Back pain in the horse, said Kent Allen, DVM, "is one of the last great frontiers." During a Table Topics discussion at the 2011 American Association of Equine Practitioners convention, held Nov.18-22 in San Antonio, Texas, Allen, owner and practitioner at Virginia Equine Imaging near Middleburg, called back pain a condition that is "underdiagnosed in the performance horse."

Co-moderator, Philippe Benoit, DVM, a private practitioner at Clinique Equine des Bréviaires in Les Bréviaires, France, added that a veterinarian needs "to get a good history" from the owner in order to diagnose equine back problems. Both clinicians stressed the importance of a precise diagnosis for back pain since the back is a complex region that has muscles, joints, ligaments, and nerves.

Benoit asked the audience how many examine the horse under tack during a lameness exam. Allen remarked that a significant difference in movement under tack versus in hand or on the longeline can be "a significant indicator of back problems."

The majority of back problems, said Benoit, are 50-60% bony in nature but are always combined with soft tissue damage. Treatment can’t ignore muscle spasm around the problem area. The most important part of therapy is to restore motion, Benoit said. Allen remarked that the more acute lesions tend to be soft tissue while the more chronic pain is likely to be of bony origin.

Benoit, Allen, and the veterinary audience discussed diagnostic techniques including radiographs (X rays), ultrasound, nuclear scintigraphy (bone scans), thermography, and diagnostic nerve blocks. They emphasized the