Osteoarthritis & lameness in horses: natural options
Horse osteoarthritis: honest overview of devil's claw, CBD and laser therapy — evidence, safety and legislation.
Short & honest
Supplementary options like devil's claw and CBD have been studied in horses, but evidence is weak (grade C): mainly small pharmacokinetic studies, no large clinical trials.
Veterinary review not yet completed
This page is awaiting review by a registered veterinary surgeon. Until then, treat the text as education based on the sources listed — not as a verified veterinary judgement.
What is osteoarthritis in the horse?
Osteoarthritis is a progressive condition in which joint cartilage slowly breaks down and the surrounding structures become inflamed. In horses, it most frequently occurs in the hock, stifle and coffin joints. Symptoms include variable lameness, stiffness after rest, heat and swelling around joints and reduced performance under saddle. Osteoarthritis cannot be cured; management focuses on pain control and slowing progression.
Additional options: what does the evidence say?
Devil's claw (Harpagophytum procumbens)
Devil's claw is one of the most commonly used herbal products in horses with joint complaints. The active substance harpagoside has anti-inflammatory properties in laboratory research. Pharmacokinetic studies in horses show that harpagoside is measurable in the blood after oral administration [1][2]. What these studies do not demonstrate is clinical efficacy: there is no randomised controlled trial (RCT) in horses proving that lameness or osteoarthritis pain actually decreases. The evidence therefore remains indirect and limited.
Competition sport: harpagoside is on the FEI doping list. Use in the run-up to competitions always requires consultation with the veterinary surgeon.
Cannabinoids (CBD and CBDA)
CBD products for horses are emerging. Pharmacokinetic research shows that oral absorption in the horse is relatively low and variable [3]. A study on CBDA or the combination CBG/CBD in horses with chronic osteoarthritis suggests potential effects on pain modulation and welfare [4], but it concerns a small population without a comparison group. Clinical substantiation for efficacy is therefore insufficient for a strong statement.
Laser therapy (LLLT) and chiropractic
A study in Quarter Horses with back pain investigated the combined use of low-level laser therapy (LLLT) and chiropractic [5]. Positive effects were reported, but the study design has limitations: small group, no blinded control, and the combined approach makes it impossible to determine which intervention contributed. Results are therefore indicative, not conclusive.
Overview per option
| Option | Study type | Clinical evidence in horse | Grade |
|---|---|---|---|
| Devil's claw | PK study | Lacking | C |
| CBD / CBDA | PK + small clinical study | Limited | C |
| LLLT + chiropractic | Small clinical study | Limited | C |
Additional is not a replacement
None of the above options replaces a veterinary diagnosis and treatment. Osteoarthritis in horses is managed in conventional medicine with joint injections, NSAIDs, targeted physiotherapy and adjustments in training and shoeing. Additional products may be considered as support in consultation with the veterinary surgeon — but never as a replacement for the conventional approach.
When to go directly to the veterinary surgeon?
See the red flags below. Acute or severe lameness is always a reason for veterinary assessment — do not wait and self-treat.
Why this verdict?
Available studies are predominantly pharmacokinetic in nature — they show that substances such as harpagoside and CBD are measurable in horse blood [1][2][3], but not that they are clinically effective. The only study with clinical outcome measures (osteoarthritis/back pain) involves a small, unblinded design without a separate control group [4][5]. Randomised controlled research in horses with osteoarthritis is lacking, resulting in grade C: weak, indirect evidence.
Interactions with medication
- Devil's claw (harpagoside) may affect the action of NSAIDs (such as phenylbutazone) — combine only in consultation with a veterinary surgeon
- CBD may inhibit the breakdown of other medicines via liver enzymes (CYP450 system); consultation required for horses receiving other medication
Legal status (Netherlands)
In the Netherlands, CBD products for animals fall under varying regulations (Opium Act, animal feed regulations, Medicines Act) and have no approved veterinary label. Devil's claw supplements are legal as dietary supplements but appear on the FEI doping list. In the Netherlands, treatment advice — including dosage — is reserved for the veterinary surgeon (Wet dieren, Article 4.1).
Sources
- [1] Pharmacokinetics of harpagoside in horses after intragastric administration of a Devil's claw (Harpagophytum procumbens) extract (Axmann et al.). Journal of Veterinary Pharmacology and Therapeutics, 2019. Pharmacokinetics doi:10.1111/jvp.12716
- [2] Pharmacokinetics of harpagoside in horses (PMC full text). PMC, 2019. Narrative review doi:10.1111/jvp.12716
- [3] Pharmacokinetic modelling of orally administered cannabidiol and implications for medication control in horses. Frontiers in Veterinary Science, 2023. Pharmacokinetics doi:10.3389/fvets.2023.1234551
- [4] Role of cannabidiolic acid or the combination of cannabigerol/cannabidiol in pain modulation and welfare improvement in horses with chronic osteoarthritis. Frontiers in Veterinary Science, 2024. Narrative review doi:10.3389/fvets.2024.1496473
- [5] Effects of Low-Level Laser Therapy and Chiropractic Care on Back Pain in Quarter Horses. Journal of Equine Veterinary Science / PubMed, 2020. Narrative review source ↗