Horse Headshaking Syndrome Welfare

Equine headshaking syndrome causes significant chronic pain and can be career-ending and welfare-compromising, with trigeminal neuralgia identified as a primary cause.

Key Facts

Equine headshaking affects approximately 4% of horses in work
Trigeminal-mediated headshaking involves painful sensitisation of the trigeminal nerve
Affected horses vertically shake or flick their heads, often in response to light and exercise
Spring and summer seasonality is common, possibly linked to pollen acting as a trigger
Nose nets reduce sunlight-triggered attacks in some horses
Cyproheptadine and carbamazepine have variable success as medical treatments
Surgical approaches including caudal compression of the infraorbital nerve show promise
Diagnosis requires ruling out other causes including dental, sinus and tack problems

Welfare Considerations

Headshaking syndrome causes significant chronic pain. Affected horses appear distressed during attacks, striking at their noses and shaking heads violently. Severe cases are incompatible with ridden work as attacks are triggered by exercise. The chronic nature of the condition and its impact on normal function creates ongoing welfare challenges. Recent advances in understanding trigeminal neuralgia as a mechanism have opened new treatment options. Welfare-centred management requires accurate diagnosis, appropriate pain management, and honest assessment of whether continued ridden work is compatible with welfare.

What You Can Do

Consult a specialist vet or referral centre with experience in headshaking if your horse shows signs
Trial a nose net as a simple first intervention - effective in some horses
Keep a headshaking diary noting triggers including light levels, exercise and season
Discuss neuralgia-targeted treatments including surgical options with a specialist
Make honest welfare assessments if headshaking is severe - retiring affected horses may be the kindest option