Understanding the factors that contribute to kissing spines development enables preventive approaches that reduce the incidence of this painful condition in sport horse populations.
Kissing spines prevention is more effective than treatment and more welfare-positive than managing horses through chronic pain. The preventive factors — appropriate saddle fit, training that encourages correct spinal biomechanics including back lifting and core engagement, and early intervention at first pain signs — are all actionable management decisions. The high radiographic prevalence of kissing spines in the horse population indicates that many horses in work have this finding, but clinical severity varies enormously. Welfare-focused management distinguishes between horses with radiographic findings but no clinical pain (who may work normally with appropriate precautions) and those with clinical pain (who require treatment, rehabilitation, and sometimes career modification). Treating every radiographic finding as a catastrophic diagnosis causes unnecessary welfare harm through inappropriate restriction.