I have always thought people and horses are a lot alike. You can see it in the way they work – their pain tolerance.
Personality is expressed through attitude when things become difficult. That is when you find out if horses really like their job or are they just doing it because they have to. From an athletic standpoint, the similarities continue. Having done long-distance triathlons for years, I have learned what it is like to have pain in places and ways you would have never expected. The plus side of that is it has made me a much more conscientious veterinarian when I am looking at horses that work, show, and live with pain. For horses and people alike, the commonality we share that we can all identify with is back pain. Young or old, athlete or couch potato, back pain is the common denominator we all share.
Granted, back pain in horses deserves its own wing in the veterinary library, so for the purpose of this article we will look at the types of back pain you will be presented with. Diagnostics, treatments and rehabilitation occupy their respective places in the library, and for good reason. When you think of the anatomy there can be multiple sources of pain. Muscle tissue, nerves, bones, ligaments and joints are all aligned in a tight, but functional unit. When this alignment is off it can cause a variety of symptoms particular to the tissues affected.
Back Pain in Horses
Like many other maladies the manifestation of symptoms is dependent on the duration, severity and location of the problem. You will see anything from skin hypersensitivity as you are brushing your horse’s back off to them carrying their tail extended behind them or off to the side. Generalized poor performance fits into the back pain file folder as well, but they may no longer hold a stop when they have in the past. Loss of top-line muscle mass is hopefully a temporary presentation of back pain, but can be dramatic. The supreme example of back pain, though, is the most dreaded – bucking. Yes, there are many reasons horses buck people off, but outside of being a larcenous individual, back pain needs to be at the top of the list.
I am fairly simple minded, so I try to keep the categorization of back pain the same way. I think of it in basically four ways: 1) Back pain from lower hind limb lameness, 2) Improper saddle fit/tack pressure, 3) Kissing spines and 4) Upper cervical causes. If you are a sorter and not a lumper like me you may not like those designations. Yes, there are many more back problems out there, but more or less any type of back pain will fit into those four designations.
Lower Limb Lameness
For me, the majority of back pain I see is caused from lower limb lameness issues. Specifically, it’s often hind limb lameness like sore hocks and stifles. These horses will have lower back symptoms and pain in the sacroiliac joint (SI), which is between the horse’s hind leg and spine, but it originates from not using their hind limbs correctly to stop. Horses should stop with their hind limbs underneath them. When they stop on their front end or with their hind limbs behind them they excessively load their lower back and SI. Think of it this way: the doctor tells you to “lift with your legs not with your back.” In turn, it makes sense when a horse stops with the majority of load in their lower back instead of their lower limbs they get sore quickly. In short, treat the lameness and the back pain goes away without extra effort if you catch it quickly enough.
Improper Saddle Fit
Improper saddle fit or excessive tack pressure is an all too common occurrence, because most people are more interested in what the saddle looks like instead of how it fits the horse. The right saddle pad can make up a lot of ground, and even the playing field across different builds of withers and shoulders. However, you may still have dry patches of hair and skin when you take your tack off. This is a sure sign of an impending problem. Those dry spots, white hairs and bald spots on your horse’s withers are more than likely what is driving poor performance and resistance while you work.
For some, this may be an occupational hazard like with tie-down calf and steer horses, but the majority is driven from conformational issues. The best example is a horse with shoulder blades that are set wide off a tall set of withers. This horse and many others like him are best served with a custom-fit saddle. In the end it’s much less expensive than the vet bills, I promise.
Kissing spines is a condition that has gotten a lot of air time in the last few years. I am not sure if that is because we are better at recognizing it and it has been here all along, or the amplification of the phenotypic traits that cause it by breeding a certain type of horse. Either way it is here to stay. The good news, however, is that kissing spines is fixable. It’s not just manageable like so many other problems, but fixable. Kissing spines horses tend to present a bit more specific in the location of their pain and prompt willingness to express that pain since it is a deeper, more severe bone pain than just sore muscles, or a skin abrasion. The dorsal spinous processes of the back bone literally grind together from overriding apposition instead of being able to move freely within the normal space between the backbones. Since kissing spines tend to occur right under your seat in the saddle bucking is a top symptom to be aware of.
Upper Cervical Issues
Now a more nebulous cause of back pain is what I categorize as upper cervical issues. These horses will often be the most reactive to light to medium pressure from your finger or brushes. Almost over reactive in a sense. They will be painful from their ears to the end of their offset tail as you palpate them. The presentation may be back pain, but the cause is from the upper neck region of the spine. Think of it this way – horses set back on lead ropes all the time pulling their neck into hyperextension. We make horses collect with a bit and break at the pole causing hyperflexion. Almost any variation of normal function will be tested just when they are grazing through a fence or over a neighbor’s feeder. Over time this abnormal range of motion will get the first cervical vertebra, the atlas, out of alignment in turn causing generalized pressure and irritation from the top of the spinal cord. So, basically the first bone in their neck has ignited a nerve fire all the way down their spine. Consequently, the place we make contact with them, their mid-back, is where we see the most symptoms. Over the years I have learned some horse problems are fixed by veterinarians, some are chiropractic fixes, and some are a combination of the two. This one is a chiropractic fix in my experience, and an amazingly quick one also.
Hopefully, I did not muddy the water in your understanding of back problems in horses. Sometimes it is a back problem, and sometimes it’s not. It may look like a back problem, but be coming from somewhere else. Clear as mud, right? Either way, backs are something we all deal with in our lifetime. The sooner we see the expression of that pain coming across as behavior changes, a bad attitude, and performance issues the easier and more effective our treatments can be to give our horses relief from what we all know too well.
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