Overriding dorsal spinous processes (kissing spines) cause significant back pain in horses and are among the most commonly misdiagnosed causes of performance decline and behavioral change under saddle.
Kissing spines represent a significant and frequently underdiagnosed cause of chronic back pain in sport and leisure horses. The challenge is that radiographic evidence of DSP impingement is common even in apparently sound horses, making clinical correlation essential — but also meaning that horses with symptomatic kissing spines may be dismissed when radiographic findings are explained away as incidental. Horses in pain from kissing spines are often labeled as difficult, resistant, or poorly schooled when their behavior reflects an attempt to avoid the pain associated with collected work. This misattribution leads to training escalation that compounds welfare harm. The welfare argument for systematic investigation of back pain in horses showing performance deterioration or behavioral change under saddle is clear: kissing spines are treatable, and treatment combined with appropriate rehabilitation and saddle fitting substantially improves welfare outcomes.