Overriding dorsal spinous processes — kissing spines — cause significant back pain in horses, requiring careful diagnosis and evidence-based rehabilitation for welfare-positive outcomes.
Kissing spines represent a significant welfare problem because pain behavior is frequently misinterpreted as disobedience rather than pain communication. Horses that buck when asked to canter, resist back contact, or show reluctance to work are often labelled difficult rather than evaluated for back pain. Delayed diagnosis means horses work through pain for extended periods before treatment is pursued. Once diagnosed, treatment decisions require careful welfare consideration: many horses with radiographic findings are comfortable in management and do not require intervention, while others with fewer visible changes have significant pain requiring prompt treatment. The welfare-positive approach involves treating confirmed pain proactively while avoiding over-medicalization of radiographic incidental findings. Rehabilitation success depends on patience, appropriate physiotherapy, and gradual return to work with ongoing pain behavior monitoring.