Back pain in horses can be observed as poor performance, pain with palpation of the back, or even limb lameness. “Once a diagnosis has been made, you have to break the pain cycle or rehabilitation will not be successful,” said Katie Ellis, DVM, MS, Dipl. ACVSMR, clinical assistant professor at the University of Georgia’s College of Veterinary Medicine, in Athens, at the inaugural American College of Veterinary Sports Medicine and Rehabilitation Symposium, held April 27-29 in Charleston, South Carolina.

Ellis, who is certified equine chiropractic and acupuncture, explained that a veterinarian’s rehabilitation plan depends on whether surgical or nonsurgical treatment was used to treat the source of the horse’s back pain. Surgery can be performed for horses with dorsal spinous impingement (kissing spine). The most common surgical treatments for back pain are:

• Interspinous ligament desmotomy—cutting the interspinous.
• Subtotal ostectomy—removing parts of spinous processes.
• Total ostectomy—completely removing processes.

Common nonsurgical treatments for back pain include local injections, systemic medications, and shock wave therapy.

Rehab Approaches for Horses with Back Pain

Physiotherapy is one of the most important elements of rehabilitation after surgical or nonsurgical treatment for equine back pain. Horses might be more resistant to these methods after surgery, however, and they should only be done after the horse’s sutures have been removed, said Ellis. Some of these movements include sternal lifts, caudal tail pulls, lateral bending, and ventral flexion.

Elastic resistance bands worn around the hindquarters and around the abdomen can be used for horses managed with and without surgery, but horses that have undergone surgery should be hand-walked with the band before they are cleared to be ridden. “Monitor your horses closely for back pain and increase time in the band by five minutes every two weeks,” said Ellis. “Horses become fatigued very quickly, so it is important to introduce them slowly.”

Whole body vibration therapy has been shown to improve balance and stabilization of the spinal cord in humans and has been shown to increase the cross-sectional area of the multifidus muscle in the horse. Proprioceptive balance pads are a relatively inexpensive and effective way to strengthen the horse’s postural muscles and improve balance.

Pole work both in hand and under saddle can be used to increase the activation of both the abdominal and multifidus muscles in horses, but it should only be used once the soft tissues in the back are fully healed after surgery.

Take-Home Message

Whether the horse has received medical or surgical treatment for back pain, adding a progressive rehabilitation plan will help strengthen the horse’s abdominal and back muscles and reduce back pain, said Ellis.