Nonsurgical management of equine kissing spines has advanced significantly, with combined rehabilitation, injection therapy, and physiotherapy protocols achieving good outcomes in many cases.
Nonsurgical kissing spines management has emerged as a genuine alternative to surgical intervention for many horses, particularly those with moderate rather than severe lesions and no spinal instability. The multimodal approach — addressing pain through targeted injections, biomechanical contributors through physiotherapy and rehabilitation, and management factors through saddle fit and rider assessment — treats the whole horse rather than the radiographic finding alone. Welfare outcomes for horses responding to conservative management are good, with many returning to previous work without the recovery period and anesthetic risks of surgery. The key welfare principle is tailoring treatment intensity and type to the individual horse and their clinical presentation rather than applying a uniform protocol based on imaging findings alone.