Extracorporeal shock wave therapy (ESWT) is an accepted form of treatment for chronic cases of proximal suspensory desmitis (PSD). Subjective evaluation of horses shortly after being treated with ESWT has led clinicians to comment on an immediate reduction in lameness. This study aimed to evaluate the analgesic effect of ESWT on 16 horses with PSD or PSD-like pain in a fore- or hindlimb. To objectively assess lameness, gait analysis was performed on an instrumented treadmill before and 6, 24, 48 and 72h after ESWT of the origin of the suspensory ligament and the results compared to the effects of local anaesthesia. Stride frequency, stance duration, vertical impulse and peak vertical force were determined. Thermographic imaging and evaluation of skin sensitivity of the treated area were carried out before and after ESWT in the same interval as gait analysis. The results showed that there were no significant improvements in the investigated parameters at any time after ESWT; however, in horses with affected forelimbs the contralateral weightbearing asymmetry decreased significantly 72h after ESWT. Neither skin sensitivity nor thermographic imaging revealed changes that could be attributed to ESWT.