Cover Story | Orthopedics

Alternative Acupuncture Modalities in Horses

By Marie Rosenthal MS

Both electroacupuncture and laser acupuncture appear to be alternative methods for pain relief for horses with thoracolumbar back pain, but electroacupuncture provided better pain relief compared with controls, according to a presentation at the 71st AAEP Annual Convention in Denver.

Electro vs laser
Electroacupuncture is a form of acupuncture that adds electrical stimulation to acupuncture needles placed on preexisting acupuncture points, explained Kaitlin Sebring, DVM, an integrative medicine and mobility specialist at the University of Florida Veterinary Teaching Hospital. She conducted the study with Katherine Ellis, MV, MS, DACVSMR, and Allison K. Dockery, DVM, MS, DACVS-LA, during her internship at the University of Georgia College of Veterinary Medicine.

Acupuncture needles are placed at various points depending on the targeted treatment, and then leads with electrodes are connected to multiple points along a circuit to stimulate them.

Laser acupuncture uses a non-thermal, low-intensity laser applied to acupuncture points rather than needles, and appears to combine the benefits of acupuncture with low-level laser therapy.

Both modalities are used in veterinary and human medicine to treat pain and other issues by triggering the development of mesenchymal stem cells and anti-inflammatory cytokines, which decrease inflammation and aid in healing.

One advantage of laser over electroacupuncture is that it does not use needles, according to Dr. Sebring. In the literature, “we’ve seen a lot of the benefits of it being a non-contact form of therapy and generally described as a shorter treatment time,” she said. This could be particularly useful in needle-shy horses.

“The purpose of this entire study was to investigate if there is an effective pain-relieving modality that is available for our needle-shy horses,” she said.

She added: “With the consideration of needle-shy horses in mind, we hypothesized that laser acupuncture and electroacupuncture would both provide statistically significant pain relief, but we anticipated that electroacupuncture would outperform laser acupuncture.”

The study
A total of 21 horses with confirmed thoracolumbar back pain were randomly assigned to 3 groups:

1. Electroacupuncture
2. Laser acupuncture
3. Controls (no treatment)

All horses underwent a physical examination and testing for signs of thoracolumbar pain. The horses could have lameness of up to 3/5 on the AAEP lameness scale. Horses were excluded if they received corticosteroids, biologics, mesotherapy or shockwave therapy within the previous 3 months; had received chiropractic work or acupuncture within the past month; and had received methocarbamol, gabapentin or nonsteroidal non-inflammatory drugs within the previous 30 days.

The researchers allowed study horses to continue light work under saddle up to 4 times a week.

“This was really just to mimic the real-world life applications of some of these horses that would most likely continue with some form of work while receiving these treatments,” Dr. Sebring said.

Investigators used a pressure algometer as a non-subjective pain measure for the horses. The face of the pressure gauge was turned away from the person who took the measurement to maintain blinding to the mechanical nociceptive thresholds (MNTs).

A higher MNT meant less pain, and a lower MNT meant a lower pain threshold and, therefore, an indication that the horse was experiencing more pain, Dr. Sebring explained.

They performed baseline MNTs at day 0 and immediately after treatment on days 1, 4, 7 and 14, which was 1 week after treatment targeting the epaxial musculature points at bilateral T13, T18, L3, L6 and S2. They then took 3 samples at each site and averaged them. The pressure points they chose were the same for both treatment groups. The control group received no treatment for the 2-week study period.

“We saw statistically significant increases in MNTs at days 7 and 14 for both the electroacupuncture group and the laser acupuncture group,” Dr. Sebring said. In addition, no increase in MNTs was reported in the control group.

“When considering the laser acupuncture group, we did see a statistically significant increase in MNTs at L6 by day 4. By day 7, sites T13, T18 and L6 also saw improvements. By day 14, these 3 sites were also maintained as statistically significant,” she said.

The electroacupuncture group had significant increases in MNTs at days 1, 4, 7 and 14. “So immediately after treatment, we were seeing improvements in overall MNTs,” she added.

The control group did not see a statistically significant increase until day 14. The electroacupuncture group provided greater pain relief than laser acupuncture, she said.

Study limitations included the small number of horses. In addition, the horses could have developed a tolerance to the pressure algometer over time. Another limitation could have been allowing the horses to do light work.

“If a horse was worked harder 1 day and then received MNT analysis, that could skew our results, as well,” Dr. Sebring said.

Lameness could also have contributed to the pain experienced by some horses, since the study allowed horses with low-grade lameness to enter. Finally, because the study was blinded, the team did not clip the hair coat in the laser group, which could have reduced its efficacy, as clipping the hair coat affects the penetration of the laser. MeV

For more information:
Sebring K, Dockery AK, Phelps LM, et al. Comparison of electroacupuncture versus laser acupuncture in horses with thoracolumbar back pain. J Equine Rehabil. 2025;3:100041.
doi: doi.org/10.1016/j.eqre.2025.100041
https://www.sciencedirect.com/science/article/pii/S2949905425000234#ack0005