Horses are stoic prey animals who mask pain effectively. Validated pain assessment scales including the Equine Pain Scale and Horse Grimace Scale have transformed the ability to detect and treat pain in clinical settings.
Equine pain recognition has been transformed by the development and validation of objective facial and behavioral assessment tools. Before these tools existed, equine pain management was inconsistent - horses who masked pain effectively received inadequate analgesia. The Horse Grimace Scale provides a tool that non-specialist observers can learn to use reliably, enabling more consistent pain monitoring in field and hospital settings. The welfare implication is direct: better pain detection leads to better pain management. Horses with chronic conditions including laminitis, dental disease, and musculoskeletal disorders can now be assessed more reliably, ensuring that pain management keeps pace with the true level of suffering. Training horse owners in basic pain recognition extends welfare assessment to everyday management.