An introduction to back pathology in the horse

Back pain, either primary or secondary, is a common presenting problem in equine practice and it can be difficult to negotiate these cases successfully. This is the result of a number of issues, including the difficulty of pinpointing the site of back pain, limited treatment options and the expectations of owners who often have preconceived ideas of what is wrong with the horse and their own opinions on treatment modalities. However, a logical approach to the case can provide a good framework for investigation of possible back pain, giving all parties the maximum chance of a successful outcome. The aims of the clinician are to: establish whether back pain exists; what is the cause of the back pain; and how it can be treated. This article provides an overview of these areas.

The history of a horse with back pain can be very varied as, like humans, different individuals interpret pain and manifest discomfort in different ways. Some recurring themes in the histories of horses with proven back pathology include a reluctance to be saddled or mounted, irritation when touched or groomed over the back and a reluctance to work forwards under saddle, often kicking out in transitions. In severe cases, the horse may be described as reluctant to lie down or to roll, or as becoming difficult to shoe.