Your horse has been diagnosed with back pain—now what? Back pain in horses is more common than we might think, and although it can take a while to resolve, there are many ways you can support your animal during the recovery process. We have asked two leading experts about advice they would give horse owners on rehabilitating horses with back pain.

Get to know what could be causing your horse’s back pain.

To treat and manage back pain correctly, horse owners need to understand its causes. “Trauma, falls, (genetic) muscle disease, muscular strain/fatigue, and compression, friction, or pinching from an ill-fitting saddle can result in back pain,” says Hilary Clayton, BVMS, PhD, Dipl. ACVSMR, FRCVS, president of Sport Horse Science, in Mason, Michigan. Vertebral lesions, such as overriding dorsal spinous processes (kissing spines) and arthritis of the facet joints (between the vertebrae), are among the more serious causes of back pain, she adds.

“Back pain can also be a consequence of compensation due to lameness,” says Gillian Tabor, DPhil, chartered physiotherapist, senior lecturer in veterinary physiotherapy, and researcher at Hartpury University, in Gloucester, U.K. Lameness leading to back pain is often subtle and sometimes not detectable by the eye, she adds, so it can be easily missed.

Although back pain in horses can be challenging to manage, adjusting basic daily practices can help improve your horse’s likelihood of recovery.

1. Allow Ample Turnout and Movement to Avoid Stiffness.

“All horses benefit from turnout, and grazing … is not only good for the back, but also for the mind,” Clayton says. Continuous, low-intensity movement (at the walk) on pasture also helps avoid arthritis in the vertebral joints or prevent the limbs from stiffening up, she adds.

“Even horses undergoing rehab from spinal surgery need to move,” Tabor notes. Therefore, offering all horses daily turnout time is vital to back health.

2. Adjust Feeding Practices for Improved Posture.

“Feeding roughage from the ground is the best option, but we have to be pragmatic if we need to reduce intake to manage weight,” Tabor says. In cases of overweight horses, choosing slow feeding methods that will have the least negative impact on your horse’s back is crucial, particularly when he is still recovering from back pain.

“We should avoid high-hung haynets at all times,” Clayton emphasizes. If haynets are hung too high for extended periods, the horse must constantly elevate his head and neck to reach his hay. This can cause muscular tension and back pain due to the hollowed back stance. But keep in mind horseshoes can get caught in haynets or slow feeders if hung too low. If your horse is not shod, you can tie the haynet lower to the ground, below chest height, she adds.

3. Feed to Support Rehabilitation.

Your horse’s nutritional needs change based on his age, the type of work he does, how much turnout he receives, and on what kind of pasture. “Some horses have poor muscle development and soreness related to nutritional factors, such as vitamin E deficiency in horses that are not turned out on pasture,” Clayton says. If you are unsure whether your horse is consuming a balanced diet, ask your veterinarian or a qualified equine nutritionist for advice.

4. Promote Good-Quality Sleep for Improved Health.

Good sleep correlates with good health. “A person under chronic stress and not sleeping well experiences higher pain levels, and we have no reason to suspect it’s any different for horses,” Tabor says. Ensure your horse has the space and an environment where he feels comfortable enough to lie down in lateral or sternal recumbency (flat on his side or on his chest/abdomen, respectively), because these sleeping positions are required to complete rapid eye movement sleep, which is linked to improved health. Research also suggests that painful musculoskeletal conditions, such as osteoarthritis, might prevent horses from lying down and entering and completing all sleep phases.

5. Improve Hoof Balance to Decrease Back Pain.

“Hoof balance is also a key point worth considering when managing your horse’s back pain, since negative palmar/plantar angles are related to changes in posture of the whole horse,” Tabor says.

If the hooves are unbalanced, they will distribute forces incorrectly throughout the horse’s body, Clayton adds, which can cause back pain. Improving your horse’s posture during recovery from back pain is important for their posture and strength, which directly relate to back pain.

6. Check Saddle Fit and Rider Weight.

Ill-fitting saddles can cause pressure points, rubbing, pinching, and soreness, says Tabor. To be sure your saddle fits your horse properly, work with a qualified saddle fitter and remember to recheck fit at regular intervals (at least every six months) because your horse’s back shape will change with increasing fitness.

“The rider should be an appropriate size and weight for the horse,” Clayton says. Not all horses have sufficient strength to carry a heavy or taller rider, she adds, which riders need to consider when selecting a horse.

7.    Train Good Posture to Prevent Back Pain in Horses.

“Ask yourself, ‘Is my horse’s back prepared for carrying me’ before riding?’” Tabor says. She strongly advises equestrians to dedicate enough training time to groundwork to help horses develop better posture, which activates the muscles needed to carry rider’s weight. Without stimulating and maintaining those muscles through a lifted back in different gaits and directions, back pain can result.

8.    Practice Stretches to Improve Range of Motion and Strength.

Clayton highlights that baited stretches are very effective in preventing and treating back problems because they maintain the horse’s range of motion and strengthen muscles stabilizing the spine. During these stretches, the horse can control the extent of his motion and is not forced to move joints beyond his pain threshold point.

9. Allow Appropriate Recovery Time.

Allowing your horse sufficient time to recover between training rides is also vital to maintaining a healthy back. Remember that it can take up to three days for your horse’s muscles to recover and perform pain-free after intense exercise. “Be sympathetic to the fact that certain gaits or movements may be painful and should be avoided, rather than trying to force the horse to comply with your request,” Clayton says.

10. Remember These Conditioning Essentials.

Clayton and Tabor suggest keeping the following training basics in mind when conditioning horses with back pain:

• Keep horses with chronic back pain in light work to maintain the muscles that support and stabilize the spine and, therefore, good posture.
• Always allow a long warmup at the walk (at least 10-15 minutes) before starting any trot or canter work.
• Work within the horse’s capabilities and fitness level and increase exercise intensity gradually.
• Walking the horse up and down hills is an excellent back-strengthening exercise—if the horse can tolerate it.
• Ask your veterinarian about specific exercises that can potentially irritate injured tissues and, thus, should be avoided.
• Work horses with a history of back pain on softer footing that causes less concussion that can negatively impact the back.
• Consider the horse’s occupation relative to the pathology (disease or damage) causing the back pain. Riders must adapt their training methods accordingly to aid recovery or prevent further damage to the back. For instance, work a horse with kissing spines in a round frame to reduce the risk of dorsal spinous process impingement.

Take-Home Message

Adhering to specific management and training practices can help horses recover faster from back pain and prevent it from recurring. Our sources say all interventions that encourage better posture and activate muscle groups.