Back Pain in Sport Horses
severe). Interestingly, the radiographic findings often don’t support the clinical findings. This individual variation is seen often and can be confusing for owners. Some horses may have severe signs with only one area of abnormality on radiographs, and other horses will have moderate to severe radiographic findings with mild clinical signs.
Often there is a bone component, as well as soft tissue and local nerve-associated pain, making treatment of “kissing spine” case dependent. Therefore, a single therapy is usually unable to significantly reduce pain and improve rideability. Treatment should be aimed at reducing pain, and this will usually involve local ultrasound-guided injections, bisphosphonates, a short course of NSAIDs, mesotherapy, shockwave therapy, and regenerative laser therapy (RLT). Therapies such as the Bemer Blanket and Magna Wave have not been clinically trialled and therefore the exact response is not discussed here. There are anecdotal reports of improvement with their use.
Diagnosis & Therapy: Ultrasound is the diagnostic technique of choice, and examination with careful evaluation of this fibrous/ligamentous structure that runs from the top of each dorsal spinous process and has a wave-like undulation along the back.
The horse should be rested for up to four to six weeks, with non-riding exercise allowed. Topical and oral NSAID treatment should be given until signs of pain and inflammation have subsided. The injury can be also treated concurrently with shockwave and RLT in addition to local therapy depending on the acute/chronic nature (ice/heat).
Thoracolumbar Facet Joint Pain (Osteoarthritis)
Osteoarthritis is a relatively common finding in sport horses but rarely discussed or diagnosed. It can present as acute or chronic pain arising from the thoracic/lumbar facet joints (the small interlocking joints that allow rotation in the back). Loss of performance, decreased rideability, and behavioural issues when ridden are all possible manifestations.
Diagnosis & Treatment: This condition is diagnosed by ultrasonographic evaluation of the joint just off midline.
The use of scintigraphy can be warranted but is expensive and requires special equipment. Radiography is also utilized but precise technique is required as well as a machine with higher settings (KV/Mas).
