The J.T. Vaughan Large Animal Teaching Hospital is now offering mesotherapy for horses that are experiencing chronic back and neck pain. Mesotherapy involves the use of multiple microinjections of a combination of products into the mesoderm (middle layer of the skin) with very fine, short needles to relieve muscle pain and inflammation. This middle layer of the skin has large nerve fibers that run directly from the spinal cord. The nerve fibers are stimulated by the treatment, which results in a decrease of pain and consequently improve healing.
There are several theories about why mesotherapy works for pain relief. One theory is that by physically injecting the dermis, there is stimulation of the inhibitory nerves which will break the pain-spasm cycle. Another theory is that by using multiple microinjections at the site, the drugs will stay for a longer period of time and will be released slowly into the area of pain or muscle spasm. Another benefit of locally delivered medication is that side effects such as stomach ulcers and kidney toxicity, encountered when systemic anti-inflammatories are administered, are avoided.
In horses, this technique is used to treat neck, back and pelvic pain caused by arthritis or other causes of chronic pain. Some of the conditions that mesotherapy has been used to treat in horses include sacroiliac pain, back pain associated with ill-fitting saddles or overriding spinous processes (aka “kissing spine”), or pain secondary to lameness.
Horses with a sore back usually are very stiff in their movements, are reluctant to saddling, are short-strided, and are generally uncomfortable when worked or exercised. It is important to perform a complete physical examination on the horse to determine the potential causes for the behavior the horse is exhibiting. Diagnostic imaging (radiographs and ultrasound) may be necessary before initiating mesotherapy treatments to evaluate for other potential causes that could explain the symptoms, such as neurologic conditions or arthritic changes that would require different management. It is important to know that mesotherapy will not be the cure for every cause of back or neck pain. Mesotherapy may need to be used in combination with other modalities such as chiropractic adjustment, acupuncture, shock wave and laser therapy.
For the procedure, the horse will be sedated and the affected area will be surgically prepared for the injections to minimize the risk of infection. Since medication is being deposited in the dermis, small bumps will be present, but they will resolve within a few days. It is recommended that the area is not washed and refrain from placing tack on the horse’s back for two days, to minimize the risk of reaction at the injection site. The majority of horses will show improvement within 5-7 days after treatment. Depending on the response of the horse to the treatment, it may be required to repeat the treatments every 6-12 months. It is important to remember that this therapy is not intended to reverse or heal the changes that are already present in the horse’s back.