Sacroiliac Disease in Horses: Pain and Performance

Key Facts

• Sacroiliac disease is increasingly recognized as a significant cause of poor performance and behavioral changes
• Signs include hindlimb stiffness, asymmetric hindquarter muscle, reluctance to engage hindquarters, and resistance under saddle
• Diagnosis requires clinical examination, nuclear scintigraphy, or ultrasound-guided evaluation
• Treatment options include corticosteroid injections, shock wave therapy, and physiotherapy
• Many horses show significant behavioral improvement after treatment suggesting chronic pain was the driver

Welfare Considerations

Sacroiliac disease causes chronic pain that manifests as behavioral changes under saddle often misattributed to training resistance. Horses with SI pain may buck, refuse jumps, or hollow their backs — these are pain responses not character flaws. The welfare implication is that horses are routinely punished for pain behaviors that should instead trigger veterinary investigation. Early diagnosis transforms both welfare and performance outcomes.

What You Can Do

• Investigate any horse showing persistent behavioral changes under saddle — resistance is often pain communication
• Request veterinary assessment including sacroiliac examination for horses with unexplained hindlimb stiffness
• Pursue imaging for definitive diagnosis in horses with suspected sacroiliac disease
• Implement physiotherapy and appropriate exercise modification during treatment and recovery
• Monitor behavioral changes as a welfare outcome measure alongside clinical signs after treatment