Would your horse benefit from joint therapy?
Horses with any joint remodeling, OCD, irregularities to joint surface, arthritis, poor hoof or limb conformation, poor hoof balance, or bad shoeing can develop inflammation and pain in the affected joints. These maladies can cause the joint to become inflamed and painful. Joint fluid can become watery with inflammation losing its ability to lubricate the joint causing further inflammation. Even horses with little to no radiographic evidence of joint pathology can suffer from joint inflammation and pain and may benefit from a joint injection.
As always, a thorough exam should be performed in order to decide if your horse might benefit from such treatments.
What is joint therapy and what does it do?
Horses with any joint remodeling, OCD, irregularities to joint surface, arthritis, poor hoof or limb conformation, poor hoof balance, or bad shoeing can develop inflammation and pain in the affected joints. These maladies can cause the joint to become inflamed and painful. Joint fluid can become watery with inflammation losing its ability to lubricate the joint causing further inflammation. Even horses with little to no radiographic evidence of joint pathology can suffer from joint inflammation and pain and may benefit from a joint injection.
As always, a thorough exam should be performed in order to decide if your horse might benefit from such treatments.
What is joint therapy and what does it do?
There are many types of joint therapies available all with the goal of reducing pain and inflammation in the joint so that your horse can feel their best and perform at their highest level. Joints therapy can include joint injections, non injectable therapy, supplementation and physical therapy.
Joint injection types
Traditional:
PESM uses high quality hyaluronic acid as well as a corticosteroid for routine joint injections as well as for navicular bursa injections. Hyaluronic acid is the main component of joint fluid and when the joint becomes inflamed can undergo degradation leading to further joint inflammation. By injecting the joint with a high molecular weight hyaluronic acid joint lubrication can be be restored. A corticosteriod is often used as well and it acts by reducing inflammation within the joint as well as the pain associated with the inflammation.
Polyacrylamide Gel:
Noltrex and Arthramid are the main contenders in this category. They work by binding with the joint tissue and forming a thick gel like layer that can help protect underlying lesions, reduce joint friction and provide shock absorption. Another key feature is that this product can provide much longer lasting effects. Its ideal for more advanced joints disease and OCD lesions.
Biologics:
-PRP (platelet rich plasma): PRP is made my taking blood from your horse and processing it to isolate and concentrate the platelets from the plasma portion of the blood. It can be injected into the joint the same way as any other joint injection to reduce inflammation in the joint. It is also used for soft tissue injuries such as wounds and tendon injuries to promote healing.
-IRAP (interluekene 1 receptor antagonist protein): IRAP is used to combat inflammation in joints by stopping the inflammatory cascade on a molecular level. Like PRP it is harvested from your horses blood. In general traditional joint injection therapy is used first but in horses that aren't responding as well anymore or aren't able to make it as long between traditional joint injection treatments IRAP can be incorporated into the therapy. It is also commonly used in horses with metabolic issues such as Equine Metabolic Syndrome where they are unable to handle steroids. Repeated injections may be necessary fro full effect.
-Strydaflex: Strydaflex contains a proprietary mix of cytokines, growth factors and exosomes— factors with a demonstrated ability to stimulate a cell-signaling cascade to reduce inflammation and promote healing. Strydaflex has been formulated to contain factors most important for joint homeostasis, including those that decrease the destructive effects of pro-inflammatory cytokines and others that have demonstrated beneficial effects in mitigating the clinical signs associated with joint disease and/or injury. It stimulates the formation of healthy hyaluronic acid within the joint.
Medical Device:
Spryng is a new option. Spryng injections are composed of two naturally-derived proteins (collagen and elastin) and one carbohydrate creating a pliable and insoluble matrix that conforms to the synovial space. It is a medical device that is designed to prevent the occurrence and re-occurrence of joint pain from loss of cartilage or tissue-bone mechanical malfunction by augmenting and reinforcing cartilage.
Non injectable joint therapy:
Shockwave Therapy: Shockwave therapy is a non invasive way to treat pain and inflammation in the joint. Pulses are applied to the joint in a series of 3-4 treatments at 1-3 week intervals for full effect. Depending on the level of lameness there is essentially no down time. There is also no risk of reaction since it is a non invasive procedure. It is ideal for horses with metabolic conditions that prohibit use of steroids.
