Signs of Pain in Horses: Horses are instinctively ‘stoic’, they do their best to mask all signs of pain in an effort to keep-up and blend-in with the rest of their herd. By the time your horse shows clear signs of lameness or injury, it is likely a lot of damage has already been done.

Although they may not scream it loud and clear, horses do display subtle signs they are in pain and/or discomfort. As horse lovers, it is our responsibility to learn to recognise these earlier signs and intervene as soon as possible.

In this article, Dr Lena Clifford, a trained veterinarian with a special interest in animal biomechanical medicine, animal acupuncture, Chinese herbal medicine and advanced neurological release techniques, lists and explains some of the subtle hints to watch out for – not just in your own horse, but every horse.

What is pain?

In my everyday work I see too many horses who have been misdiagnosed and have been given all sorts of labels – pushy, hard-mouthed, stubborn, dangerous, head-shy, spooky, cold backed, lazy… you get the idea.

In my life and work with horses, I have come to appreciate one thing. Horses don’t wake up one day to make your life hard. They don’t want to be difficult. Horses want to have an easy life. They are flight animals that try and preserve energy as much as possible.

Horses will exhibit high energy behaviour for a few reasons: mating, fight, flight and play. If a horse uses too much energy other than for survival he might get eaten by the next predator. The same thing is true for showing pain.

According to the Oxford Dictionary, pain is defined as “Highly unpleasant physical sensation caused by illness or injury“.

The International Association for the Study of Pain states: “Pain is an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage or described in such terms.” Pain is a sensation that motivates us to protect the body from physical harm.

Being a flight animal, the horse has learnt to hide pain very well. This does not mean they feel pain less, they just do not show it as obviously. This is because a wild horse showing lameness or other signs of being unwell is going to be targeted first by predators.

By the time a horse shows clear signs of pain such as lameness, it is often too late and the physical damage is done. A horse in pain will change his/her gait and behaviour to try and avoid physical damage before going obviously lame.

Don’t get me wrong, there are horses who do have behaviour issues. Usually, they are caused by stress, environmental factors, nutrition or training issues. So, how can you tell that the horse you are dealing with is in pain?

Here are a few hints to watch out for in your horse – and every horse in the future.

Signs of pain in horses

Sudden behaviour changes

When a horse changes his/her behaviour suddenly and nothing much has changed in everyday life it is worth investigating to see if the behaviour change is caused by pain. A horse that is sore might show new behaviour like, for example:

  • The horse doesn’t want to flex when you ask because that movement hurts, rather than ‘being stubborn’.
  • The horse doesn’t want to go forward or faster because the muscles in his/her shoulders are sore, rather than because he/she is ‘lazy’.
  • The horse with a bridle that is pressing on a sore poll may become head-shy rather than trying to ‘avoid being ridden’.

This subject gets really interesting when it comes to spookiness or oversensitivity in horses. Often, these horses are actually neurologically challenged.

In human neurology there is a term called “noisy brain” an overloaded brain that is getting too many signals from the body constantly. Consciously or unconsciously, we have the brain (and other parts of the nervous system) tell our body what to do. At the same time, we have every part of our body send signals to the brain so the brain knows what is going on in the body and how to react to it.

For example, when we want to stand upright we need the brain to know where in space we are. This is called proprioception.

When a horse has a noisy brain, the brain gets too much information from its body – this could be due to soreness or stress – and the brain gets overloaded with information. This horse might get spooky because it cannot process all the information in its own body, let alone what is coming in as information from the outside world.

High head carriage

A horse who is sore will change their head carriage (head and neck posture) tending to hold it higher than usual. This causes tightness and tension through the neck muscles and puts pressure on the temporomandibular joint (TMJ) and the poll. In turn, this can lead to dental problems as a tight TMJ changes the way of chewing. It might also make the horse head shy, as he/she tries to stop you from touching that sore poll. The higher head carriage can also affect vision and make your horse more spooky.

Tight jaw

A tight jaw can be caused by a high head carriage and it can also be caused by teeth problems and other issues in the mouth area.

A horse with a tight TMJ might start playing with the bit more, put the tongue over the bit or become ‘hard-mouthed’ or heavy in the bridle. Also, a horse with a TMJ issue might refuse to accept any contact with the bit or be inconsistent in their contact.

Worried eyes

When a horse is in pain they tense the muscles around the eyes, particularly the upper eyelid, which gives them a worried look. This can also happen when a horse is worried about something in the environment in a situation that he/she is not happy about, but in this case, the eyes should relax once the horse settles down again, whereas with pain, the eye lids remain tense.

A horse showing a worried eye - a sign of pain - on the left, and a horse showing a normal eye on the right.

On the left, a horse showing a ‘worried eye’ which could be a sign of pain. Notice the wrinkles on the upper eye lid. On the right, a horse showing a normal eye. Images sourced from 

Inverted or u-neck

A change in the neck muscles can be caused by incorrect training or pain, which will often derive from the front end of the horse. This means that the front feet, legs, shoulders or neck can all cause the horse to change the muscles of the neck.

I often see horses develop a u-neck combined with their riders complaining that the horse will not ‘stretch out’ anymore or accept a contact with the bit. 

When a horse doesn't develop the top line despite good feeding and exercise, it could be that they are sore and over using the muscles to brace against pain.

