🩺 Equine Back Pain: A Vet’s 2025 Guide | Dr Duncan Houston BVSc

Meta description: Understand causes of back pain—kissing spine, muscle strain, sacroiliac dysfunction—in horses. Learn to diagnose, treat, prevent, and use Ask A Vet for custom care.

1. 💥 Why Back Pain Matters

Up to 94 % of ridden horses show some signs of back pain—ranging from performance loss and behavioral changes to physical injuries and compensation issues :contentReference[oaicite:3]{index=3}. Addressing back pain early boosts welfare and prolongs athletic careers.

2. 🦴 Common Causes

• Kissing spine (impinging spinous processes): Causes pain from adjacent vertebrae rubbing—affects ~40 % of horses and is frequent in performance breeds :contentReference[oaicite:4]{index=4}.
• Muscle strain: Overuse, poor warm-up, or compensation from limping can strain back muscles :contentReference[oaicite:5]{index=5}.
• Sacroiliac dysfunction: Alters gait and can create secondary back soreness :contentReference[oaicite:6]{index=6}.
• Arthritis or osteoarthritis: In thoracic/lumbar joints causing stiffness :contentReference[oaicite:7]{index=7}.
• Poor saddle fit or rider position: Creates pressure points and compensatory muscle pain :contentReference[oaicite:8]{index=8}.

3. 🔎 Recognizing Clinical Signs

• Behavioral changes: girthiness, bracing, reluctance to saddling or mounting :contentReference[oaicite:9]{index=9}.
• Pain responses during grooming or palpation, hollowed or tense back posture :contentReference[oaicite:10]{index=10}.
• Performance issues: bucking, short stride, cross‑canter, loss of impulsion :contentReference[oaicite:11]{index=11}.
• Subtle signs: sweating, facial tension, stiffness turning, sensitivity to touch :contentReference[oaicite:12]{index=12}.

4. 🧪 Diagnosis & Evaluation

Start with a vet-led clinical exam and palpation. Use nerve blocks to localize pain. Imaging includes:

• Radiography: To detect kissing spine, joint degeneration :contentReference[oaicite:13]{index=13}.
• Ultrasound: Useful for soft tissue and spinal assessments :contentReference[oaicite:14]{index=14}.
• Advanced imaging: CT, MRI, bone scan for deep pathology if needed :contentReference[oaicite:15]{index=15}.

5. 🛠️ Treatment Options

Treatment is multimodal, combining medical, manual, and rehabilitation strategies:

• NSAIDs: Phenylbutazone, flunixin or COX-2 inhibitors reduce inflammation :contentReference[oaicite:16]{index=16}.
• Muscle relaxants: Methocarbamol eases muscle spasm :contentReference[oaicite:17]{index=17}.
• Corticosteroid injections: Localized to articular processes or spinal ligaments :contentReference[oaicite:18]{index=18}.
• Shockwave therapy: Supports tissue healing and breaks pain cycles :contentReference[oaicite:19]{index=19}.
• Chiropractic / acupuncture: Realign spine/joints and alleviate pain :contentReference[oaicite:20]{index=20}.
• Rehabilitation: Core strengthening, dynamic mobilization, aqua‑treadmill exercises :contentReference[oaicite:21]{index=21}.
• Saddle fit assessment: Essential to remove mechanical causes :contentReference[oaicite:22]{index=22}.
• Supplements: Joint & muscle support with glucosamine or muscle nutrients as needed :contentReference[oaicite:23]{index=23}.
• Surgery: For kissing spine when conservative therapy fails—spinous process resection often succeeds :contentReference[oaicite:24]{index=24}.

6. 🧩 Rehabilitation & Prevention

• Design a graded exercise program focusing on posture, core engagement, and back mobility.
• Apply manual therapy—massage, mobilization, physiotherapy to loosen tight regions :contentReference[oaicite:25]{index=25}.
• Ensure correct tack fit—never ride on a bridging pad.
• Maintain proper conditioning—warm-up, cool-down, balanced training workload :contentReference[oaicite:26]{index=26}.

7. 🤝 Ask A Vet Remote Support

Ask A Vet enhances outcomes with:

• 📸 Remote posture assessment and gait video analysis.
• 📋 Tailored rehab, manual therapy, and saddle-fit plans.
• 📆 Treatment reminders, symptom tracking, and progress logs.
• 🎓 Access to webinars: “Understanding Back Pain,” “Rehab Exercises,” “Shockwave & Manual Therapies.”
• 🔁 Follow-up scheduling after rehab milestone achievements.

8. ❓ FAQs

Will my horse heal fully?

Yes—82 % of primary back pain cases improve with non‑surgical treatment, especially with rehab included :contentReference[oaicite:27]{index=27}.

Is surgery necessary for kissing spine?

Only 14–28 % require surgery; most respond well to rehab, injections, manual therapy :contentReference[oaicite:28]{index=28}.

How long is recovery?

Initial improvement seen in 4–6 weeks; full return may take 3–6 months with consistent rehab.

Do alternative therapies work?

Yes—shockwave, chiropractic, acupuncture and massage support healing when combined with core rehab :contentReference[oaicite:29]{index=29}.

9. ✅ Final Takeaway

Equine back pain hampers performance and welfare—but responds well to early, multimodal treatment. Use veterinary diagnostics, rehab, manual therapies, tack review, and Ask A Vet's structured remote support to restore comfort, function, and longevity. As Dr Duncan Houston, I’m here to guide you and your horse to a strong and pain-free future in 2025 and beyond.