Physiotherapy for neck pain in the horse
Authors: Tabor Gillian
Journal: UK-Vet Equine
Summary
Neck pain represents a significant proportion of cases managed by equine physiotherapists, yet effective treatment requires understanding both the localised pathology and its wider musculoskeletal context. Gillian's 2021 review outlines the physiotherapy assessment framework for identifying functional limitations in the cervical region—including restricted range of motion, muscle atrophy, and pain-related movement patterns—alongside the specific manual therapy techniques and therapeutic exercise protocols that complement veterinary diagnosis and intervention. The key takeaway for practitioners is that physiotherapy addressing cervical dysfunction should never be isolated; instead, assessment must encompass the entire kinetic chain, as compensatory patterns in the thoracic spine, forelimbs and core often perpetuate neck pain and limit recovery. By integrating targeted mobilisation, soft tissue work and progressive strengthening exercises within a coordinated multidisciplinary approach, physiotherapists can meaningfully restore range of motion, reduce pain and support return to performance. For farriers, vets and coaches working with affected horses, recognising physiotherapy as an integral part of the treatment pathway—rather than an adjunct—optimises outcomes and reduces recurrence risk.
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Practical Takeaways
- •Include physiotherapy assessment and treatment in your neck pain cases—it addresses functional deficits (pain, ROM, weakness) that support veterinary intervention and improve outcomes
- •Work with qualified veterinary physiotherapists who can design specific exercises and manual therapy tailored to your horse's cervical dysfunction and overall musculoskeletal balance
- •Consider the whole horse's movement patterns and posture, not just the neck in isolation, to achieve lasting restoration of function and performance
Key Findings
- •Horses with neck pain represent a high percentage of veterinary physiotherapists' caseloads, indicating prevalence of this condition in equine practice
- •Physiotherapists can identify functional limitations in the neck region through specific assessment strategies
- •Manual therapy techniques and therapeutic exercise prescription can address pain, range of motion limitations, and muscle weakness in the cervical region
- •Physiotherapy is most effective as part of a multidisciplinary team approach alongside veterinary medical or surgical intervention