When a horse doesn’t develop the top line despite good feeding and exercise, it could be that they are sore and over using the muscles to brace against pain. Images courtesy of Linda Zupanc

Muscle wastage/tightness

If your horse changes his/her top line and develops, for example, a big wither dip, it is often due to a change in the way the horse is ‘holding itself’. In other cases you may see muscles wasting away in the hind end and you are not sure why. Another scenario could be that the horse is very tight (tense and sore) in their muscles.

All of these are a result of them trying to protect a sore area by bracing themselves against the painful movement.

Wither dip on left. Uneven shoulders on right.

On the left, a big dip behind the withers. On the left, a bird’s eye view of a horse with very uneven shoulder development. Images courtesy of Dr Clifford.

Uneven shoulders

Uneven shoulders are a big red flag. If your saddle slips to one side all the time or you feel like you are riding longer in one stirrup than the other despite them being the same length, have a good look at your horse’s shoulders.

An unevenness is caused by the horse getting off one leg and overloading the other. This could be caused by a so-called high heel-low heel syndrome (this is when the horse has one upright foot and one flat foot) or by other pain issues in the front limbs or feet.

Laying down more often

Have you noticed your horse laying down more often than they used to? This might also be a sign that your horse is uncomfortable while standing up or too sore standing up. A good reason to get your horse checked out for some underlying pain issues.

There are also horses who collapse whilst resting standing up – this is a sign that they are not completing the deep (REM) part of their sleep cycle, the part where all muscles (including the stay apparatus) have to relax completely. Horses may be reluctant to lie down if they are sore and feel they will not be able to stand up quickly, or when they are distressed or feel unsafe, and this leads to sleep deprivation induced collapse. Read this article for more information. 

Fascia lines

Fascia lines are a sign that the horse is overworking the area where the line is showing. This might be due to soreness in a different area – whether it is a fair way away from the fascia line or close to it. Fascia lines will go away once you fix the underlying issues.

Pelvis angle

A horse needs a functional pelvis area to be able to develop propulsion no matter if they are a dressage horse, a campdrafter a show jumper or a trail pony. If a horse is sore he/she can sometimes change the angle of the pelvis, either making it steeper or flatter depending on the way they are compensating or bracing against the pain.

This angle change leads to a reduced mobility in the pelvis which changes the way the horse can use himself and causes a lot of sacroiliac (SI) joint problems.

However, it is not always a problem in the hindend that causes the horse to change pelvis angle, more often than not it is actually coming from a pain issue in the front of the horse and the change in pelvis angle is the way the horse is compensating for that.

A change in the angle of the pelvis, changes the way the horse can use himself, and this can lead to sacroiliac joint issues. Images courtesy of Dr Clifford.

Uneven pelvis

When you look at your horse from behind and they are standing square but the rump appears uneven, this is another sign that your horse might be sore, even if he/she is not visibly lame.

Tucked tail

Can’t lift your horses tail easily? This often happens in combination with a change in pelvis angle and can be a sign of soreness in your horse.

Roached lumbar spine

If your horse gets very tight over the lumbar spine (the part between the last ribs and the pelvis) or the spine roaches up in that area, it is likely that your horse is dealing with some pain issues.

If you see lumps and bumps along the spine, chances are that your horse is experiencing some form of pain and is compensating for it. Image courtesy Dr Clifford.


Does your horse always place the same foot out the front when it is grazing? Does he always stand the same way when you tack up? Can your horse never stand square when you halt? Getting to know how your horse stands normally and noticing small changes in stance down the track, is a good way to recognise if your horse is sore.


Your horse is standing on his/her feet almost 24 hrs a day. If the feet are sore, your horse will have to compensate for that. Are the horse’s feet changing shape? Are they showing signs of bruising? Brittle hoof horn or wall separation? Flares or cracks? Get an expert to check for soreness in the feet.

Coat colour

Sudden changes in coat colour like white spots or washed out appearance can be a sign for soreness in your horse. This can be caused by changes in blood flow due to restrictions in the fascia and pressure on blood vessels.


Struggling to keep weight on your horse? If a horse is sore the muscle work very hard to try and avoid the painful movement and to compensate for the weakness in one area. Your horse is tired before it starts work and you can not feed your horse enough to gain weight. Once the soreness is dealt with and your horse is comfortable, you might have to cut the feed down so your horse does not get too fat.

So, what next?

As with everything, these few hints are guidelines for you as a horse owner to help you recognise when something is wrong with your horse.

The conditions listed here are the more common ones we see in our everyday work, but there are many other conditions that could cause your horse to show these changes.

The first, most immediate thing you can do is ensure that all the gear is fitted correctly and not causing your horse any discomfort or undue pressure.

Every horse compensates differently, but if something changes behaviour wise or body wise please get your horse checked by a registered biomechanical professional (the ABPA in Australia) or other qualified professionals that understand and can help your horse with the issues it is dealing with.

If one thing is not working you might need more people on board to help your horse. One person cannot know everything, but the pain can also come from different areas and you might need your vet, your farrier and other therapists working together for a good outcome.

Do not be afraid to ask questions and insist on getting them answered. You are your horse’s advocate – your horse relies on you to get the help he/she deserves.

This article about recognising the subtle signs of pain in horses was published in Horses and People January-February 2019 magazine.