Back Pain in Horses by a Vet – 2025 Guide to Diagnosing Multifidus Muscle Injury with Ultrasound 🐴🧠
In this article
Back Pain in Horses by a Vet – 2025 Guide to Diagnosing Multifidus Muscle Injury with Ultrasound 🐴🧠
By Dr Duncan Houston, BVSc
Introduction
Equine back pain is a silent performance killer. Often misunderstood or misdiagnosed, back problems in horses can lead to:
- Unexplained stiffness or resistance
- Bucking or rearing under saddle
- Asymmetrical muscle development
- Loss of topline condition
Why Diagnosing Back Pain Is So Hard 🔍
- Many horses show subtle signs that mimic behavioral or training issues
- Back problems often don’t show on X-rays or routine palpation exams
- Bone scans may miss deep muscle or attachment injuries
The Multifidus Muscle Explained 🧠
The multifidus is a group of overlapping deep muscles found along both sides of the spine. Key facts:
- Split into five bands of muscle
- Each muscle spans 2–4 vertebrae
- Responsible for postural support, spinal alignment, and stability
Why It’s Important:
Injuries or atrophy in the multifidus muscles can result in:
- Chronic pain or fatigue under saddle
- Loss of core strength and spinal stability
- Compensatory gait issues and secondary lameness
Using Ultrasound to Diagnose Back Pain in Horses 💡
In 2025, ultrasound is now widely available in equine practices. According to research presented at the American Association of Equine Practitioners (AAEP), ultrasound allows for:
- Visualization of deep back muscles
- Identification of tears, inflammation, and atrophy
- Side-to-side muscle comparison for asymmetries
What Vets Look For:
- Decreased muscle size on one side
- Changes in echogenicity – muscle appears darker or lighter on scan
- Signs of localized swelling or scar tissue
Symptoms That May Suggest Multifidus Injury 🐴
- Loss of top line muscle
- Crabby attitude or behavioral change under saddle
- Poor engagement or impulsion from the hind end
- Asymmetrical saddle sweat marks
- Unwillingness to bend or lift the back
Treatment of Back Pain in Horses 🔧
1. Targeted Rehabilitation & Core Strengthening 🏋️♀️
- Belly lifts and carrot stretches
- Cavaletti work and hill walking
- Underwater treadmill or swimming (if available)
2. Shockwave Therapy
- Stimulates healing and reduces inflammation in muscle injuries
3. Mesotherapy or Injections
- Used for trigger points or inflammation in the epaxial muscles
4. Chiropractic or Acupuncture Support
- Helps restore range of motion and relieve muscle guarding
5. Addressing Saddle Fit
- Improper saddle fit can cause chronic back tension
- Use a saddle fitter experienced in biomechanics
Case Study: Dressage Gelding with Decreased Topline
- 14-year-old warmblood gelding began resisting collected work and bucking on right lead canter
- Multifidus muscle asymmetry noted on ultrasound
- Rehab with belly lifts, water treadmill, and two shockwave sessions
- Returned to medium-level dressage with improved topline after 6 weeks
FAQs About Equine Back Pain & Ultrasound 🧬
Q: Is ultrasound safe?
A: Yes. It’s non-invasive, painless, and widely available in equine practices.
Q: How long does a back ultrasound take?
A: Typically 30–45 minutes. The vet will measure and compare both sides of the back.
Q: Can I see the images?
A: Yes! Most vets will show you the scan results and explain the differences in muscle tone or injury.
Conclusion
In 2025, equine veterinarians have better tools than ever to uncover the root causes of subtle performance loss and chronic pain. Back pain—especially involving the multifidus muscles—is often underdiagnosed, but no longer invisible thanks to ultrasound. If your horse shows stiffness, resistance, or uneven muscling, it’s time to look deeper—literally.
Think your horse’s back pain might be holding them back? Visit AskAVet.com or download our app 📱 to consult with Dr Duncan Houston for an ultrasound-based diagnosis and a tailored rehab plan. 🩺🐴
