Just like human athletes, horses can suffer from back pain, especially those in demanding disciplines like eventing, show jumping, and dressage. Horses will manifest it through subtle changes in performance or behavior. If your horse isn’t moving like they used to or seems reluctant to work, it could be more than attitude, it might be pain.

Recognizing the Signs of Back Pain

Back pain in horses can be tricky to spot. Here are some common red flags:

• Resistance when being saddled or mounted
• Bucking, rearing, or refusing to go forward
• Stiffness or uneven movement, especially on a circle
• Trouble bending or collecting
• Poor performance or changes in jumping behavior
• A dip in the back or tense muscles when touched

Horses with back pain often present with vague or inconsistent issues, which is why a thorough evaluation is essential.

What Causes Back Pain in Horses?

Back pain can be either primary (originating in the back itself) or secondary (resulting from problems elsewhere, like lameness). Some of the most common back-related conditions include:

1. Kissing Spines (Overriding Dorsal Spinous Processes – ORDSP)

This condition occurs when the bony projections along the spine come too close or touch, causing pain. It’s especially common in the area behind the saddle (T13–T18) and can be linked to poor conformation, weak topline, or an ill-fitting saddle.

2. Supraspinous Desmitis

Inflammation of the ligament running along the spine can cause pain, particularly between the mid to lower back (T15–L3). It’s often diagnosed with ultrasound.

3. Facet Joint Arthritis

The joints between the vertebrae can develop arthritis, leading to stiffness and soreness. While imaging can detect changes, these must be interpreted carefully to ensure they’re actually causing pain. Diagnosing Back Pain: A Step-by-Step Process.

Diagnosing back pain involves several steps:

• History & Observation: Your vet will ask about changes in performance and behavior, and observe your horse moving in-hand and on the lunge.
• Palpation & Flexion Tests: Gentle pressure on the back and mobilization of the spine help identify pain or tension.
• Ridden Assessment: Sometimes issues only show up under the saddle. Your vet may observe your horse while being ridden.
• Advanced Imaging:
  • X-rays can reveal changes in the bones.
  • Ultrasound is used to assess ligaments, soft tissue and facet joints.
  • Scintigraphy (bone scan) helps detect “hot spots”.
  • Nerve blocks can sometimes be used.

It’s important to remember that imaging findings alone don’t confirm pain—many horses with radiographic signs of “kissing spines,” for example, show no symptoms. A complete clinical picture is key.

Treatment Options for Equine Back Pain

Treatment depends on the diagnosis but often involves one or more of the following approaches:

1. Medical Management

• Back injections: Steroids and orthobiologics (PRP, Prostride, Alpha-2 macroglobulin) are injected directly into problem areas like the space between kissing spines or joints.
• Shockwave Therapy: This non-invasive treatment uses sound waves to stimulate healing and reduce pain.
• Rehabilitation: Carefully managed return to work, helps reduce inflammation and rebuild strength.
• Physiotherapy: Chiropractic work, massage, stretching (like carrot stretches), and core-strengthening exercises are often part of the rehab process.
• Mesotherapy: A series of small injections along the skin help reduce nerve sensitivity and relieve pain.

2. Surgical Option

Surgery may be considered if medical treatments don’t work, especially for severe cases of kissing spines.

Can My Horse Compete Again After Treatment?

Yes, many horses return to full work after successful treatment. Studies show that up to 95% of horses treated for back pain, including those with kissing spines, return to ridden work. However, ongoing management, conditioning, and appropriate tack are crucial to prevent recurrence.

Preventing Back Pain in Performance Horses

Prevention is always better than cure. Here are some practical steps you can take: ● Regular Saddle Fit Checks: Ill-fitting saddles are a leading cause of back discomfort.

• Build a Strong Topline: Core-strengthening exercises like carrot stretches, hill work, pole work, and lunging with correct posture can help.
• Warm-Up and Cool-Down: Properly preparing your horse for work, and allowing time to relax afterward, reduces injury risk.
• Routine Vet Checks: Early detection of lameness, muscle soreness, or subtle performance changes can stop back pain before it worsens.
• Conditioning and Cross-Training: Avoid repetitive strain by mixing up the horse’s work routine.

When to Call the Vet

If your horse shows signs of back pain, don’t ignore it. Small issues can escalate into long-term problems if left untreated. A thorough evaluation can uncover underlying issues that aren’t visible to the naked eye.

Final Thoughts

Back pain is a common but often misunderstood issue in sport horses. With the right diagnosis and treatment, many horses go on to compete successfully and comfortably. Don’t let discomfort hold your horse back.

If you’ve noticed any of the signs mentioned and would like one of our experts to assess your horse for back pain or poor performance, schedule an appointment online Book Now or give us a call at (08) 9479 1800. We’re here to help you every step of the way.

Best Regards,
Dr. Augie
Equine Veterinarian at Perth Equine Hospital
(08) 9479 1800
au***@*********************om.au
www.perthequinehospital.com.au

References: García-López, J. M. (2018). Neck, Back, and Pelvic Pain in Sport Horses. Veterinary Clinics of North America: Equine Practice, 34(2), 235–251