Kissing spine, where adjacent thoracic vertebrae make contact, is a significant cause of back pain and poor performance in horses. Early diagnosis and multimodal treatment improve welfare and working life.
Back pain from kissing spine profoundly affects horses' ability to perform and their willingness to engage with work. The pain cycle — where the horse resists work due to pain, receives stronger aids, experiences more pain, and becomes more resistant — is a welfare failure that often manifests as behavioral labels like "naughty" or "stubborn." Diagnosing and treating the underlying pain is both a welfare and training obligation. The risk of misattributing pain-related behavior to training problems means many horses suffer unnecessarily. A pain-first diagnostic approach ensures horses receive appropriate treatment before training interventions.