Multimodal treatment approaches for equine kissing spines syndrome combine medical management, physiotherapy, and surgical intervention for improved welfare outcomes.
Kissing spines syndrome illustrates the complexity of pain assessment in horses — the gap between radiographic findings and clinical signs challenges straightforward diagnosis and welfare assessment. Horses with severe radiographic changes may perform normally, while those with mild changes may show significant pain behavior, reflecting the multifactorial nature of back pain. Treatment selection requires weighing the welfare costs of procedures against expected benefits. The post-treatment rehabilitation phase — progressive core strengthening and gradual return to work — is as important for welfare outcomes as the initial intervention.