Does high-intensity laser therapy speed return to primary function in horses with suspensory ligament desmopathy?
Authors: James Rushing
Journal: Veterinary Evidence
Summary
# High-Intensity Laser Therapy for Equine Suspensory Ligament Injuries: What the Evidence Shows Suspensory ligament branch injuries represent a significant cause of lameness and prolonged rehabilitation in performance horses, prompting investigation into adjunctive therapies that might accelerate return to work. A 2023 systematic review by Rushing examined whether high-intensity laser therapy (HILT; >500 mW output) combined with standard conservative management could facilitate faster functional recovery compared to conservative management alone in affected horses. Two studies—one randomised controlled trial and one non-randomised controlled clinical trial—were critically appraised, both reporting improvements in pain on palpation, lameness grade, soft tissue swelling, and imaging findings (ultrasound and MRI) in HILT-treated groups. However, the overall strength of evidence remains weak due to significant limitations in study design, methodology, statistical analysis and reporting, meaning we cannot confidently conclude that HILT meaningfully accelerates return to primary function beyond conservative management. For practitioners considering HILT as part of a treatment protocol, clinical decision-making should integrate individual expertise, the specific case presentation, owner expectations, and local resource availability, whilst recognising that the current evidence base does not provide strong support for its use as a standalone or primary intervention.
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Practical Takeaways
- •HILT shows promise for suspensory ligament injuries but current evidence is too weak to recommend it over standard conservative management as a primary treatment
- •If considering HILT for a lame horse with suspensory ligament injury, factor in your clinical experience, client values, equipment availability, and cost — the evidence alone doesn't strongly support its use
- •Continue conservative management (box rest, controlled exercise, farriery support) as the foundation of treatment; HILT may be considered as adjunctive therapy pending stronger evidence
Key Findings
- •Two studies reviewed (one non-randomised controlled trial, one RCT) both reported positive effects of HILT on pain, lameness, swelling, and imaging findings
- •Evidence is weak due to design, methodology, statistical analysis and reporting issues that reduce reliability and external validity
- •Insufficient evidence to conclude HILT combined with conservative management returns horses to primary function faster than conservative management alone