Kissing spines (overriding dorsal spinous processes) cause significant back pain in horses and require careful welfare management combining medical treatment with training and management changes.
Kissing spines welfare management requires recognizing that back pain profoundly affects quality of life in ridden horses — every schooling session and competition becomes an experience of pain rather than engagement. The high prevalence of radiographic findings without clinical signs creates complexity in welfare decision-making. The welfare priority is horses showing clinical signs of pain from the condition, who benefit from appropriate treatment combined with saddle assessment, training modification and careful rehabilitation. Surgery has excellent outcomes for appropriately selected cases. The long-term welfare outcome of kissing spines horses depends heavily on thoughtful management that respects their pain experience rather than overriding behavioral responses with training techniques.