Horse Kissing Spines: Diagnosis, Treatment, and Welfare

Overriding dorsal spinous processes, commonly called kissing spines, are a significant and often underdiagnosed source of back pain in horses.

Key Facts

Kissing spines occur when adjacent spinous processes contact or overlap, causing pain and inflammation
Prevalence estimates range from 20-40% of sport horses, though many show no clinical signs
Diagnosis requires standing radiographs and careful clinical evaluation including back palpation
Treatment options include mesotherapy, corticosteroid injections, shockwave therapy, and surgery
Saddle fit, rider position, and physiotherapy are essential components of long-term management

Welfare Considerations

Horses with kissing spines often exhibit subtle behavioral signs of back pain: reluctance to be saddled, cold-backed behavior, bucking, and resistance to collection. These signals are frequently misinterpreted as behavioral problems and addressed with punishment rather than veterinary investigation. Early diagnosis and multimodal treatment, including physiotherapy and modified training, significantly improves welfare outcomes. Not all horses with radiographic kissing spines require treatment if they are asymptomatic.

What You Can Do

Investigate behavioral changes under saddle with a vet and physiotherapist before assuming naughtiness
Ensure saddle fit is assessed by a qualified saddle fitter at least annually
Include regular back physiotherapy in performance horse care routines
After surgical intervention, follow evidence-based rehabilitation protocols
Learn to recognize early back pain signals: ear pinning when girthing, dipping spine when mounted