Conservative nonsurgical management of equine kissing spines through injection therapy and rehabilitation produces welfare outcomes comparable to surgery for many horses.
The evidence that conservative management of kissing spines produces outcomes comparable to surgery for mild to moderate cases has significant welfare implications — it means many horses can achieve good quality of life without surgical risk and recovery. The welfare decision framework for kissing spines now includes honest consideration of disease severity, response to initial conservative treatment, competitive requirements, and owner capacity for the extended rehabilitation that both surgical and nonsurgical approaches require. Horses whose welfare suffers from prolonged inadequately treated back pain, however, should not be managed conservatively simply to avoid surgical costs if surgery would provide more durable relief.