If you've owned horses long enough, you've watched one age. The grey hairs appear around the eyes. The topline softens. And somewhere along the way, they start moving differently. Stiffer in the morning. Slower to warm up. Less willing to canter.

For most senior horses, the culprit is osteoarthritis. It's not a question of if, but when and how severe. Studies suggest that over 80% of horses over age 15 have radiographic evidence of joint disease, even if they're not obviously lame.

The good news: arthritis management has improved significantly. We understand the disease better, and we have more tools than ever. This guide covers what works, what to avoid, and how to keep your senior horse comfortable for the long haul.

Understanding Equine Arthritis

Osteoarthritis is progressive joint disease. Cartilage breaks down, bone remodels, and inflammation becomes chronic. It's driven by wear and tear, old injuries, conformational stress, and simple age.

The joints most commonly affected in horses:

• Hocks: Bone spavin is extremely common in older horses
• Fetlocks: High-motion joints that accumulate damage
• Coffin joints: Often involved in navicular-related changes
• Stifles: The equine knee, prone to degenerative changes
• Pasterns: Ringbone (high and low) affects these joints
• Neck and back: Facet joint arthritis causes stiffness

Arthritis isn't curable. Cartilage doesn't regenerate. But the inflammation and pain that make arthritis debilitating? Those can be managed. That's what treatment focuses on.

Recognising Arthritis in Senior Horses

Horses are stoic. They don't complain. By the time arthritis is obvious, it's usually advanced. Learning to spot early signs gives you more options.

Early Signs

• Stiffness when first moving, improving with warm-up
• Reluctance to pick up a particular lead
• Shortened stride, especially behind
• Difficulty with lateral work or collection
• Resistance to having feet picked up or held
• Slight changes in movement that come and go

Progressive Signs

• Visible stiffness that takes longer to work out
• Swelling or heat around joints
• Changes in stance (resting legs more, shifting weight)
• Reluctance to go downhill
• Difficulty lying down or getting up
• Muscle loss over the hindquarters

Advanced Signs

• Obvious lameness, even at walk
• Joint enlargement or bony changes you can feel
• Significant muscle wasting
• Reluctance to move at all
• Weight loss from chronic discomfort

If you suspect arthritis, get a veterinary assessment. X-rays can confirm the diagnosis and show which joints are affected. This guides treatment decisions.

The Foundations of Arthritis Management

Before discussing medications and supplements, get these basics right. They matter more than any pill or injection.

Movement Is Medicine

This is counterintuitive. The horse is stiff and sore, so rest them, right? Wrong.

Arthritic joints need movement to stay functional. Movement circulates synovial fluid (the joint's natural lubricant), maintains muscle mass that supports the joint, and prevents the stiffness that comes from immobility.

The worst thing for an arthritic horse is standing in a stall. Turnout matters. Daily movement matters. Controlled exercise maintains what rest destroys.

The key is consistency without overload. Short daily turnout beats weekend-only pasture time. Regular light riding beats occasional hard work. The goal is keeping everything moving without creating inflammation spikes.

Weight Management

Every extra kilogram loads arthritic joints. An overweight horse with arthritis is fighting two battles at once.

Senior horses often gain weight as their workload decreases but their feed stays the same. Others become hard keepers as metabolism and dental function decline. Either way, maintaining appropriate body condition is critical for joint health.

For overweight seniors: reduce concentrates, use a grazing muzzle if needed, and increase movement. For underweight seniors: address dental issues, consider senior feeds designed for older digestive systems, and rule out other health problems.

Hoof Care

Poor hoof balance stresses joints. An arthritic horse with long toes and underrun heels is working harder than necessary with every step.

Work with your farrier to ensure balanced, regular trimming. Some arthritic horses benefit from supportive shoeing. Others do better barefoot with frequent trims. The right approach depends on the individual horse, their hoof quality, and which joints are affected.

Footing

Hard, uneven, or deep footing is brutal on arthritic joints. Where your horse lives and works matters.

Ideal: level ground with some give. Grass paddocks, arena footing with cushion, rubber matting in high-traffic areas. Avoid: concrete, frozen ground, deep mud, rocky terrain.

Pain Management Options

Once the foundations are in place, most arthritic horses need some form of pain management. The options range from pharmaceuticals to nutraceuticals, with different risk and benefit profiles.

NSAIDs (Bute, Banamine, Equioxx)

The workhorse of equine pain management. NSAIDs block inflammation at the source and provide reliable relief. For acute flare-ups or short-term use, they're hard to beat.

The problem is long-term use. Bute in particular carries significant risks: gastric ulcers (affecting up to 90% of horses on long-term therapy), right dorsal colitis (potentially fatal), kidney damage, and impaired healing.

For senior horses needing daily pain management for months or years, these risks accumulate. Many vets now try to minimise NSAID use in chronic cases, reserving them for flare-ups rather than daily maintenance.

Firocoxib (Equioxx) is safer for long-term use than bute, but costs more and still carries some risk.

