Overriding dorsal spinous processes, commonly called kissing spine, causes chronic back pain in horses and requires accurate diagnosis and appropriate management.
Kissing spine is a welfare issue where accurate diagnosis is particularly important because radiographic findings alone do not confirm clinical significance. Horses with back pain from kissing spine may show subtle behavioural changes including resistance under saddle, reluctance at mounting, and behavioural deterioration that owners attribute to training problems rather than pain. Expert clinical assessment correlating imaging with physical and performance findings is essential before treatment commitment. Treatment responses vary, and horses who do not respond adequately to conservative management require honest reassessment of workload expectations and quality of life under continued training demands.