Navigating Equine Neck Problems

Make sense of the challenges surrounding neck pain in horses

A pain in the neck” is a saying for a reason. Neck issues can derail your day in a hurry and are just as painful for your horse. Cervical pain and deficits in horses can be confusing, difficult to pinpoint, and even the end of a sport horse career.

But don’t despair if you are dealing with equine neck pain. We’re here to help make sense of the challenges surrounding it. Sue Dyson, MA, Vet MB, PhD, DEO, Dipl. ECVSMR, FRCVS, an independent consultant and former head of Clinical Orthopaedics at the Animal Health Trust Centre for Equine Studies, in Newmarket, U.K., and José M. García-López, VMD, BS, Dipl. ACVS, ACVSMR, associate professor of large animal surgery and director of equine sports medicine at the Tufts University Cummings School of Veterinary Medicine, in North Grafton, Massachusetts, explain what you need to know.

Neck Problems Aren’t New, Just Tricky

With equine veterinarians diagnosing more neck problems than they used to, it might seem that these issues are increasingly common. The more likely explanation, however, is advancements in research and technology are making it easier to diagnose issues that have always been present.

“I think we are becoming more accustomed to looking at areas like the poll and cervical vertebrae, which make up the neck region, and have a better understanding of how they can influence a horse’s level of soundness,” García-López says. “With the great improvements and increased accessibility to advanced imaging modalities such as nuclear scintigraphy and computed tomography (CT), we have been able to look at this region beyond what historically was the norm, which was plain radiographs and ultrasound.”

Still, neck issues can be challenging to definitively identify. They don’t discriminate; they can plague all ages and breeds of horses. Potential causes—“genetic, conformational, level of use, how the neck is carried during exercise, adequate muscle development or lack thereof, external trauma, and such,” García-López says—and clinical signs can be all over the board. In fact, some clinical signs that might scream “neck problem” to a horse owner are rooted in a completely different part of the body. That’s why he and Dyson agree that a whole-horse exam is key.

“One of the big misconceptions is that there are ‘classic’ signs that tell you that you have neck issues,” he says. “We always, as part of our examination for any lameness, should look carefully at the conformation of the neck region—just as we do when looking at the limbs—(the) level of muscle development and how the horse likes to carry his or her head during rest, low-rein-contact exercise, and moderate or high degree of neck flexion and contact with the bit. In addition, doing range-of-motion tests—both lateral to medial (side to side) and in dorsi- and ventroflexion (up and down)—is

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