September 14, 2023

Decoding Equine Pain: How to Recognize the Signs

September is Pain Awareness Month, and what better time to shed light on a topic that affects our equine companions more often than we might think? While horse owners are often quick to recognize the unmistakable signs of acute pain, such as colic or obvious lameness, it's important to remember that horses can experience milder or moderate discomfort too. These subtle signs of discomfort can easily be missed, particularly in well-trained and cooperative horses that may soldier on despite their aching backs or stiff legs. Horses, as prey animals, have evolved not to display overt signs of pain, making it challenging for owners to discern when they are hurting. So, how can you as a horse owner detect these more subtle indicators of discomfort in your equine companion?

Understanding your horse's baseline behavior is key to identifying subtle signs of discomfort. Owners should pay close attention to behavioral changes such as diminished enthusiasm for feeding, sluggish or hesitant movements, or an unusual preference for solitude over the company of other horses. Some horses may exhibit discomfort when being saddled or become overly reactive under saddle. While behavioral alterations can arise from various causes, investigating potential pain or physical issues should be a priority when addressing changes in behavior or training challenges.

Teeth Grinding (Bruxism):

A horse may grind its teeth (bruxism) in response to anxiety, frustration, or pain. The timing of this behavior can offer valuable insights. For instance, post-meal teeth grinding might indicate a gastric ulcer, while grinding during riding could point to discomfort associated with carrying a rider.

Facial Grimace:

Equine facial expressions help us pinpoint pain. In 2014, Danish researchers pioneered the idea of the "equine pain face" and outlined its key features. They also introduced the Horse Grimace Scale, a structured method for gauging pain in horses. During studies involving procedures like castration, scientists identified six specific facial actions linked to pain. Remarkably, the intensity of these actions corresponds with the level of pain, giving rise to a practical pain-rating system.

Why is this important? Well, analyzing facial expressions beats traditional methods like checking the horse's gait or feeling for sore spots. It's a simple, swift, and safe way to evaluate pain, even when dealing with an uncomfortable horse. Plus, it lets you assess pain intensity, from mild to severe, helping you monitor your horse's progress or response to treatment with ease.

Reading Your Horse's Face

Now that you have an understanding of the science behind equine facial expressions, let's explore how you can apply this knowledge to assess your own horse's well-being. While every horse is unique, here are some basic features to look for:

  1. Backward, Asymmetrical Ears: Pain often causes a horse's ears to rotate backward, creating the illusion of increased space between the base of the ears across the forehead. However, note that fear can also result in backward ears.
  2. Tightening of the Eyes: If your horse's upper eyelid is partially closed, it could indicate pain. Severe pain might cause it to cover 50 percent or more of the eye.
  3. Tension Above the Eye: Look for tightening of the muscles above the eye, giving the upper eyelid a V-shaped appearance. You might also notice more of the sclera (the whites of the eye) exposed above the inner corner of the eye.
  4. Prominent, Strained Chewing Muscles: Increased tension above the mouth and obvious chewing muscles along the side of the head can signal severe pain. However, remember that fear can also lead to strained chewing muscles.
  5. Mouth Strained and Chin Pronounced: In painful situations, your horse's upper lip may appear drawn back, creating the illusion of a more pointed chin.
  6. Strained Nostrils: Pain may cause your horse's nostrils to dilate on the sides, giving them a squarish appearance and flattening his profile.
Unexplained Sweating:

Pain can trigger sweating in horses. If you observe unusual sweating patterns on your horse, such as sweating in cold weather or during minimal physical activity, it warrants further investigation. Patches of sweat in specific areas might indicate localized pain or stress.

Hill Difficulty:

Managing inclines can exacerbate soreness in a horse's neck, back, and hindquarters. A horse experiencing pain may struggle with or resist traversing hills. Reluctance to navigate inclines or a lack of energy on flat terrain may signal discomfort in the back or hindquarters.


Unlike the more overt signs of colic, such as rolling and belly-nipping, some horses may simply stare at their abdomen when experiencing pain.

Abnormal Posture:

Pay attention to your horse's posture and movements. A horse that constantly shifts its weight, points a hoof, or assumes an unusual stance may be attempting to alleviate discomfort in a specific limb. Acute laminitis, for instance, results in a distinctive "rocked-back" stance, while chronic laminitis may lead to more subtle postural changes. Additionally, horses that stand with one forefoot extended ahead of the other or with their weight shifted off their forefeet could be indicating discomfort in their feet. Horses adopting a "goat on a rock" posture, with all four feet bunched up beneath them, may be experiencing pain in the hock, stifle, or back. Lastly, horses that stretch as if to urinate during riding might be signaling back soreness or muscle tension due to metabolic issues.

In conclusion, vigilantly observing your horse's behavior and posture can provide valuable clues about their well-being and comfort. Subtle changes in behavior or stance should not be dismissed as quirks, especially if they manifest suddenly. Such signs can help owners and veterinarians identify and address potential sources of pain or discomfort in horses.