Joint Injections

Corticosteroids injected directly into affected joints can provide significant relief. The anti-inflammatory effect is localised and powerful. Many arthritic horses do well on a schedule of joint injections every 6-12 months.

Downsides: requires veterinary procedure, repeated injections may accelerate cartilage breakdown in some cases, and the effect is temporary. But for targeted relief of specific joints, injections remain valuable.

Hyaluronic acid (Legend) can be given IV or into joints to support joint fluid quality. Some horses respond well, others less so.

Adequan (PSGAG)

Polysulfated glycosaminoglycan, given as intramuscular injections. Adequan is thought to support cartilage health and reduce inflammation. The loading protocol involves injections every 4 days for 28 days, then monthly maintenance.

Evidence is mixed, but many horse owners report meaningful improvement. It's generally safe for long-term use.

PEA (Palmitoylethanolamide)

PEA is gaining attention for senior horse management. It's a compound horses produce naturally, and supplementation supports the body's own anti-inflammatory and pain-modulating systems.

The appeal for arthritic seniors: PEA works through different pathways than NSAIDs (PPAR-α activation and mast cell stabilisation rather than COX inhibition). This means no gastric ulcer risk, no kidney concerns, no right dorsal colitis. It's safe for indefinite daily use.

PEA isn't fast-acting. It takes 2-4 weeks to build up, with full effects developing over 6-8 weeks. But for horses needing ongoing support, this gradual approach avoids the risks of daily NSAID use.

Many owners now use PEA as daily baseline support, with NSAIDs reserved for flare-ups. This reduces total NSAID exposure while maintaining comfort. Read our complete guide to PEA for horses for dosing information.

Traditional Joint Supplements

Glucosamine, chondroitin, MSM, and similar supplements have been used for decades. Evidence for efficacy is limited, but they're safe and some horses seem to benefit. They're best viewed as supportive rather than primary treatment.

Omega-3 fatty acids (from fish oil or flaxseed) have better evidence for anti-inflammatory effects. They're a reasonable addition to any arthritis management program.

Physical Therapies

Medications and supplements are only part of the picture. Physical therapies can make a significant difference for arthritic seniors.

Controlled Exercise

The right exercise program maintains muscle, supports joints, and keeps everything moving. Work with your vet or an equine physiotherapist to design an appropriate routine.

General principles: warm up slowly (walk for 10-15 minutes before asking for more), avoid hard or deep footing, keep sessions shorter but more frequent, include gentle stretching, and stop before fatigue.

For some seniors, a 20-minute walk hack is ideal. Others can still do light flatwork. The goal is movement that supports without stressing.

Massage and Bodywork

Arthritic horses develop compensatory muscle tension. They brace against pain, change their movement, and end up sore in places far from the affected joints.

Regular massage or bodywork helps release this tension. It's not treating the arthritis directly, but it improves comfort and mobility. Many senior horses visibly relax and move better after a bodywork session.

Chiropractic and Physiotherapy

Qualified equine chiropractors and physiotherapists can address joint restrictions, muscle imbalances, and movement compensations. For some horses, regular sessions are part of ongoing management.

Cold and Heat Therapy

Cold therapy (ice, cold hosing) reduces inflammation after exercise or during flare-ups. Heat therapy (warm packs, heated boots) can ease stiffness before exercise. Both have a place in management.

Putting It All Together

Arthritis management works best as a multimodal approach. No single treatment does everything. Combining strategies produces better results than relying on any one intervention.

A typical management program for an arthritic senior might include:

• Daily turnout on good footing
• Appropriate body weight maintenance
• Regular farrier care with attention to balance
• Daily PEA for baseline pain and inflammation support
• NSAIDs as needed for flare-ups (not daily)
• Joint injections once or twice yearly for severely affected joints
• Omega-3 supplementation
• Light riding or groundwork several times weekly
• Monthly bodywork session

Not every horse needs every intervention. The right combination depends on severity, budget, and individual response. Start with the foundations, add treatments based on response, and adjust over time.

Quality of Life Considerations

At some point, every owner of an arthritic senior faces difficult questions. Is my horse comfortable? Is management working? When is enough enough?

There's no universal answer. But there are signs to watch:

Good quality of life: Horse is interested in surroundings, moves willingly (even if stiffly), maintains weight, has good days more often than bad days, responds to management interventions.

Declining quality of life: Increasing pain despite treatment, difficulty lying down or rising, weight loss, withdrawal from herd or environment, more bad days than good, requiring escalating interventions just to maintain baseline.

Regular reassessment matters. What works at 20 may not work at 25. Be willing to adjust the plan as your horse's needs change.

The Bottom Line

Arthritis is part of life for most senior horses. But with thoughtful management, many horses stay comfortable and functional well into old age.

Get the basics right: movement, weight, hoof care, footing. Build a pain management approach that's sustainable for long-term use, minimising the risks of daily NSAID therapy. Consider PEA as a safe foundation for ongoing support.

Work with your vet to develop a plan tailored to your horse. Monitor response and adjust over time. And remember that quality of life, not just quantity, is what matters.