Neck Arthritis in Horses by a Vet – 2025 Guide to Forelimb Lameness & Cervical Nerve Pain 🧠🐴
In this article
Neck Arthritis in Horses by a Vet – 2025 Guide to Forelimb Lameness & Cervical Nerve Pain 🧠🐴
By Dr Duncan Houston, BVSc
Introduction
When a horse is lame in the front limb, most owners and even veterinarians begin their search in the leg. But in 2025, more equine professionals are recognizing a less obvious source: the neck. Cervical arthritis, especially in the lower neck, is increasingly identified as a cause of subtle or intermittent forelimb lameness. If your horse is “off” but limb exams are inconclusive, the problem could be neurological in origin, stemming from cervical nerve compression.
What Is Cervical Arthritis? 🦴
- Degeneration of the facet joints and intervertebral joints in the neck
- Most commonly affects the lower cervical vertebrae: C6–C7
- Leads to inflammation, stiffness, and compression of nerves exiting the spinal column
How Neck Arthritis Causes Lameness 🤔
- Inflammation in cervical joints irritates or compresses:
- Spinal nerves (especially C7) associated with shoulder and forelimb control
- Spinal cord in more severe cases, leading to hindlimb weakness
- The result can be:
- Forelimb lameness
- Shoulder muscle loss or stiffness
- Abnormal gait or shortened stride
Signs Your Horse’s Neck May Be the Problem 📋
- Forelimb lameness with no identifiable leg issue
- Stiffness or resistance in the neck, especially when turning
- Reluctance to bend in one direction under saddle
- Asymmetrical muscle development in the shoulders
- Shortened stride without limping
- Hindlimb weakness if spinal cord is involved
Why C6–C7 Is the Hotspot 🔥
This joint region bears high rotational stress in ridden horses. The C7 spinal nerve affects the:
- Shoulder stabilizers
- Forelimb flexors
- Gait symmetry
In research studies, anesthetizing the C7 nerve in sound horses resulted in noticeable gait and shoulder tone changes, even without pain—confirming its crucial role.
Diagnosing Cervical Arthritis 🧠🔍
1. Eliminate Limb Causes
- Use flexion tests and nerve blocks to rule out hoof or leg pain
2. Look for Neurologic Signs
- Asymmetrical gait, weak reflexes, muscle atrophy
3. Imaging
- Neck radiographs – detect arthritis in facet joints
- Ultrasound – assess soft tissue inflammation and nerve compression
- Myelogram or CT – for advanced cases where spinal cord compression is suspected
Treatment Options for Cervical Arthritis 💉🧘♂️
1. Joint Injections
- Corticosteroids or IRAP into affected cervical joints
- Ultrasound or CT-guided for precision
2. NSAIDs and Pain Management
- Phenylbutazone or firocoxib to manage inflammation
- Gabapentin or other neuro-pain medications for nerve-related discomfort
3. Physical Therapy and Stretching
- Gentle stretching and neck mobilization
- Acupuncture or chiropractic care may provide temporary relief
4. Rest and Work Modification
- Reduce collected work and sharp turns
- Consider bitless or soft-hand aids if discomfort is worsened by rein pressure
Case Example: Eventer with Intermittent Shoulder Lameness
- 10-year-old gelding with forelimb lameness that didn’t resolve with hoof balancing or injections
- Neck x-rays showed moderate arthritis at C6–C7
- Ultrasound-guided joint injections and 30 days of modified work
- Returned to performance with improved stride length and shoulder mobility
FAQs About Cervical Arthritis in Horses
Q: Can neck arthritis cause hindlimb weakness?
A: Yes—especially if spinal cord compression is present. Horses may wobble or drag toes behind.
Q: Is cervical arthritis curable?
A: No, but it is manageable with injections, pain control, and modified work.
Q: How can I prevent neck issues in sport horses?
A: Encourage natural head carriage, use properly fitted tack, avoid repetitive strain, and cross-train.
Conclusion
In 2025, we’re learning that many cases of “mystery lameness” in performance horses actually originate in the cervical spine. Neck arthritis and C7 nerve compression are common—and often missed—sources of forelimb dysfunction and performance loss. If your horse is lame but imaging and blocking reveal no leg issues, it's time to look up—literally.
Need help evaluating neck pain or unexplained lameness? Visit AskAVet.com or download our app 📱 to consult with Dr Duncan Houston on diagnostics and safe, effective treatment plans. 🩺🐴
