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Author of 4 books, including an Amazon bestseller in Horse Care, and 2 DVDs, Chartered Physiotherapist, Equine Behaviourist and BHS Accredited Professional BHSAI, Sue is passionate about helping owners to unlock their horse's potential.

Wednesday, 5 October 2016

Head shaking – a new treatment…?



A recent study looked at whether PENS percutaneous electrical nerve stimulation therapy is a safe and effective form of treatment for trigeminal-mediated headshaking in horses.

At present there are limited resources to treat headshaking in horses, and the PENS treatment is already recommended under NICE guidelines for the safe and effective treatment of humans. The PENS treatment works by inserting a probe which stimulates the relevant nerve according to a pattern and frequency determined by treating humans using the same method. The treatment is then repeated as the effects wear off.

In this study seven horses with severe headshaking were treated. All seven coped with the treatment well, two horses had an increase in symptoms for three days after the treatment. Six horses showed signs of remission after the first treatment and five continued to improve after the second treatment. The average remission time for the first treatment was 3.8 days increasing to 20 weeks after the fourth treatment.

As with humans it was not possible to achieve a 100% success rate, however as safe treatment without side-effects it proves to be a good solution to headshaking treatment. It is believed that the effectiveness of the treatment increases as the operator becomes more skilled with the placement of the probe, which could bode well for the future as this treatment becomes more mainstream.

As an interesting aside, out of the seven horses involved in the study, three of them managed to injure themselves over the next few months, and were either turned away or put on box rest. Which just goes to prove that horses are endlessly inventive with their injuries!

If you have had any experience with headshaking in horses, please get in touch, or contact your vet with your concerns.


Roberts, V., Patel, N. and Tremaine, W. (2015). Neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking: A safe procedure resulting in medium-term remission in five of seven horses. Equine Vet J, 48(2), pp.201-204.

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