How to spot a horse in pain

Recognising the signs of pain in horses can be a real challenge, especially when discomfort is mistaken for bad behaviour or poor training.

While equine vets are trained to detect subtle indicators of pain, riders and owners can easily overlook early warning signs. Obvious symptoms – such as vigorous rolling or kicking at the stomach – may point to colic, but many other signs of pain in horses are far more subtle.

As prey animals, horses are hardwired to mask vulnerability, which means pain-related behaviour is often hidden until a problem becomes more serious. Learning to spot early changes in facial expression, body language and behaviour can help you identify discomfort before it escalates into lameness, poor performance or a long-term condition. This awareness may also help you to avoid more extensive interventions further down the line.

Misinterpreting pain-related behaviour can delay treatment and lead to further complications – especially in performance horses, where subtle issues can significantly affect movement and training. Keeping an open mind and knowing what to look for are essential in safeguarding your horse’s welfare.

What your horse’s face is telling you

The most overlooked signs of pain in horses are their facial expressions. The development of the Horse Grimace Scale (HGS) has helped vets and researchers link specific facial movements to discomfort. Here are the areas to watch:

Ears pinned back

If your horse holds their ears back for more than a few seconds while being ridden, it may signal discomfort, especially if this is new behaviour. Ears that flick back occasionally are often just listening, but persistent ear pinning suggests stress or pain.

Eyes glazed or tense

A horse in pain may have a distant, glassy look in their eyes. You might also notice tightened muscles around the eye, frequent blinking or momentarily closing of the eyes during work. These are all subtle but telling signs of discomfort.

Mouth and jaw tension

Look for a clamped jaw, slight separation of the teeth, or the tongue sticking out. Grinding the teeth or excessive salivation without a clear reason may also suggest mouth pain or general discomfort.

Behavioural changes to look out for

Behavioural signs of pain in horses are often mistaken for disobedience. Here are some key signs:

Bucking or kicking out

Often dismissed as high spirits, bucking can also signal signs of back pain in horses, including conditions such as kissing spines or sacroiliac joint region pain – an area notoriously difficult to assess without specialist diagnostics. Bucking after a fence, or showing resistance to upward transitions, often has a physical cause.

Unusual head carriage

A horse in pain may hold their head unusually high or low, or become over-bent or behind the vertical (avoiding the contact). Excessive head movement, including tossing or nodding, can also be linked to dental discomfort, poorly fitting tack, or even neurological pain such as headshaking syndrome, which can be a significant welfare concern.

Switching canter leads or unbalanced movement

If your horse frequently changes lead in canter or displays a bunny-hop motion, it may be a sign of hock pain in horses or hindlimb lameness, such as suspensory ligament desmitis. These issues can affect one or both hind legs and may not be obvious in trot – especially if both limbs are affected.

You may just notice your horse feels unbalanced or less willing, without seeing a clear head bob or limp.

Inconsistent appetite or feed fussiness

One of the lesser-known signs of pain is a reluctance to eat. This particularly relates to gastric ulcers. If your horse shows a reduced appetite or avoids hard feeds or high-fibre foods, it could be due to stomach discomfort. Ulcers are also frequently associated with agitation at tacking up, poor performance or reluctance to move forward when ridden.

What to do if you suspect your horse is in pain

‘Pain is often the last thing people consider,’ explains equine vet Gil Riley. ‘Riders might think their horse is being grumpy or resistant. But in many cases, the horse is trying to communicate that something hurts.’

If you’re concerned about any of the signs of pain above, start by keeping a diary of your horse’s behaviour and performance. Note any changes in routine, tack, workload or farriery.

In addition to the facial and behavioural signs, covered earlier, keep an eye out for other common signs of pain, including:

• Lameness or an uneven, abnormal gait
• Shifting weight between legs
• Unusual stance or posture
• Muscle tremors or flinching
• Localised or excessive sweating
• Lying down more than usual
• Squinting or keeping one or both eyes partially closed
• Biting, or staring intently, at a specific body area
• Mood changes, irritability or withdrawal
• Reduced appetite or water intake
• Grinding teeth or excessive drooling
• Sudden aversion to grooming or being tacked up
• Unexplained weight loss
• Any signs of swelling, heat or visible injury

‘Even small changes can offer important clues to what’s going on beneath the surface,’ adds Gil. ‘Sharing these details with your vet can really speed up diagnosis and treatment planning.’

Trust your instincts

Trusting your instincts is vital. If your horse suddenly becomes resistant, sluggish or unpredictable, don’t assume it’s behavioural.

While not every change signals a serious issue, recognising signs of pain in horses early can make a dramatic difference in their comfort, performance and overall health. The sooner pain and lameness are detected and diagnosed, the better the prognosis – you’re limiting the damage and improving the horse’s chance of recovery.

By paying attention to subtle cues – especially those linked to the signs of back and hock pain, and facial expressions – you’ll be in a better position to support your horse and act before a minor issue becomes a major one.