Horse Kissing Spines: Pain, Behaviour, and Treatment Decisions

Overriding dorsal spinous processes (kissing spines) cause significant back pain in horses, affecting performance and welfare across many disciplines.

Key Facts

Kissing spines occur when dorsal spinous processes of thoracic vertebrae impinge or overlap, causing inflammation and pain.
Radiographic evidence of kissing spines is found in up to 50% of performance horses, though not all have clinical signs.
Thoroughbreds and warmbloods in jumping and dressage disciplines are most commonly affected.
Signs include reluctance to be saddled, bucking, cold-backing, changes in canter quality, and loss of topline muscle.
Treatment options range from physiotherapy and rehabilitation to corticosteroid injections and surgical ostectomy.

Welfare Considerations

Kissing spines cause chronic back pain that is frequently misinterpreted as "naughtiness" or training resistance, leading to escalated training pressure that worsens welfare. The pain-behaviour connection is well-established — horses with back pain buck, rear, and refuse not from disobedience but from pain avoidance. The British Equine Veterinary Association has emphasised that many horses presented for training problems have underlying musculoskeletal pain. Welfare management requires accurate diagnosis (radiography, scintigraphy), appropriate treatment, and honest assessment of whether return to the previous workload is in the horse's welfare interests. Some horses require retirement to low-demand work or turnout following treatment.

What You Can Do

Seek veterinary assessment including back palpation and radiography for any horse showing behavioural changes under saddle.
Ensure saddle fit is assessed by a Society of Master Saddlers qualified fitter annually.
Work with a ACPAT or IRAP certified equine physiotherapist on rehabilitation programmes.
Maintain good muscle condition through appropriate exercise and physiotherapy.
Contact the British Horse Society or BEVA for guidance on horse back pain welfare.