Veterinarians Weigh in on Back Pain Diagnosis and Treatment in Horses

Veterinarians across the U.S. share their most successful diagnostic methods and treatments for back pain in horses.
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Veterinarians preferred to use palpation and a ridden examination for diagnosis of back pain. | Photo: Anne M. Eberhardt/The Horse
Back pain: Horse owners commonly call their veterinarians about it, and researchers estimate up to 94% of horses experience it at least once in their lives. Signs of back pain in horses can include poor performance, limb lameness, and reaction to palpation, which can lead to chronic pain and performance limitations if not treated, said Marianne Marshall-Gibson, DVM, MS, cVMA, CAC, CERPM, of Front Range Equine Performance, in Berthoud, Colorado, who presented on the subject at the inaugural American College of Veterinary Sports Medicine and Rehabilitation Symposium, held April 27-29 in Charleston, South Carolina.

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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Written by:

Haylie Kerstetter, Digital Editor, holds a degree in equine studies with a concentration in communications and a minor in social media marketing. She is a Pennsylvania native and, as a horse owner herself, has a passion for helping owners provide the best care for their horses. When she is not writing or in the barn, she is spending time with her dog, Clementine.

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