The Scoop On Alternatives
Alternative therapies are primarily useful in controlling pain and muscle spasm without having to resort to heavy or frequent use of drugs. They include:
Acupuncture: Helpful in control of lower back muscle spasm and pain.
Chiropractic: May be helpful temporarily in relieving local and lower back muscle spasm but the joint is far too deep to be influenced by any surface manipulations. Forceful "adjustment" is directly contraindicated.
Laser and/or therapeutic ultrasound: May help with lower back muscle spasm, stimulation of ligament injury that involves the most superficial portions of the dorsal ligaments. Can't penetrate to the lower structures.
Pulsed electromagnetic therapy: This is the only energy therapy that can penetrate to the level of the sacroiliac joint. It's useful in relieving pain, inflammation and muscle spasm, but it's unknown whether there's any actual effect on healing time.
First, you must get the inflammation under control. Your veterinarian may recommend a course of systemic anti-inflammatories (e.g. phenylbutazone, flunixin or herbal) or local injections (corticosteroid, herbal such as Sarapin, or homeopathic such as Traumeel). Because they can slow healing and result in ligament weakness, corticosteroid injections shouldn't be done repeatedly, but their judicious use with severe inflammation may be warranted.
After the initial inflammation is under control, the horse should be kept moving. (Note: Complete stall confinement with restriction of movement is rarely necessary, except with fractures or a rupture of the ligament.) Field turnout is best, as long as the footing is good, with no steep inclines to negotiate and no other horses in the group that could force the injured horse to exercise more than he would voluntarily.
If field turnout isn't an option, the horse should at least have as large a stall/pen as possible, liberal paddock time and be hand-walked. Some veterinarians also recommend daily range of motion exercises, moving the leg as far forward and as far back as comfort allows.
Long-term use of pain medications or corticosteroids should be avoided, so that progress can be monitored accurately and the horse doesn't exercise more than he should.
Some veterinarians will use periodic Traumeel or Sarapin injections to help with low-grade pain/inflammation during rehab, as it may help the horse work through the rehab program to achieve the best possible flexibility. Injection of counterirritants such as iodine used to be popular, but it's probably best avoided because it can increase scarring in the area.
Bottom Line
The truth of the matter is that most horses with sacroiliac-area injuries, even fractures, can return to full use if given enough time to heal. Ligaments heal the slowest of all tissues, and nothing can change that.
The oldest effective treatment is turnout for nine months to a year. When you see the horse is sound again at all gaits at pasture, it's time to gradually resume formal work to bring him back.
Although severe injuries certainly could limit a horse's future career, especially in demanding sports, many horses that reportedly fail to return to their original work do so simply because they aren't given enough time.
