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  I have been hiding behind the curtains watching the escalating 
argument over which measures are proper and those that are not for 
helping horses with joint maladies. Joints are my life (No, not that 
kind) and so I thought I'd throw in my perspective that might help steer 
the conversation onto a more civil and useful path.
 Diagnosing pain, especially joint pain, and the lamenesses that result 
is a difficult task. A task that is made easier with some understanding 
of how pain is generated, and whether inflammation or wear and tear is 
present and/or responsible. It is my experience that much joint pain 
(especially in the spine) is misdiagnosed. By far, most back pain that 
people (and animals, for that matter) have is non-inflammatory and 
mechanical in nature. In other words, there is a "catch" or "jamming" 
that has occurred in one or more joints as a result of the joint being 
overwhelmed, underused, misused, or overused. The term we use is "Joint 
Dysfunction." Luckily for me, it is extremely common in people, and 
highly treatable. Some of these people even have good health insurance. 
:> It gets a little tricky, though. In the early stages of joint 
dysfunction, there is usually no inflammation. Just the pain that comes 
from abnormal stimulation (and suppression) of certain nerve endings 
that carry pain messages. Manipulation turns on certain nerve endings 
and turns off others, and thereby reduces or eliminates pain( the 
"pinched nerve" concept is rare and doesn't explain most people's pain). 
Until that is done, there is a series of "compensations" that occur. The 
nervous system tells certain muscles to shorten and contract 
differently, weight shifts, and perhaps a limp develops. So, by this 
mechanism, which is far and away the most common for producing joint 
pain, "wear and tear" is not the cause, even though it may be present on 
an x-ray. Follow me so far? All the textbooks are clear on the fact that 
the x-ray appearance does not correlate with the presence of pain. There 
are people (and horses) with clean x-rays who are in agony, and those 
with ugly x-rays who are pain free. This paradox can't be explained with 
a "wear and tear," "arthritis," "sprain/strain," or "inflammation," 
model only.  Joint dysfunction can't be seen on an x-ray. It is a loss 
of function that is present before a manipulation, and absent or 
improved afterward.
  Now, these processes are all related. Here's where it gets 
interesting. Joint dysfunction, if present long enough, will begin to 
contribute  to wear and tear in a joint. It can also cause inflammation 
if present in a consistently exercised joint. Joint dysfunction doesn't 
improve with exercise. Which is why exercise alone is not a good regimen 
for joint or back pain. Inflammation can accelerate wear and tear. An 
arthritic joint can develop joint dysfunction which is relieved by 
manipulation, and therefore not an "arthritic" pain. An inflamed joint 
may be aggravated by manipulation. A sprained joint may be harmed by 
manipulation. However, after healing has taken place, that joint will 
often benefit from a manipulation/moblization to restore proper 
function, and prevent accelerated wear and tear. How many of you have 
presented at your doctor with a skeletal pain, an x-ray was taken, and 
if a little wear and tear shows up, you are given a diagnosis of 
"arthritis", and a prescription, and sent home? And, how many vets have 
examined your lame horse, and even with the help of x-ray and other 
diagnostic tests, can't tell you for sure why your horse is lame, 
especially in the absence of obvious injury, inflammation or swelling?
Welcome to my world.
 As far as Legend and other such interventions, I view it as a way of 
positively affecting this whole process, just as manipulation restores 
function, relieves pain, and probably slows down the degenerative 
process, so that the horse can stay healthy as he goes down the trail. I 
think any good vet can tell when a horse (just as I can about people) 
ought to retire from a certain activity, even when there are reasonably 
conservative medical measures that can help.
 I guess my point is that there are a myriad of reasons why a horse may 
have mechanical difficulties that keep him from traveling straight and 
pain free, and they aren't always ( and in my opinion, initially usually 
aren't) signs of a relentless downhill arthritic "slide" that we are 
selfishly and inhumanely suspending so he can do things that ought not 
be asked of him.
  I'd be interested in hearing about the experiences your Ridecampers 
have had in dealing, successfully and unsuccessfully, with lameness. 
Anyone?   Dr Q




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