Acupuncture: Acupuncture has been used for thousands of years to treat or alleviate many maladies including joint pain. Thin needles are used and placed at points that correlate according to the horse's specific needs. This is generally repeated 2-4 times for full effect and can be used intermittently for maintenance. There is also no risk of reaction. It is ideal for horses with metabolic conditions that prohibit use of steroids.
Supplementation:
IV/IM injections: There are many products containing ingredients such as hyaluronic acid and PGAGs (polyunsulfated glycose amino glycans) that are administered initially as a loading dose of an injection every week for 3-4 weeks then given monthly or given as repeated loading doses every 3-6 months. They work systemically to help reduce inflammation in the joint.
Physical Therapy:
Exercises designed to increase strength and range of motion can be very helpful in improving joint health and function. Example includes band therapy and stability exercise that help encourage strengthening of muscles and increase joint range of motion.
Joint injection types
Traditional:
PESM uses high quality hyaluronic acid as well as a corticosteroid for routine joint injections as well as for navicular bursa injections. Hyaluronic acid is the main component of joint fluid and when the joint becomes inflamed can undergo degradation leading to further joint inflammation. By injecting the joint with a high molecular weight hyaluronic acid joint lubrication can be be restored. A corticosteriod is often used as well and it acts by reducing inflammation within the joint as well as the pain associated with the inflammation.
Polyacrylamide Gel:
Noltrex and Arthramid are the main contenders in this category. They work by binding with the joint tissue and forming a thick gel like layer that can help protect underlying lesions, reduce joint friction and provide shock absorption. Another key feature is that this product can provide much longer lasting effects. Its ideal for more advanced joints disease and OCD lesions.
Biologics:
-PRP (platelet rich plasma): PRP is made my taking blood from your horse and processing it to isolate and concentrate the platelets from the plasma portion of the blood. It can be injected into the joint the same way as any other joint injection to reduce inflammation in the joint. It is also used for soft tissue injuries such as wounds and tendon injuries to promote healing.
-IRAP (interluekene 1 receptor antagonist protein): IRAP is used to combat inflammation in joints by stopping the inflammatory cascade on a molecular level. Like PRP it is harvested from your horses blood. In general traditional joint injection therapy is used first but in horses that aren't responding as well anymore or aren't able to make it as long between traditional joint injection treatments IRAP can be incorporated into the therapy. It is also commonly used in horses with metabolic issues such as Equine Metabolic Syndrome where they are unable to handle steroids. Repeated injections may be necessary fro full effect.
-Strydaflex: Strydaflex contains a proprietary mix of cytokines, growth factors and exosomes— factors with a demonstrated ability to stimulate a cell-signaling cascade to reduce inflammation and promote healing. Strydaflex has been formulated to contain factors most important for joint homeostasis, including those that decrease the destructive effects of pro-inflammatory cytokines and others that have demonstrated beneficial effects in mitigating the clinical signs associated with joint disease and/or injury. It stimulates the formation of healthy hyaluronic acid within the joint.
Medical Device:
Spryng is a new option. Spryng injections are composed of two naturally-derived proteins (collagen and elastin) and one carbohydrate creating a pliable and insoluble matrix that conforms to the synovial space. It is a medical device that is designed to prevent the occurrence and re-occurrence of joint pain from loss of cartilage or tissue-bone mechanical malfunction by augmenting and reinforcing cartilage.
Non injectable joint therapy:
Shockwave Therapy: Shockwave therapy is a non invasive way to treat pain and inflammation in the joint. Pulses are applied to the joint in a series of 3-4 treatments at 1-3 week intervals for full effect. Depending on the level of lameness there is essentially no down time. There is also no risk of reaction since it is a non invasive procedure. It is ideal for horses with metabolic conditions that prohibit use of steroids.
Acupuncture: Acupuncture has been used for thousands of years to treat or alleviate many maladies including joint pain. Thin needles are used and placed at points that correlate according to the horse's specific needs. This is generally repeated 2-4 times for full effect and can be used intermittently for maintenance. There is also no risk of reaction. It is ideal for horses with metabolic conditions that prohibit use of steroids.
Supplementation:
IV/IM injections: There are many products containing ingredients such as hyaluronic acid and PGAGs (polyunsulfated glycose amino glycans) that are administered initially as a loading dose of an injection every week for 3-4 weeks then given monthly or given as repeated loading doses every 3-6 months. They work systemically to help reduce inflammation in the joint.
Physical Therapy:
Exercises designed to increase strength and range of motion can be very helpful in improving joint health and function. Example includes band therapy and stability exercise that help encourage strengthening of muscles and increase joint range of motion.