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Equine Back Pain: Causes and Conditions

Updated: Sep 12, 2023

looking at a horses back for pain

The horse's back is a remarkable and intricate structure, composed of a complex network of bones, muscles, tendons, ligaments, and cartilage. Among its many components, the spinal cord that runs within the spinal vertebrae stands as the most critical and sensitive. One could aptly liken the spinal cord to the superhighway of the nervous system.

With each passing moment, an astonishing multitude of nervous signals traverse this spinal cord, orchestrating the seamless coordination of the central nervous system with the entirety of the horse's body. Indeed, every movement your horse makes, every step it takes, is governed by this remarkable neural pathway.

Within this intricate web of interconnected components, it becomes evident that any discomfort or pain in the horse's back can reverberate throughout its entire body. The interconnectedness of the equine anatomy means that a malady in one area can manifest in the back. When your horse experiences injury or pain elsewhere in its body, you might observe telltale signs such as arched posture, muscle strains, and noticeable spasms in the back region.

Experts in equine physiology affirm that the power and impetus for a horse's performance emanate predominantly from their hind legs. Thus, it follows that any injury or discomfort in the horse's back can profoundly affect its ability to utilize its hind legs effectively, potentially limiting movement in other areas of its body as well. Recognizing that performance horses often operate under high stakes, the conscientious owner seeks to safeguard their equine companion from the specter of back pain through preventive measures.

Therefore, we embark on a journey to demystify, once and for all, the enigma of back pain in horses. This article is dedicated to educating you on the identification, management, and prevention of back pain in your cherished equine partner, ensuring their continued well-being and unwavering ability to perform at their best.

What are the causes of back pain in horses?

Veterinarians say that 60-80% of back pain disorders in horses are diagnosed correctly. The most important step of diagnosing and treating back pain is finding its cause. It is easy to identify that the horse is in pain; however, it is not easy to find out its cause, which helps in the right treatment. There can be many causes of back pain in horses; some are the primary causes, and some are secondary causes.

Primary Causes of Back Pain in Horses

Primary causes of back pain include acute or chronic trauma to the back. There can be many ways your horse experience trauma in the back. Some of them are mentioned below.

woman saddle fitting a horse

Ill fitted saddle

Saddle fitting is not just a matter of convenience; it's a fundamental aspect of horse riding that directly affects your horse's comfort and well-being. The saddle's placement on the horse's back is of paramount importance, as it can have far-reaching consequences if not done correctly. When a saddle is ill-fitted, it can lead to various types of trauma in the horse's back muscles, bones, tendons, and ligaments.

An ill-fitted saddle can cause significant discomfort and pain for the horse. Here's how:

  1. Pressure Points: A saddle that doesn't fit correctly can create pressure points on the horse's back. These pressure points, if not addressed, can result in chafing, bruising, or even open sores. The constant rubbing and friction during riding can lead to stretching and tearing of the skin and underlying tissues.

  2. Muscle Strain: When a saddle doesn't distribute the rider's weight evenly, it can strain the horse's back muscles. Over time, this muscle strain can lead to stiffness, soreness, and a reluctance to move freely. Horses may become resistant to saddling and riding due to the discomfort caused by an ill-fitted saddle.

  3. Bone and Joint Issues: Prolonged use of an ill-fitted saddle can result in more severe problems, such as damage to the horse's spine, ribs, and surrounding structures. The constant pressure and stress on these areas can lead to bone and joint issues, which may require extensive veterinary care and rehabilitation.

To prevent back injuries caused by an ill-fitted saddle, it is crucial to invest in a saddle that fits your horse correctly. This may involve consulting with a professional saddle fitter who can assess your horse's unique anatomy and recommend an appropriate saddle. Regular saddle checks and adjustments are also essential to ensure the saddle remains properly fitted as your horse's body changes over time.


Arthritis is another significant contributor to back pain in horses. Unlike acute trauma, arthritis is a chronic, degenerative condition that often develops gradually over time. It primarily affects the spinal joints, leading to inflammation, stiffness, and persistent pain.

Here's how arthritis in the spine can impact a horse:

  1. Degenerative Changes: Arthritis in the spinal joints results from wear and tear of the bone and cartilage over the years. As the joints deteriorate, they become less flexible and lose their shock-absorbing capabilities. This degeneration leads to chronic inflammation and pain.

  2. Limited Mobility: Horses with spinal arthritis may experience reduced mobility and flexibility in their back. This limitation can manifest as a reluctance to engage in certain movements, stiffness during exercise, or difficulty in bending and flexing the back.

