagine, this strategy is most effective overall.
Sometimes, though, a combination of the two is needed, because working only on the root cause of the pain may not have an immediate payoff in terms of pain relief. This is most often the case with chronic pain. Horses dealing with chronic pain generally require a multifaceted approach – a truly wholistic approach, in fact.
Let’s take a look at arthritis as an example. Osteoarthritis or degenerative joint disease is one of the most common causes of chronic pain in horses. In devising a treatment plan, I first consider the horse’s age, breed, build, conformation, occupation, work history, habits of posture and movement, trimming/ shoeing, footing (i.e. living and work surfaces), housing, exercise regimen, diet, social interactions, medical history, overall health, and other things.
In other words, I’m looking for all the factors that may be contributing to joint health or disease in this individual horse. From there, I devise an individualized plan of care that aims to get and keep the whole horse, and thus her joints, in a better state of health. The body is more than just a collection of parts, and no problem occurs in isolation.
So if I feel, for example, that the underlying cause of joint disease in a particular horse is a compromised gut barrier, then the focus of my treatment plan will be on restoring gut and liver health. Often, no specific “joint therapy” is needed once the digestive system is in a better state of health and function. In other cases, the focus may be on hoof care, saddle fit, or movement re-education.
My point is that there is no simple formula for pain management in the horse. What works for one may be only moderately effective or entirely ineffective in another. That’s because disease is a highly individual thing; it does not follow a formula. That’s not what the conventional scientific paradigm would have us believe, but it is nonetheless the true state of things. Find out why the individual horse has pain, and the solution for that horse begins to reveal itself.
In my practice
I want to finish by listing the pain relief and pain-management tools I use most often in my practice. They reflect the healing methods to which I am most drawn: nutritional therapy, herbs, homeopathy, manual and movement therapies, and energy medicine.
• A healthy diet, daily exercise, and loving social connections.
• Homeopathics, such as Traumeel and Spascupreel (www.HeelUSA .com); Traumeel for any kind of inflammatory condition, and Spascupreel for colic pain. I also use single homeopathic remedies as the case requires and following classical homeopathic principles.
• Herbal supplements, such as Mobility Blend, Spicy Magic, Green Magic, and Ulcer Care (www.animavet.com).
• Herbal essences, especially Devil’s Claw, Frankincense (Boswellia), Ginger root, Raspberry leaf, Chamomile, and Wild Oat (www.animavet.com).
• Manual and movement therapies (various).
• Spinal mobilization, based on osteopathic principles, but primarily energetic in application.
• Energy work: hands-on and remote, including an emotional release technique (as chronic physical problems often reflect an underlying emotional disorder).
• I also include dental care, saddle fit, and restorative hoof care (trimming to restore optimal digital biomechanics).
For my own use, for the various aches and pains of a vet’s life, I use: Traumeel, Cimicifuga Homaccord (a Heel remedy that works a treat for upper back and neck pain), and the various herbal essences I make (especially Devil’s Claw and the others listed above).
Daily exercise (a brisk walk with my dog first thing each morning), some spinal mobility exercises (Trager Mentastics, to be specific), and a healthy diet also are essential. When I slack off with any of these three, my body starts grumbling at me. So, too, with many of the horses and other animals in my practice. The principles of healthy living cross species boundaries and are immutable. Trying to cheat the system or addressing only the most obvious part of the problem (i.e. pain) is missing the point.
To find a holistically oriented veterinarian in your area, go to the American Holistic Veterinary Medical Association website at: www.ahvma.org or check out the directory listings in this magazine. Copyright ©2008 Christine King BVSc, MACVSc, MVetClinStud
Dr. Christine King is an Australian equine veterinarian with over 20 years of experience and advanced training in equine internal medicine and equine exercise physiology. She takes a wholistic approach to equine health and performance which emphasizes natural strategies for restoring and maintaining health and well being. Her mobile practice , Anima – Wholistic Health & Rehab for Horses , is based in the Seattle area. Dr. King is also the creator of Animal Herbal Solutions. www.animavet.com; email firstname.lastname@example.org; phone 425-876-1179.