Lameness or orthopedic pain is a common complaint among horse owners. We must remember that horses are athletes just like humans and commonly get discomfort associated with athletic endeavors. A typical exam starts with a detailed history from the owner, rider and/or trainer to determine how long the lameness has been present, any factors that might have led to the lameness, performance history and so on. Then a complete physical exam occurs with special attention paid to the limbs and associated joints, tendons, ligaments, and hoof. The horse is then examined at several different gaits both on the ground and sometimes under saddle to assess if the lameness is associated with one or more limbs.
Once a limb has been identified, more attention is paid to the affected limb. Typically hoof testers are used around the hoof to identify any sources of pain since the hoof is the most common source of lameness in the horse. The joints and soft tissues are palpated to identify effusion, swelling, heat or pain. Then, limb flexion tests are performed. The purpose of the flexions is to place increased strain on particular joints suspected of having inflammation, and then jogging the horse off to see if the lameness has been made worse. If an obvious source is identified, the veterinarian may progress to advanced diagnostics such as radiography, ultrasonography, or referral for nuclear scintigraphy, CT scan or MRI. If the source is not as obvious or confirmation is needed, regional nerve blocks can be performed. This is similar to a person going to the dentist and the dentist blocking the tooth to be worked on. We can isolate lamenesses to certain portions of the limb by targeted systematic nerve blocks. Once the region of the limb has been identified, your veterinarian will then likely use diagnostic equipment to determine the specific cause of the lameness. Once we have a diagnosis, we can then target a customized course of therapy to your horse to get him sound again.