In this article
Joint Injections in Horses by a Vet – 2025 Guidelines on Frequency, Risks, and Alternatives 💉🐎🦴
By Dr Duncan Houston, BVSc
Introduction
In 2025, managing arthritis in horses remains a key challenge—especially for performance horses. Joint injections, often involving corticosteroids, are widely used to relieve inflammation, reduce pain, and prolong an equine athlete's career. But how often is too often? And what happens when injections stop working? Let’s dive into evidence-based strategies for joint care and injection frequency. 🧠🩺
What Are Joint Injections Used For? 🦴
Joint injections are most commonly used to treat osteoarthritis (OA), also known as degenerative joint disease (DJD). This condition causes:
- Breakdown of cartilage
- Joint capsule inflammation
- Pain and decreased performance
Injected treatments aim to reduce inflammation, relieve pain, and support cartilage health.
Common Injections and Medications 💉
1. Corticosteroids (e.g., Triamcinolone)
- Strong anti-inflammatory effect
- Can protect cartilage if used properly
- Most effective for acute or moderate joint pain
2. Hyaluronic Acid (HA)
- Often combined with corticosteroids
- Supports synovial fluid and joint lubrication
3. Platelet-Rich Plasma (PRP) 🧪
- Uses your horse’s own blood components to support healing
- Regenerative and long-lasting when effective
4. Stem Cell Injections 🌱
- Used in younger horses or early-stage OA
- Stimulates tissue repair and modulates inflammation
5. Shockwave Therapy ⚡
- Non-invasive technique that reduces inflammation and promotes circulation
- Often used with or instead of injections
How Often Should a Horse’s Joints Be Injected? ⏱️
There is no universal standard. Frequency depends on:
- Severity of arthritis
- Performance level
- Response to previous injections
- Risks of infection or cartilage damage
General Guidelines 🧾
- ✅ Most vets aim for no more than 2 injections per year per joint
- ⚠️ If you’re injecting more than twice annually, it may be time to reconsider your treatment plan
- 🚫 Routine "maintenance injections" without diagnosed issues are discouraged
When to Stop Injecting Joints ❌
If the effect of the injection is lasting only a few weeks, that’s a red flag that the disease is progressing. Other signs your horse may need a different plan include:
- Shorter periods of relief after each injection
- Persistent lameness despite injections
- Increased reliance on pain meds between injections
Risks of Repeated Joint Injections ⚠️
- Joint infection (septic arthritis) – serious, life-threatening emergency
- Cartilage damage with overuse of corticosteroids
- Masking pain and allowing continued work may worsen joint damage
Alternatives to Frequent Injections 🧠
1. Oral Joint Supplements 🍽️
- Glucosamine, chondroitin, MSM, omega-3s
- May support overall joint function
2. Intravenous or Intramuscular Medications 💉
- Adequan (PSGAGs) or Legend (IV hyaluronic acid)
- Systemic anti-inflammatories like Equioxx
3. Weight Management ⚖️
- Less weight = less joint strain
- Especially important for leisure or older horses
4. Targeted Rehab and Conditioning 🏃
- Builds muscle to support joints
- Focus on hind end strength, core fitness, and balance
Case Example: Reining Horse on Yearly Joint Plan 🐎
- 7-year-old gelding with moderate hock arthritis
- Initially injected every 6 months, but effects shortened over time
- Switched to shockwave therapy and IV Adequan
- Now maintained with oral MSM and rehab program
- Hasn’t needed injections in over a year
FAQs About Joint Injections in Horses 💬
Q: Can joint injections prevent arthritis?
A: No. They relieve symptoms and slow progression but don’t prevent arthritis onset.
Q: Should I inject on a schedule?
A: Only if your vet identifies inflammation or arthritis in that joint. Injections should not be routine “tune-ups.”
Q: How long does a joint injection last?
A: It varies—anywhere from 3–6 months or more, depending on the horse and disease severity.
Conclusion
Joint injections are powerful tools for managing arthritis in horses, but they should be used thoughtfully. In 2025, veterinary best practices prioritize diagnosis-based, evidence-backed use of injections—with no more than two per year per joint whenever possible. Alternatives like regenerative therapy, shockwave, and systemic anti-inflammatories are proving highly effective for long-term care. 🧠💉🦴
Want a personalized arthritis management plan for your horse? Visit AskAVet.com or download the Ask A Vet app 📱 to consult directly with Dr Duncan Houston and find the safest path forward for your horse’s comfort and performance. 🐴
