Accurately diagnosing the cause of caudal back pain—that found in the lumbar and sacral areas, behind where your saddle sits—in horses can be challenging. But because pain in the lower regions of the spinal column is a common occurrence in athletic horses, researchers are looking for better diagnostic modalities.

Case in point: Veterinarians from North Carolina State University’s (NC State) College of Veterinary Medicine recently evaluated the use of a human procedure called lumbosacral epiduroscopy (during which the practitioner inserts a flexible video endoscope into the epidural space—the outermost space in the spinal canal) to see if this approach could benefit horses.

“Back pain in horses can cause lameness, gait alterations, and poor performance,” said Timo Prange, Dr. Med. Vet., MS, Dipl. ACVS, a clinical assistant professor of equine surgery at NC State. “Diagnosing the underlying cause of pain in the lumbosacral area is challenging because of the complex anatomy in that area and the fact that radiographs, ultrasonography, and scintigraphy only produce a two-dimensional image.”

Potential causes of caudal back pain include osteoarthritis, compression of a spinal nerve or its root, stenosis (narrowing) of the opening to the vertebrae through which the spinal cord passes, disc herniation, cysts, and tumors.

In their study, Prange and colleagues performed an epiduroscopy in seven standing horses to assess both its feasibility and safety for diagnosing back pain.

“Using this approach, we were able to directly visualize the dura mater, spinal nerve roots, fat, and blood vessel