Evidence-based nonsurgical management of equine kissing spines combines corticosteroid treatment, physiotherapy, and saddle fit correction to achieve welfare improvement for many affected horses.
Nonsurgical management of kissing spines offers welfare improvement for the majority of affected horses without the welfare costs of surgery and extended convalescence. The key welfare principle is accurate diagnosis through appropriate imaging followed by a structured treatment protocol rather than indefinite analgesia without addressing the underlying pathology. The combination of reducing inflammation, managing pain, strengthening supporting musculature, and eliminating exacerbating factors through saddle fit correction addresses multiple components of the welfare impact simultaneously. Regular reassessment is essential to evaluate treatment efficacy and identify horses who require escalation to surgical management when conservative approaches have been genuinely maximized.