Back Pain in Horses: Diagnosis and Welfare

Back pain is frequently underdiagnosed in horses, causing chronic discomfort and performance issues that significantly affect welfare.

Key Facts

Equine back pain is caused by muscular, ligamentous, joint, or neurological pathology
Kissing spines (overriding dorsal spinous processes) is a common radiographic finding
Not all radiographic kissing spines cause clinical pain - interpretation requires clinical correlation
Signs of back pain include behavioural changes, reluctance to work, bucking, and cold-backed response
Diagnostic local analgesia, nuclear scintigraphy, and ultrasound guide diagnosis
Treatment options include physiotherapy, mesotherapy, shockwave therapy, and surgery for severe cases
Saddle fit is a significant contributor to equine back pain and should be assessed by qualified fitters

Welfare Considerations

Horses cannot verbally report pain, and back pain manifests through behavioral changes that are often attributed to training issues or poor attitude. Horses labeled 'difficult' or 'naughty' may simply be hurting. The welfare implications of chronic, undiagnosed back pain are significant - affected horses work through pain daily. A thorough veterinary investigation of any unexplained behavior change, combined with appropriate saddle fitting and physiotherapy, provides meaningful welfare benefit to many horses.

What You Can Do

Investigate behavioral changes under saddle as potential pain rather than attitude
Have saddle fit assessed by a qualified fitter at least annually and when horses change shape
Consult an equine vet experienced in musculoskeletal diagnosis for persistent back issues
Consider physiotherapy and controlled exercise as first-line treatment for mild to moderate pain
Keep records of behavioral changes and responses to treatment to monitor welfare over time