What is the best treatment for joint pain in horses?

The most effective treatment depends on diagnosis. Options include ultrasound-guided joint injections, corticosteroids, hyaluronic acid, regenerative therapies such as PRP or Pro-Stride APS, systemic medications, and shockwave therapy. A gait assessment and imaging help identify the most appropriate approach.

What is Pro-Stride APS for horses?

Pro-Stride APS is an autologous protein solution containing anti-inflammatory cytokines and alpha-2-macroglobulin (A2M). It provides steroid-free joint support and is used to manage osteoarthritis and synovitis in performance horses.

When should a horse receive joint injections?

Joint injections are recommended when a horse shows signs of synovitis, osteoarthritis, persistent lameness, joint effusion, or performance decline. Precise diagnosis through examination, gait analysis, nerve blocks and imaging guides treatment.

Do systemic joint medications help horses with arthritis?

Yes. Pentosan, Pentosan Gold, Zycan and 4CYTE may support cartilage metabolism, reduce inflammation and improve joint comfort, especially in horses with multi-joint osteoarthritis or those needing long-term management.

Joint Therapy & Regenerative Medicine

Comprehensive Joint Treatment for Horses

Horses place exceptional biomechanical load on their joints, and even subtle inflammation can affect comfort, performance and long-term soundness.

At Core Equine, we provide a comprehensive suite of evidence-based joint therapies, integrating advanced diagnostics, ultrasound-guided treatment, and regenerative medicine to support the full spectrum of musculoskeletal health.

Our approach is diagnostic-led, scientifically informed, and tailored to each horse’s level of work — from pleasure horses to elite sport horses.

Ultrasound-Guided Joint Injections

Ultrasound guidance allows precise visualisation of the joint capsule, synovial margins, and peri-articular structures — ensuring medication is placed exactly where it is required.

This improves therapeutic accuracy, reduces the risk of iatrogenic trauma, and increases consistency between treatments.

Intra-Articular Medications

We offer a range of evidence-based injectable therapies to manage inflammation, support cartilage, and improve joint function:

- Corticosteroids - Potent anti-inflammatories

- Hyaluronic Acid (HA) - Joint lubricant

- Arthramid

- Regenerative biologics - Blood derived products

Systemic Joint Support Medications

For horses requiring whole-body joint support or management of multi-joint osteoarthritis, we offer several systemic therapies:

- Zycan

- Pentosan & Pentosan Gold

- Hyaluronic Acid (Halo & Matrix 6000)

- 4CYTE™

- Osphos

Regnerative Medicine Options

Regenerative medicine refers to treatments that use the horse’s own blood components to reduce inflammation, support tissue repair and improve joint health. These therapies do not rely on corticosteroids; instead, they harness naturally occurring proteins, growth factors and anti-inflammatory molecules to restore healthier joint function.

They are particularly valuable for performance horses, chronic osteoarthritis, and cases where steroid-free management is preferred.

Pro-Stride® APS

Pro-Stride is an advanced, single-visit regenerative system that concentrates anti-inflammatory cytokines and growth factors from the horse’s own blood. Unlike A2M alone, Pro-Stride contains a broader blend of molecules that modulate inflammation and support tissue repair.

How Pro-Stride Works

The system produces a concentrated solution rich in:

Interleukin-1 receptor antagonist protein (IRAP)
Anti-inflammatory cytokines
Platelet-derived growth factors
A2M (as part of the protein profile)

This combination provides both inflammation control and biologic support for cartilage health, making it a strong option for horses with more established OA.

Benefits of Pro-Stride APS

Steroid-free therapy safe for competition horses
Often longer-lasting than corticosteroid injections
Useful for chronic synovitis, mild to moderate OA, or horses with multi-joint issues
Prepared and administered in one visit

Pro-Stride is a versatile choice when horses need joint comfort with fewer medication restrictions.

Alpha2EQ® - A2M

A2M is a naturally occurring protein in the horse’s blood that helps protect cartilage from degenerative enzymes. In osteoarthritic joints, enzymes such as MMPs and aggrecanases break down cartilage; A2M works by binding and neutralising these destructive molecules.

How A2M Therapy Works

A small blood sample is processed to concentrate alpha-2 macroglobulin.
The purified A2M is injected directly into the affected joint under sterile technique.
Once inside the joint, A2M binds harmful enzymes, slowing or halting cartilage breakdown.

When A2M Is Useful

Early to moderate osteoarthritis
Chronic, low-grade joint inflammation
Cases where preserving cartilage is a priority
Horses requiring longer-term joint comfort with reduced reliance on steroids

A2M is often chosen for horses with recurrent synovitis or early degenerative change identified on imaging.

Restigen® PRP

PRP is a biologic created by concentrating the horse’s platelets, which release growth factors that stimulate tissue repair and modulate inflammation.

'How PRP Works

Platelets contain biologically active molecules that:

Promote angiogenesis (new blood vessel formation)
Improve cellular repair signalling
Reduce inflammatory mediators
Support cartilage and soft tissue healing

Clinical Uses

PRP can be used for:

Early osteoarthritis
Synovitis and capsulitis
Joint-associated soft tissue injuries (e.g., collateral ligaments)
Adjunct treatment during rehabilitation

Restigen® PRP is prepared stall-side under sterile technique and injected directly into the joint or surrounding soft tissues, depending on the condition.