Horse Kissing Spine: Back Pain, Diagnosis, and Welfare

Kissing spine (overriding dorsal spinous processes) is a painful spinal condition in horses that causes back pain and performance issues. Recognition and treatment are key for welfare.

Key Facts

Kissing spine occurs when adjacent dorsal spinous processes (the bony projections on top of vertebrae) touch or overlap, causing inflammation and pain.
It is most commonly found in the thoracic spine (where the saddle sits) of sport horses, particularly Warmbloods and Thoroughbreds.
Prevalence in sport horses is significant — some studies report radiographic kissing spine in 40-60% of horses, though not all are clinically affected.
Signs include back pain on palpation, reluctance to accept the girth, resistance under saddle, bucking, and reduced performance.
Diagnosis combines clinical examination, radiography, nuclear scintigraphy, and response to local analgesia.
Treatment options include corticosteroid injections, interspinous ligament injections, physiotherapy, and surgical intervention (bone shaving or cutting of interspinous ligaments).
Saddle fit is a critical management factor — ill-fitting saddles exacerbate kissing spine pain significantly.

Welfare Considerations

Kissing spine causes back pain that significantly impairs a horse's welfare when working under saddle. The challenge is that horses are expected to perform — and may do so while experiencing chronic pain that manifests as resistance, behavioral changes, and reduced performance rather than obvious lameness. Riders and trainers who attribute these signs to "attitude" or "training problems" may inadvertently demand work from horses in significant pain. Welfare-centered management requires proper diagnosis before attributing resistance to behavioral causes, appropriate treatment, and honest assessment of return to work expectations. Well-fitted saddles and appropriate conditioning are preventive welfare measures. For horses with severe or recurrent kissing spine, retirement from ridden work may be the most welfare-positive outcome.

What You Can Do

Have a veterinarian assess your horse if it shows back pain, girth aversion, or unexplained resistance under saddle.
Invest in professional saddle fitting by a qualified saddle fitter — ill-fitting saddles are a primary contributor to back pain.
Ask your vet about physiotherapy and exercise modification as part of kissing spine management.
Discuss corticosteroid or surgical treatment options with a specialist if conservative management fails.
Be realistic about return to work expectations — not all horses with kissing spine can return to full competition.
Treat resistance under saddle as a potential pain signal first, not a behavioral or training problem.