Managing Topline Dysfunction in Horses

Back pain and topline dysfunction can shorten horses’ careers. Learn how one veterinarian diagnoses and treats this soundness problem.
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horse topline
Topline dysfunction can cause back pain in horses which can manifest in many ways. | iStock

Topline dysfunction can lead to back pain and poor performance in horses, making long-term management crucial to keeping them sound in their careers. “I describe topline dysfunction as a triangle where weakness, hypomobility (stiffness), and generalized pain meet,” said Tena Ursini, DVM, PhD, Dipl. ACVSMR, CERP, clinical assistant professor at the University of Tennessee’s College of Veterinary Medicine, in Knoxville, during her presentation at the 2024 American College of Veterinary Sports Medicine and Rehabilitation Symposium, held April 11-13, in Naples, Florida.

Intrinsic factors that can predispose a horse to back pain and topline problems include breed, conformation, flat or negative palmar angles (the angle the bottom of the coffin bone makes with the ground), limb lameness, and age, said Ursini. Extrinsic factors might include rider/horse mismatch, lack of rider skill (i.e., inability to get the horse to lift his back), discipline/horse mismatch, and poor saddle fit.

Diagnosing Back Pain in Horses

If you suspect your horse might have back pain, schedule a thorough examination with your veterinarian to determine a diagnosis and effective treatment plan. During this exam your veterinarian will look for muscle hypertonicity (abnormally increased muscle tone, which can be associated with muscle spasm and pain), primary muscle or soft tissue pain in the back, and limited lateral range of motion of the spine (through manual movement), said Ursini. “Signs of weakness during exam include lack of muscle fluidity or spasm during baited movements (i.e. carrot stretches), atrophy, lack of whole-body control, and inability to perform any exercises.”

Treating Back Pain in Horses

Tailor treatment to each horse is crucial, said Ursini. Treatment for topline dysfunction and back pain in horses often includes a combination of medications, rehabilitation modalities, and therapeutic exercises, she added.

Common treatments veterinarians use for back pain include branched-chain amino acids, Chinese herbs, joint injections (as indicated), non-steroidal anti-inflammatory drugs (NSAIDs, such as phenylbutazone), and methocarbamol (a muscle relaxant). They might use rehabilitation modalities such as electroacupuncture, and chiropractic adjustments in combination with medication to relieve back pain.

Therapeutic exercises for treating back pain should be low-impact with a focus on mobility and stretching and engaging and lifting the core, said Ursini. “Some exercises that help accomplish this are serpentines, standing the horse with a narrow base (feet close together), ground poles and cavaletti, leg yields in hand, underwater treadmill, transitions (within and between gaits), and long-lining.” Ursini cautioned against overusing overusing resistance bands and commercial longeing systems because the horse might start to become dependent on these for support over time and research has indicated these devices decrease muscle activity during exercise.

Once the horse is ready for work under saddle, the rider should continue to work the horse in a long and low frame and practice transitions, serpentines, leg yields, and ground poles and cavaletti, slowly progressing as recommended by the veterinarian, said Ursini. Riders should work closely with their veterinarians and contact a reputable local training professional to help them determine if their horses are working over the back correctly.

Take-Home Message

If you suspect your horse has back pain or topline problems, ask your veterinarian to perform a thorough examination to determine the cause and develop an effective treatment plan. Using a combination of medication, rehabilitation modalities, and therapeutic exercises both in hand and under saddle can help reduce your horse’s back pain and potentially increase the length of his career.


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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