b'SPORTS MEDICINEaccustomed to this asymmetrical positionThoracicLumbar and begin to perceive it as normal, thevertebrae vertebraetire will eventually blow. In this article well help you learn toSupraspinousrecognize such asymmetry, along withligamentdescribing solutions.Recognizing Back PainThe first step toward successfully di-agnosing a thoracolumbar issue involves identifying the back as the true source of discomfort. This necessitates ruling outThoracolumbar the back as a secondary cause of painjunction(e.g., subsequent to neck pain, sacro-iliac disease, limb lameness, and more) or congenital issues such as scoliosis. Further, more than one source of pain ISTOCK.COMmight be contributing to your horses signs, as often happens, say veterinarians. Diagnosing the exact cause of back pain in horses can be complicated and involvesNext Steps Failing to diagnose the source of tho-your veterinarian performing a completeOnce you and your veterinarianracolumbar pain properly and jumping and thorough historical and physicalsuspect back pain as the cause of yourstraight to treatment might not manage examination.horses performance issue, its time tothese horses pain effectively, leavingWhen a horse suffers back pain, own- identify the exact source of discomfort.them in the same or worse condition than ers often report their horse has recentlyThanks to recent technological advances,when first examined.undergone behavioral changes such asdiagnostic imaging of horses backs is farThough there are many causes of bucking or an unwillingness to bend,easier than it used to be. thoracolumbar (the part of the spine that move forward, or jump, says Jos Gar- Your veterinarian will determine whichruns from the withers to the pelvis) back ca-Lpez VMD, Dipl. ACVS, ACVSMR,imaging modalities to useradiographs,pain in horses, our sources will focus on associate professor of large animalnuclear scintigraphy (bone scan), and/ two: osteoarthritis of the intervertebral surgery and director of equine sportsor ultrasonographybased on his or herarticular facets (joints between the spi-medicine at Tufts Universitys Cummingsmanual palpation and visual inspectionnous processes and vertebral bodies) and School of Veterinary Medicine, in Northof the horse at rest and in motion, assupraspinous desmitis.Grafton, Massachusetts. Complaintswell as the results of diagnostic analgesia regarding performance, a change in head/ (administering a numbing agent to helpOsteoarthritis of the Intervertebral neck carriage, reduced motion of thepinpoint areas of pain). Facet Joints back when longeing, and pain on palpa- Using more than one of these tech- Because the spine is a series of joints, tion of the back are also common. niques will provide a more accurate,it should come as no surprise that Kent Allen, DVM, owner of Virginiaclinically relevant diagnosis, says Allen.inflammation and degeneration of the Equine Imaging, in The Plains, adds thatOnly once this accurate diagnosis hascartilage lining the ends of the bones avoidance behavior, poor jumping tech- been made can treatment be instituted. where adjacent vertebrae meet can cause nique, and resistance to saddling can alsosubstantial pain. Classic lesions found point to back pain.on radiographs that support a diagnosis During the moving evaluation, horsesOther possible causes of thoracolumbarof osteoarthritis (OA) of the articular are frequently rigid in the back, resistantback pain you and your veterinarianfacets include lipping and bony irregulari-should rule out include:to moving forward, and buck or bunnyImpinging or overriding dorsal pro- ties around the joints. The joints most hop when weight is applied over thecesses (kissing spines), TheHorse. frequently affected are T15-L1a region saddle region, Allen says. com/169095 veterinarians refer to as the thoracolum-Equine behavior researchers from F ractured vertebrae, TheHorse. bar junction.Frances University of Rennes 1 (Rochais,com/149819 Veterinarians must interpret radio-et al., 2016) recently reported that a Sacroiliac desmitis or joint pain,graphs in combination with physical and TheHorse.com/17720horses reduced engagement in his dailylameness examination findings, Garca-environment might also indicate back Muscle strain, TheHorse.com/117695 Lpez says, because some radiographic Poor saddle fit, TheHorse.com/19373pain. Horses suffering from chronic painPoor core strength or conditioning,evidence of degeneration might be can isolate themselves, become aggressiveTheHorse.com/155076 present but not actually cause the horse toward humans, and show less interest inRider position, TheHorse.com/110756 discomfort. daily tasks. If your veterinarian diagnoses your 46February 2020The Horse|TheHorse.comSportsMed_Feb.indd 46 1/3/20 11:45 AM'