Chronic pain management in horses requires multimodal approaches combining appropriate analgesia, physiotherapy, management modifications, and quality of life assessment to maintain welfare through long-term conditions.
Chronic pain welfare in horses demands the same comprehensive, sustained approach used in human chronic pain management: recognizing that pain is multifactorial, that no single treatment is universally effective, and that quality of life must be monitored longitudinally rather than assessed at single time points. The stoic nature of horses means that chronic pain often manifests primarily as behavioral changes, reduced willingness to work, and altered social behavior rather than overt pain signs, making owner and handler education essential. Multimodal pain management that combines appropriate analgesia with physiotherapy and environmental modification achieves better welfare outcomes than any single intervention. The honest assessment of when chronic pain management is no longer maintaining adequate quality of life is one of the most challenging but important welfare decisions in equine practice.