Kissing spine, or overriding dorsal spinous processes, is a common and painful spinal condition in horses that has been significantly underdiagnosed and undertreated for decades.
Kissing spine has caused decades of unrecognised suffering in performance horses. Many behaviours historically attributed to "naughtiness," "laziness," or "resistance" — bucking under saddle, pinned ears when girthed, cold-backed behaviour — are now understood as pain responses. Horses cannot verbalise pain, so conditions producing chronic back pain were systematically misattributed to training or temperament, leading to punishment of pain-related behaviour rather than treatment. Validated horse pain scales and grimace scores now enable more objective assessment. The high radiographic prevalence raises challenging questions: how many horses working in pain have never been diagnosed? Poorly fitting saddles are among the most common aggravating factors, and their widespread use on horses with no welfare-based saddle assessment represents a systematic welfare failure. Post-surgical horses and those receiving appropriate physiotherapy often show dramatic improvement in both performance and willingness, confirming the pain basis of previous behaviour.