I’ve lost count of the number of times I’ve heard (or seen on social media) someone say “I’ve had all the physical checks so it must be behavioural” when referring to a behavioural problem. What exactly are “all the physical checks”? A quick once-over from the vet? A 5 star vetting? Checks from vet, saddler and dentist? Checks from vet, saddler and dentist plus additional checks from two osteopaths, a chiropractor, 3 complementary therapists, and a physiotherapist? I’m not being facetious in my last suggestion. Sometimes this is what it takes to find a physical problem that is the underlying cause of something apparently behavioural. I’d go as far as saying that we can never say we have “done all the checks” — until the problem has been solved, there is always a chance there could be a physical cause.

We all have the point at which we feel tempted to blame an emotional or psychological problem, and stop looking for something physical, though. I must confess that with one of the horses that I trim — or attempt to trim — there had been so many physical checks that his apparent inability to stand for his hind hooves to be trimmed seemed to me to be more likely in need of shaping and behavioural work after all. But after years of trying all manner of professionals to solve the problem, the owner found a wonderful new osteopath who has indeed apparently found and solved a physical problem that caused him to struggle to hold up his hind legs for trimming. I can now trim all four feet without any issue.

Many owners would have assumed this horse’s issues were behavioural a long time ago, and many horses are subjected to pain and fear in all sorts of routine tasks, ridden and unridden, because physical problems are ruled out too soon, and behavioural problems are not addressed in a kind and effective manner.

We have never “done all the checks”, we have just not found the source of the problem yet. And that is very different.

Pain causes all sorts of changes in an animal’s biology and psychology. I’m in a bit of pain at the moment. Thankfully it will be short-lived and I have already had some professional help at addressing the cause of it, but it has been interesting to see some changes in my behaviour.

Firstly I am preoccupied. Everything I do, engage in, talk about is through a “filter” of having a sore back. It means I fail to engage fully in what people are saying to me, what my children want from me. I am also irritable for what looks like no apparent reason, although of course it is apparent to me.

Secondly, whenever I move my body I am compensating in some way for the pain. This causes secondary pain in various other parts of my body at different times, depending on what else I have been doing. My children are confused because sometimes I say it’s my arm that is sore, sometimes my shoulder, sometimes my back. Of course they are all physically connected and so they all relate to the same soreness. My inconsistency may even seem like malingering — why would a back problem cause me to be unable to walk very far tomorrow; unable to lift a grocery bag the next day? But to me it feels very real.

Thirdly, it has changed the sort of social behaviours in which I would normally want to engage. Scratching my horse in his itchy spots, hugging or lifting my children — everything feels aversive, just urgh, all owwwww.

Pain changes psychology, too. In my case, being in pain has also triggered memories of 7 years ago when I had previously had back pain, despite being in a different location, different sort of pain and having had different ways of managing it. I find I am being unnecessarily over-cautious in some ways, protecting myself “just in case” and being reluctant to engage in movements that might hurt, even if I later find that they would have been fine.

In talking to my osteopath, I found it hard to communicate exactly what was sore and in what way. Even simple questions like “how much does it hurt on a scale of 1-10?” are difficult to answer because the pain wasn’t constantly the same, its character changes depending on what I’ve been doing and my physical and emotional state. Although my first appointment was only 8 days after my initial injury and only 5 days after a day of hoof-trimming worsened everything to the point where I needed help, I still felt like I was expressing something that was so subjective it was impossible to fully communicate about it, even through a common verbal language.

I think it is probably clear where I am going with these observations. Horses frequently suffer in silence for much longer and so have many more layers of compensatory pain on top of the original injury than humans do. We are reliant on our interpretation — or our clients’ interpretations — of their body language, their feeding habits, and other behaviours to make a best guess about their physical state. Ourselves and our clients are often the gatekeepers to veterinary care for our horses, too, it’s only if we think there is a good chance that there’s a problem that we will commit the time and resources to investigate with a veterinarian.

If they are irritable or distracted, there is a reason. If they seem sore in random places, then they are not “faking it,” the pain may well move around depending on the different ways in which they are expected to use their bodies. A single treatment or check-up will likely not be sufficient to remove all the pain, even if (as frequently fails to happen) the correct source of the pain is immediately found. And the memories of the pain may be extremely long-lasting and resurface because of a triggering experience that we can’t recognize as such because we weren’t around in their past, or we don’t see the world in the same way with the same salient features as they do. But that doesn’t make it any less of a concern to the sentient animal who is experiencing it.

Learning to communicate about pain so that we can advocate for our clients’ horses is also important. As I learned at the osteopath, it’s not easy to talk about pain even when you’re the one experiencing it. Explaining what might be hurting and why that is causing a behavioral issue is vital to help clients understand why it’s important that they make the environmental and training changes you’re asking of them. Clients may also feel defensive for various reasons — nobody wants to think of their animal in physical pain that they could have prevented to cured if they’d known about it, and many clients feel like they’ve done everything they can to rule out physical issues when they call us, only for us to tell them there were many more avenues they could have explored. Sensitivity is important for both the horse in pain and our emotionally hurt clients; horses benefit from having a team of veterinary and behavioral people on their side.

Catherine is a CHBC in the South-East of England. In between home-educating her two children, she works as an equine behaviorist and independent barefoot hoof trimmer. She hosts the Thinking Horsemanship Forum and is a co-founder of the Equine Behavior and Training Association.