Multiple sclerosis (MS) is a lifelong condition that affects the central nervous system. Medications are available, but physical therapy can also reduce some of the symptoms. Hippotherapy is a type of alternative physical therapy that involves horses.

Hippotherapy can have beneficial results as part of a therapy program to engage sensory, neuromotor, and cognitive systems. The therapy affects different parts of the body, including the central nervous system (CNS), which means that it may be an effective treatment for people with MS.

This article explains what MS is, how hippotherapy works, and how this therapy may benefit a person with MS.

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Hippotherapy is still a relatively new alternative therapy technique, but research suggests that the outcomes are often positive.

For example, a 2017 study in Germany found that alongside standard care, the therapy significantly benefitted people with MS by:

  • improving balance
  • reducing fatigue
  • reducing spasticity
  • increasing quality of life

A 2015 study in the United States also noted that hippotherapy could help people with MS process the senses that play a role in balance and gait, thus improving their ability to maintain a controlled, upright posture.

Additionally, the researchers behind a 2019 study in Spain noted the benefits of hippotherapy for strengthening the pelvic floor and alleviating depression in people with MS.

Finally, a 2020 study that did not focus on MS acknowledged how spending time in nature could improve a person’s quality of life. The research suggests that spending more time connecting with nature leads to higher levels of happiness, positive emotions, and satisfaction with life. Hippotherapy allows people to undertake physical therapy while also connecting with nature.

Hippotherapy is a form of alternative therapy that involves horses and is also known as equine-assisted therapy. It is not a stand-alone therapy, as people generally use it alongside other treatment approaches, such as speech-language therapy and occupational therapy, to meet specific therapy goals and objectives.

The therapy looks to improve both the mental and physical health of the person taking part in the session.

A person can use this online tool to find therapists or therapy assistants in their area who use hippotherapy in their practice.

Hippotherapy uses the horse’s movements to help a person work toward certain goals and objectives. The animal’s movements resemble the human gait and provide as many as 2,500 neuromotor inputs to the person in a 25-minute therapy session. As a result, this therapy may improve balance, mobility, and posture.

During a hippotherapy session, the person sits on the horse’s back and allows the therapist to guide them. Hippotherapy is not about learning to ride, although a certified riding instructor may attend the session.

The combination of a natural environment with cooperation between the human and animal can yield positive physical and mental benefits. Hippotherapy may reduce tension, fatigue, and stress, as well as increasing a person’s quality of life and sense of well-being.

MS is an unpredictable, chronic disease in which damage to the CNS affects the spinal cord, brain, and optic nerves. The disease can cause severe physical, mental, and cognitive responses in the body, and the symptoms range from mild to severe.

Estimates suggest that there could be as many as 1 million people living with the disease in the U.S.

Learn more about the different types of MS here.


MS can cause a range of symptoms, which can vary among individuals. The table below shows the most common symptoms and some of the rarer ones.

SymptomMost commonRarer
sensory impairment
motor impairment
vision problems
poor coordination
difficulty concentrating
difficulty remembering new information
hearing loss
difficulty swallowing
breathing difficulty

There is currently no cure for MS, but treatments may reduce the symptoms. The options range from prescribed medications, such as immunomodulatory and anti-inflammatory drugs, to complementary and alternative therapies, such as hippotherapy.

Risk factors

Although the exact cause of MS is unknown, several risk factors may contribute to the disease onset, including the following:

  • Gender: MS affects more females than males.
  • Age: People with MS usually get a diagnosis between the ages of 20 and 40 years.
  • Genetics: A susceptibility to the disease may pass from a person to their children.
  • Environmental factors: Smoking and a lack of sunlight are among the factors that may contribute to MS.

MS is an unpredictable, chronic condition that generally presents between the ages of 20 and 40 years. However, diagnosis may occur at any age. There is no cure for MS, but alternative treatment options, such as hippotherapy, may alleviate some of the symptoms.

During hippotherapy sessions, a person sits on a horse and allows a therapist to guide them. The gait and motion of the horse create a form of physical therapy by challenging the sensory and physical systems of the body. The benefits of hippotherapy may include improvements to physical and mental well-being.