A pioneering clinical trial has investigated a promising new non-invasive treatment for horses suffering from trigeminal-mediated headshaking (TGMHS), a debilitating neuropathic pain condition that can have a profound impact on equine welfare and performance.
The first equine trial of the novel treatment was recently conducted at B&W Equine Hospital under the leadership of equine medicine specialist Dr Veronica Roberts at the University of Bristol.
The research project was funded through a grant from The Langford Trust for Animal Health and Welfare and brought together an expert multidisciplinary team including Dr Veronica Roberts (University of Bristol), Dr Kirstie Pickles (Harper & Keele Veterinary School), Professor Jane Williams (Hartpury University) and Dr David Marlin (Animalweb). Ethical approval for the study was granted by the University of Bristol.
The trial also involved consultant neural and spinal surgeon Mr Nik Patel from Southmead Hospital, Bristol, alongside commercial partners Med-E-Tech and Springlife, who supplied the specialist equipment used during the study.
A challenging condition
Trigeminal-mediated headshaking is recognised as a neuropathic pain disorder affecting the trigeminal nerve. Horses with the condition may exhibit sudden, repeated head movements, nose rubbing, snorting and signs of facial discomfort, particularly during exercise or in certain environmental conditions. In severe cases, the condition can significantly compromise both welfare and ridden performance.
Neuropathic pain remains notoriously difficult to treat in both human and veterinary medicine, with considerable variation in how individuals respond to available therapies.
A non-invasive approach
The treatment evaluated in this trial uses transcutaneous pulsed radiofrequency, a non-invasive pain management technique that has shown encouraging results in people and dogs suffering from a range of chronic pain conditions.
One of the notable findings from the study was that all six horses accepted the procedure without requiring sedation, and no adverse side effects were observed.
Researchers also used objective measurements of headshaking by fitting horses with poll-mounted sensors before and after treatment, allowing changes in head movement to be assessed scientifically rather than relying solely on subjective observations.
Early findings
Four weeks after treatment, one of the six horses remained in remission, according to unpublished trial data.
Although the horse continues to require a face mask and nose net, these management strategies had previously failed to control the condition before receiving the treatment.
While the initial results are based on a small number of horses, the research team says there is encouraging evidence from previous studies using Percutaneous Electrical Nerve Stimulation (PENS) neuromodulation to suggest that an initial course of three treatments may provide greater pain relief than a single procedure.
The researchers are now seeking ethical approval to offer a three-treatment protocol to suitable self-funding clinical cases in order to further evaluate the technique.
Further research needed
The researchers stress that these findings are preliminary and that larger studies will be needed to determine how effective the treatment is across a wider population of horses with trigeminal-mediated headshaking.
However, the trial represents an important step in the search for safe, non-invasive treatment options for a condition that has long proved difficult to manage and for which effective therapies remain limited.
As further research progresses, the team hopes to better understand which horses may benefit most from the treatment and whether repeated sessions can provide longer-lasting relief for affected animals.
One of the patients enjoying a molasses lick whilst undergoing treatment.
