Veterinarians Weigh in on Back Pain Diagnosis and Treatment in Horses
Marshall-Gibson and her fellow researchers recently developed, distributed, and analyzed a survey completed by equine veterinarians in the U.S. regarding back pain in their patients. Of the 97 respondents, 58% were general practitioners, 16% specialists, 14% university teachers, and 4% private referral hospital veterinarians. The most common breeds these practitioners examine and treat are Warmbloods, Thoroughbreds, and Quarter Horses.
Most veterinarians noted they evaluated horses’ reaction to palpation over the spinous processes and performed dynamic mobility and ridden exams, with higher preference for palpation and the ridden examination. Most practitioners chose radiographs of the spinous processes and vertebral bodies, ultrasonography, or regional anesthesia of the limbs to diagnose primary back pain and its cause, said Marshall-Gibson.
“The most common pathologies reported in the survey were kissing spines, sacroiliac joint disease, and osteoarthritis of the thoracic and lumbar articular facets (those running from the withers to the pelvis). The most recommended first-line treatments for back pain were shock wave, non-steroidal anti-inflammatories (NSAIDs), chiropractic, and acupuncture, but the most popular was rehabilitation exercises.”
In their responses the veterinarians noted they found rehabilitation approaches such as various dynamic mobility exercises, chiropractic, and acupuncture to be the most effective treatment and management modalities, followed by shock wave therapy, local injections of corticosteroids, Sarracenia purpurea (pitcher plant) extract, or platelet rich plasma (PRP).
“The veterinarians reported that many horses responded positively to rehabilitation alone and that choosing the right treatment and management modalities is the most important factor for successful treatment of back pain,” said Marshall-Gibson. Most veterinarians responding to the survey only recommended surgical options for kissing spines when other treatment methods failed, and surgical intervention, when performed, did not avoid the need for medical or nonsurgical intervention to manage residual back pain.
She said researchers need to study the efficacy of invasive and noninvasive procedures and rehabilitation for back pain in horses with or without medical or surgical intervention; compare medical and surgical treatment of kissing spines; and determine long-term effectiveness of rehabilitation, medical, and surgical treatments.
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