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Managing Your Horse’s Back Pain

Managing Your Horse’s Back Pain
By  Diane E. Rice 
Two veterinarians share how they diagnose, treat, and rehab back-sore horses
Yesterday you led your horse out of his stall and into the crossties, ready to enjoy some time in the saddle. When you brushed his back, he flinched. When you tightened the girth, he swung his head to the side, clearly annoyed. Your red-flag radar told you something wasn’t right. And as soon as you swung lightly into the saddle and felt his back sink, you knew your normally happy, easygoing mount was hurting. Recognizing the signs of back pain but not knowing just what the problem was, you dejectedly untacked him and called your veterinarian.
Because your horse can’t verbalize where exactly his back hurts or how and when it all began, how does your veterinarian go about pinpointing the problem and forming a treatment plan to eliminate, or at least minimize, the source of his pain? Read on to learn how veterinarians know what diagnostic path to pursue and how to manage your horse’s short- or long-term back pain.
Choose Your Team
Your regular veterinarian knows your horse better than any other vet, and with your help and possibly that of other local equine specialists, he or she has the best potential for relieving your horse’s pain.
Sometimes, however, another opinion or approach might be helpful. Melinda Story, DVM, Dipl. ACVS, ACVSMR, an assistant professor of equine sports medicine and rehabilitation at Colorado State University’s College of Veterinary Medicine and Biomedical Sciences, in Fort Collins, says that even if you’re not near a specialist or a veterinary teaching hospital or school, finding a veterinarian who’s open to an integrative approach—working with multiple modalities and professionals—is important.
Review Possible Causes
It can be a chicken-or-egg-type scenario: Did the back pain result from discomfort somewhere else in the body, or is it truly the root of your horse’s problem?  
Back pain can stem from one or more of a long list of causes—some preventable and some not. Your veterinarian can help you determine if there’s a rider- or management-based reason for your horse’s pain. Common causes include:
Your veterinarian can advise you on your horse’s suitability for a particular discipline; some horses simply aren’t built for the movement required in a specific activity. It’s helpful to determine this during the prepurchase exam and not well into your ownership of the horse.  
Grace Buchanan, DVM, of Buchanan Mobile Veterinary Services, a satellite of Teigland, Franklin, and Brokken, DVMs, PA, based out of Rutherfordton, North Carolina, says improper ­shoeing can create trigger points (muscle spasms) that can lead to back discomfort. This is especially true in horses with “clubby” feet, long toes and low heels, or underrun heels.  
Rider position and posture
“If back pain is consistently recurring or not resolving like I think it should, I look at rider position to see if they’re riding in a way that’s causing pressure over time,” says Buchanan.
Training methods and conditioning
Improper approaches can lead to muscle strains and injury. Make sure you ­condition your horse sufficiently and work the appropriate muscle groups to withstand workouts in your discipline.  
Tack fit
“If I’m finding a lot of pain at the withers, I’ll be suspicious of saddle fit,” says Buchanan. “Usually I’ll have the horse’s owner put the saddle on with no saddle pad (and no rider) and insert three fingers between the pommel and the withers. If they can fit more than three fingers, the saddle is too narrow and sitting too high; if less than three fingers, it’s too wide and sitting too low. This isn’t a 100% perfect science, but it’s a good guideline.
“Another thing I look for is bridging,” she adds. “The saddle’s panels should lie smoothly all along the horse, with no areas that aren’t touching the horse’s back. Areas without contact mean other areas are getting too much pressure.
“A third test is to ride in a clean saddle pad, and after you’ve ridden, check the pad for dry spots that indicate uneven pressure,” she adds. “Then if there are more significant tack-related problems, I’ll refer the client to a saddle fitter.”
Have an expert saddle fitter evaluate saddle fit frequently. “If a horse has underlying pathology, he’ll lose some musculature, so a saddle that fit before may not fit anymore,” says Story. “Check fit at least a few times a year or after any significant change in work or time off.”
Muscle and/or ligament strains or tightening
A back injury can cause pain at the place of insult. Or, an injury in one area—­including soft-tissue injuries such as wounds and resulting scars—can cause a horse to compensate, or move other body parts abnormally in an effort to minimize the pain, resulting in injury of other muscles, joints, or ligaments.  
This progressive and painful degenerative disease process can occur in the joints along the spine.
Acute trauma from falling
Do all you can to eliminate the risk of falls. Keep turnouts and stalls free of objects such as rocks that could cause your horse to trip and/or injure him if he falls. If possible, exercise your horse indoors when the ground outside is slick or icy. Even without a fall, says Story, your horse can strain his back muscles by slipping and sliding on icy or wet footing.
Kissing spines
Veterinarians see this overriding or impinging of the spinous processes most commonly in middle-aged horses involved in racing, jumping, and performance events. “In the case of kissing spines, we can assess using radiographs,” says Story. “In most horses, however, because of the large muscle mass, it’s difficult to penetrate and obtain clear images of the facet joint (small stabilizing joint of the spine) regions.”  
Sleuth a Diagnosis
Your veterinarian will follow a fairly standard protocol looking for clues to help pinpoint your horse’s problem.  
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