As veterinary physiotherapy for horses has developed, understanding the welfare implications of musculoskeletal pain and rehabilitation has transformed equine care. Evidence-based rehabilitation improves both welfare and performance.
Equine musculoskeletal pain is widespread but often unrecognized because horses mask pain signs and behavioral changes may be attributed to training issues rather than physical discomfort. Back pain that is not identified and treated causes chronic suffering during ridden work and may worsen progressively. Saddle fit problems transmit pressure directly to the spinal musculature during exercise, causing pain that is experience during what should be positive interaction with humans. Rehabilitation from injury is a welfare-sensitive process - too little exercise risks muscle wastage and secondary problems while too much risks re-injury. The development of validated equine pain assessment tools has enabled more objective monitoring during rehabilitation, allowing treatment to be adjusted based on welfare indicators rather than performance outcomes alone.