<b>Efficacy of acupuncture in racehorses: A review</b>

Racehorses endure high physical demands, which often result in musculoskeletal pain, fatigue, and reduced performance. Although conventional therapies are effective, competition-related drug regulations restrict their use. Acupuncture, rooted in Traditional Chinese Veterinary Medicine, has gained interest as a non-pharmacological alternative for managing pain, enhancing recovery, and promoting overall welfare in equine athletes. This review aims to critically evaluate the current evidence on the efficacy of acupuncture in racehorses, focusing on musculoskeletal pain management, post-exercise recovery, performance outcomes, and welfare implications. Studies published between 2015 and 2025 were identified, and a narrative review was conducted using PubMed, Scopus, ScienceDirect, and Web of Science. The inclusion criteria targeted original research on acupuncture or electroacupuncture in racehorses or comparable high-performance equines, with outcomes related to pain relief, recovery, or athletic performance. A total of 9 studies met the eligibility criteria, including randomized controlled trials, observational studies, and mechanistic reviews. Most studies have reported the beneficial effects of acupuncture on thoracolumbar pain, muscle tension, gait abnormalities, and metabolic recovery. Electroacupuncture was highlighted for its effectiveness in treating deep muscle conditions by modulating pain pathways and reducing inflammation. Observational reports also showed improvements in soreness, appetite, and demeanor after training. However, the treatment protocols, sample sizes, and outcome measures of the studies varied. The limited inclusion of objective performance metrics, such as heart rate variability and race outcomes, restricts the generalizability of the results. Acupuncture has potential as an adjunctive intervention for managing musculoskeletal conditions and the enhancement of recovery in racehorses. Despite encouraging findings, methodological inconsistencies and a paucity of high-powered, controlled trials limit the existing body of research. Future investigations should prioritize the implementation of standardized treatment protocols and the incorporation of objective, quantifiable outcome measures to substantiate their integration into evidence-based equine sports medicine.