Depending on the circumstance and my findings during a thorough clinical exam, I recommend diagnostics that may provide additional information helpful to reaching a definitive diagnosis:
PRIMARY & SECONDARY CAUSES
Primary back pain can result from lesions of the skin, muscle, connective tissue, nerves, joints and bones of the back. These are usually a result of some traumatic injury – either an individual injury or chronic wear and tear. Poor tack fit can contribute to or cause these problems. Poor riding can cause or worsen problems. Different types of primary back problems affect horses of different types, from different disciplines, and of different conformation.
Secondary back pain or soreness is a result of an underlying lameness, or back soreness somewhere else resulting in a change in movement. Hind limb lameness, especially hock pain, is frequently associated with back pain but any lameness can result in secondary back pain. The back and limbs are linked in anatomy and function. If a horse is not moving symmetrically and freely for any reason, soreness and asymmetry will often develop in the back.
POOR SADDLE & TACK FIT
The main concern of good saddle fit is that the force bearing surfaces of the saddle conform well to the horse’s back and evenly distribute the weight of the rider. There should not be focal areas of pressure any-where. The saddle should be level, front to back, and sit in such a position that it favors the free movement of the horse and reduces discomfort. A saddle that fits correctly should put the rider in a position where he or she is balanced, not thrown forward or backward.
I often use this commonly described analysis when looking at a horse and rider: Look at the horse and rider from the side. If the horse is removed from the image, the question is whether the rider would be able to balance on the ground given where their feet are located. If not, there may be a saddle problem (or rider positioning problem) that could be contributing to back pain. In addition, improperly adjusted or fitting bridles and poor riding can cause a horse to resist the bit and raise the head high, which causes the horse to flatten or hollow its back. This counteracts the correct physics of the horse’s back, reducing performance and potentially leading to back soreness.
TREATMENT FOR EQUINE BACK PROBLEMS
If a diagnosis can be reached, treatment may involve addressing the primary contributing factors like con-formation and suitability for the present use, underlying lameness, tack fit and rider technique and position. Veterinary treatments for back pain depend on the specific nature of the injury and may involve combinations of the use of rest, change in use, anti-inflammatory drugs, muscle relaxants, direct injection of affected muscles, ligaments and joints, therapeutic ultrasound, pulsed shock wave therapy, physical therapy, massage, application of heat and cold, chiropractic, acupuncture, and many others, often used in combination.
Even with advanced technology and imaging, and dozens of available treatment approaches, the equine back will likely remain something of a mystery for a long time. Proper treatment should always start with every attempt being made at a diagnosis. Is this primary back soreness or is it secondary to an underlying low-grade lameness? Is there a behavioral component?
While many lay practitioners may have a single perspective that has some value, your equine veterinarian is still the one who is trained to put the whole picture of your horse’s health in perspective. They can help you coordinate your approach towards better understanding the equine back.
Douglas O. Thal DVM Dipl. ABVP
Board Certified in Equine Practice
Thal Equine LLC
Last Updated August 2011
About the Author…
Doug Thal DVM DABVP is an equine veterinarian, the owner of a full-service equine hospital near Santa Fe, New Mexico called Thal Equine www.thalequine.com. He is a lifelong horseman and has been an equine practitioner for 23 years.
Over the last 4 years, he created a free web based database of equine health information, especially for horse owners, called Horse Side Vet Guide www.horsesidevetguide.com, and the critically acclaimed Horse Side Vet Guide Smartphone app, available for iPhones and Android Smartphones http://horsesidevetguide.com/the-hsvg-smartphone-app. The HSVG app has been downloaded in 60 countries and is the most highly rated equine health app in the world.
Mobile App… www.HorseSideVetGuide.com
Copyright 2013. Thal Equine LLC. All rights reserved. The information contained in this article is not intended as medical advice and should not be relied on in lieu of consultation with your local equine veterinarian. In fact, we strongly encourage you to maintain and strengthen that relationship.
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BACK PROBLEMS IN HORSES
By Thal Equine LLC
Understanding a Mysterious Part of Equine Anatomy...
While back pain is poorly understood in human medicine, equine back pain is even more difficult to comprehend, diagnose and treat. We start with an animal who can’t tell us where or how it is experiencing pain. This animal is so massive that we only have access to the very “shallow” layers by touch, radiography and most other diagnostic equipment. The spine is buried up to a foot deep in heavy muscle and tough connective tissues sheets. Now introduce tack, the trainer’s and rider’s interpretations of the problem, and the placebo effect - and we are faced with a difficult and confusing problem to solve.
COMMON SIGNS OF EQUINE BACK PAIN
Signs of equine back pain are usually subtle and are often confused with those caused by other problems, including behavioral issues. Some horses are more sensitive to back pain than others or respond differently to it and show more obvious signs. The most common signs I hear associated with back pain are:
EQUINE BACK ANATOMY & FUNCTION
The most important thing to know about the anatomy of the equine back is that it is very complicated. There are hundreds of joint surfaces and small stabilizing ligaments. There are massive muscles and thick ligaments that are attach adjacent vertebrae to one another, to the skull, and the vertebral column to the limbs. There are multiple, intersecting sheets of extremely tough and thick connective tissue surrounding the spine. Nerve roots exit from the spinal cord through small spaces between and in the vertebrae and course between the sliding planes of connective tissues. Vertebrae have spines of bone that project upward or outward and to which the back muscles attach. Only the very tips of these spines can be felt along the horse’s back. The spinal cord is located far deeper in the back than most horse people think.
The vertebrae (the individual back bones) are essentially cube-shaped bones separated by joints. There are four distinct regions of the equine back, each of which have uniquely shaped bones and joints and different ranges of motion. In each region, unique vertebral design, joint design and support and muscle attachment allows for more or less flexibility side to side, up and down and in rotation. The basic form and function of the equine back is critical information in understanding back pain and the causes of and treatments for that pain. Desirable back conformation is also very important for an animal that is expected to perform athletically with the weight of a rider on its back.
DIAGNOSIS OF BACK PAIN
Veterinary examination of the equine back is difficult. The muscles are so heavy and thick that it is impos-sible to evaluate the deeper structures that might be involved simply by feel. That said, a thorough physical examination (at rest and in movement) is still the cornerstone of diagnosis. When I evaluate a horse for back pain, I do the following: