Overriding dorsal spinous processes (kissing spines) are a common cause of back pain in horses, with welfare implications spanning diagnostic accuracy, treatment selection, and return to work decisions.
Kissing spines welfare issues are complex because the correlation between radiographic findings and clinical pain is imperfect — some horses with radiographic contact are pain-free, while others with minimal changes are significantly affected. This diagnostic complexity means welfare decisions must be based on the whole clinical picture, not imaging alone. Horses working with unrecognized back pain experience chronic discomfort that alters their behavior and relationship with riders — many behavioral problems attributed to training issues are actually pain responses. The welfare imperative is accurate pain assessment, treatment where indicated, and work modification or cessation when pain cannot be adequately managed. Riders and trainers must be educated to recognize pain-based behavior rather than attributing it to resistance or disobedience.