Back or Neck Pain in Horses by a Vet – 2025 Guide to Kissing Spines, Cervical Stiffness & Rehab 🧠🐎

By Dr Duncan Houston, BVSc

Introduction

Back and neck pain in horses is an increasingly recognized issue—especially in disciplines requiring quick turns, tight lateral work, or jumping. In 2025, better diagnostic tools and treatment techniques are helping us manage these tricky and often subtle conditions. Whether it's kissing spines, cervical arthritis, muscle strain, or ligament pain, addressing the root cause is critical to restoring performance and quality of life.

How Common Is Back and Neck Pain in Horses? 📈

Very common—especially in performance horses. Horses involved in:

• Barrel racing
• Cutting
• Eventing
• Show jumping

Key Structures Involved in Pain 🧠

Neck (Cervical) Area:

• 7 large vertebrae (C1–C7)
• Over 100 muscles
• Important nerves affecting shoulders and front limbs

Back (Thoracolumbar) Area:

• Dorsal spinous processes (site of “kissing spines”)
• Epaxial muscles and supporting ligaments
• Facet joints and sacroiliac (SI) region

Common Causes of Neck & Back Pain in Horses 🔎

• Arthritis in the facet or vertebral joints
• Muscle strain or spasm from overuse or poor saddle fit
• Ligament inflammation or microtears
• Overriding dorsal spinous processes (“kissing spines”)
• Compensatory pain from hock arthritis or lameness elsewhere

Symptoms of Cervical or Back Pain 🧠🐴

• Stiffness turning the neck or unwillingness to bend
• Poor quality canter or refusal to pick up a lead
• Crabby or aggressive behavior when saddling
• Kicking out or bucking under saddle
• Cross cantering or difficulty jumping
• Resistance to collection or engagement

Diagnosing Back and Neck Pain in Horses 🩺

• Palpation and flexibility testing
• Local anesthesia blocks in affected areas
• Radiographs to identify kissing spines or arthritis
• Ultrasound of ligaments and muscle groups
• Nuclear scintigraphy (bone scan) or MRI for complex cases

Kissing Spines Explained 🦴

Kissing spines, or overriding dorsal spinous processes (ORDSP), occur when the bony projections on the vertebrae in the horse's back rub together. This causes:

• Chronic inflammation
• Muscle atrophy
• Sharp pain on motion

Treatment Options for Neck and Back Pain 💉🧘‍♂️

1. Anti-Inflammatory Medications

• NSAIDs like Equioxx or bute
• Corticosteroid injections into:
  • Facet joints
  • Ligaments
  • Interspinous spaces

2. Shockwave Therapy

• Used to stimulate healing in affected muscle and ligament areas

3. Mesotherapy

• Involves injecting small doses of anesthetics and steroids under the skin
• Targets nerve endings involved in chronic pain cycles

4. Acupuncture and Chiropractic Care

• Helpful for releasing muscle tension and improving motion

5. Surgery for Kissing Spines

• Interspinous ligament desmotomy (cutting ligament to create space)
• Partial resection of spinous processes
• Many horses return to work after surgery with proper rehab

Rehabilitation and Prevention Tips 🐴🏃‍♂️

• Include core-building exercises like belly lifts and hill work
• Ensure correct saddle fit and check it regularly
• Warm-up and cool-down properly
• Use cross-training to reduce repetitive strain

Case Example: Barrel Mare with Bucking Under Saddle

1. 9-year-old mare began resisting tight turns and bucking when saddled
2. Neck flexion was limited; ultrasound revealed ligament inflammation at C6–C7
3. Mesotherapy + shockwave + 4-week rehab plan
4. Returned to light work with improved comfort and flexibility

FAQs About Equine Back and Neck Pain

Q: Can neck arthritis mimic leg lameness?

A: Yes. Especially in the forelimbs—cervical nerves can cause gait abnormalities or shoulder stiffness.

Q: Are kissing spines curable?

A: They are manageable—and sometimes surgically correctable. Many horses return to full work.

Q: Is saddle fit really that important?

A: Absolutely. Ill-fitting saddles cause chronic back tension and can worsen pain patterns.

Conclusion

In 2025, we understand more than ever that subtle behavioral changes and stiffness under saddle may point to neck or back pain. Whether it’s arthritis, kissing spines, or muscle strain, diagnosing the true cause is key to successful treatment. Don’t let vague signs of discomfort go unchecked—early detection and rehab can prevent chronic pain and restore your horse’s comfort and performance.

Concerned about your horse’s stiffness, bucking, or uneven gait? Visit AskAVet.com or download our app 📱 to connect with Dr Duncan Houston for a full diagnostic and rehab plan tailored to your horse’s spine health. 🩺🐴