Back Pain and Kissing Spines in Horses: Welfare-Centered Diagnosis

Thoracolumbar pain is common in ridden horses but frequently misdiagnosed as behavioral issues, with accurate diagnosis enabling effective treatment and improved welfare.

Key Facts

Overriding dorsal spinous processes (kissing spines) affect approximately 40% of horses assessed for back pain
Clinical signs include reluctance to be saddled, dipping away from grooming, reduced back flexibility, and poor performance
Scintigraphy (bone scan), radiography, and ultrasound are complementary diagnostic tools
Local anaesthetic infiltration over suspected lesions confirms pain localization
Mesotherapy, corticosteroid injections, and surgical treatment are evidence-based management options
Physiotherapy, appropriate saddle fit, and rehabilitation exercise address contributing factors
The Ridden Horse Pain Ethogram (RHpE) identifies behavioral indicators of pain during ridden work

Welfare Considerations

Back pain is one of the most commonly misinterpreted welfare issues in ridden horses. Behaviors arising from pain - reluctance to work, resistance, rearing, bucking - are often attributed to temperament or training issues rather than physical discomfort. Horses may be subjected to aversive training techniques to suppress pain behaviors rather than addressing the underlying cause. The availability of validated behavioral assessment tools like the RHpE enables recognition of pain-related behavior in ridden horses, prompting appropriate diagnostic investigation and treatment rather than punishment.

What You Can Do

Learn the Ridden Horse Pain Ethogram behavioral indicators and apply during your horse's work
Interpret resistance and reluctance to work as potential pain signals warranting investigation
Seek veterinary assessment including thoracolumbar palpation and imaging for unexplained performance changes
Ensure saddle fit is assessed by a qualified fitter - ill-fitting saddles cause and worsen back pain
Include physiotherapy as part of back pain management and rehabilitation
Provide appropriate warm-up and cool-down exercises to support spinal musculature
Report back pain concerns to competition welfare officials if you observe ridden horses showing pain indicators