Overriding dorsal spinous processes, commonly called kissing spines, cause chronic back pain in horses and are frequently underdiagnosed.
Kissing spines cause chronic, often severe back pain that profoundly affects quality of life. Because horses are prey animals that suppress pain signals, the condition is routinely mistaken for behavioral problems — bucking, reluctance to work, or poor performance. Riders and trainers may apply harsher training methods to overcome what they perceive as resistance, worsening suffering. Awareness of kissing spines has grown substantially among equine veterinarians, but remains low among general horse owners. Early diagnosis through clinical examination and radiography, followed by appropriate multimodal treatment, can dramatically improve comfort and function.