  3. Gradual Onset of Pain: Arthritis-related back pain tends to progress slowly, making it challenging to detect in its early stages. Horses may adapt to the discomfort, and subtle changes in behavior or performance may go unnoticed until the pain becomes more severe.

Managing arthritis-related back pain in horses typically involves a multi-faceted approach. It may include veterinary assessment and diagnosis, pain management strategies, such as medications or joint supplements, and physical therapy or chiropractic care to help alleviate discomfort and improve mobility.

Kissing Spine

horse skeleton showing kissing spine
Photo credit: Tad Coffin Saddles

Kissing Spine, scientifically known as dorsal spinous process impingement, is a condition that can cause significant discomfort and pain in horses. It is characterized by the spinous processes of the horse's vertebrae coming into contact with each other, resulting in pain, inflammation, and swelling in the affected area. Normally, these spinous processes are evenly distributed along the horse's spine and should not touch each other. The spinal processes that are most at risk are the thoracic vertebrae 13 - 18.

Several factors contribute to the development of Kissing Spine, and understanding these causes is crucial for both prevention and treatment:

  1. Ill-Fitted Saddle: An ill-fitted saddle is a common culprit in the development of Kissing Spine. When a saddle doesn't fit properly, it can exert uneven pressure on the horse's back, causing discomfort and encouraging the horse to carry itself with its head up and its back hollowed. This posture, in turn, can lead to the spinous processes coming into contact and causing the condition.

  2. Postural Issues: How a horse carries itself and engages its core muscles also plays a role in Kissing Spine. When a horse habitually carries its head up and its back hollowed, it places increased pressure on the spinal processes. Over time, this strain can lead to the processes touching and impinging on each other.

  3. Location of the Issue: Kissing Spine most commonly affects the thoracic vertebrae 13 to 18. These vertebrae are situated in the mid-back region of the horse. When the spinous processes in this area come into contact, it can result in severe discomfort.

The severity of Kissing Spine can vary, and clinical signs may range from subtle to pronounced:

  • Mild Cases: Horses with mild Kissing Spine may not display obvious clinical signs. They might experience occasional discomfort during certain movements but otherwise appear normal.

  • Moderate Cases: In moderate cases, horses may exhibit signs of discomfort and pain, such as reluctance to engage in certain movements, stiffness, and behavioral changes during riding or handling.

  • Severe Cases: When Kissing Spine is severe, horses may suffer constant back pain. This can lead to a significant decrease in performance, as they may resist saddling, riding, or any activity that puts pressure on their back.


Injury is a broad category that encompasses various circumstances in which a horse can experience back pain. These injuries can range from mild to severe, and understanding their causes is essential for both prevention and appropriate treatment.

  • Traumatic Falls: Horses are naturally prone to accidents, and a traumatic fall can lead to significant back injuries. Whether it's a slip on a wet surface, a misstep during a ride, or a collision with an obstacle, falls can result in acute back pain. Immediate veterinary attention is crucial to assess the extent of the injury and determine the best course of treatment.

  • Hard Object Impact: Horses, especially in pasture or while playing, can inadvertently collide with hard objects such as trees, fences, or even other horses. These impacts can cause injuries to the back, ranging from bruising and swelling to more severe damage to the muscles, bones, or soft tissues.

  • Interactions with Pasture Mates: Horses, while social animals, can sometimes engage in aggressive behaviors with pasture mates. Bites and kicks can cause injuries to the back, leading to pain, swelling, and potential complications. Proper management of pasture dynamics and monitoring of herd interactions can help prevent such incidents.

  • Accidents in Stalls or Paddocks: Horses can experience injuries even within their stalls or paddocks. Casts in stalls, slipping on wet surfaces, or colliding with stall fixtures can result in back pain and discomfort.

Most injuries to the horse's back are acute and treatable. It is essential to promptly assess the severity of the injury through a veterinary examination. Treatment may involve rest, pain management, physical therapy, and, in some cases, surgical intervention. Early intervention and a tailored rehabilitation plan are critical for the horse's recovery.

Pinched Nerve

A pinched nerve, also known as nerve impingement or nerve compression, can be a source of severe pain and discomfort for horses. This condition can occur due to various factors, and understanding its potential causes is essential for horse owners and caretakers.

  • Fall or Awkward Movement: A sudden fall or an awkward movement can put pressure on a nerve in the horse's spine, leading to pinched nerve syndrome. This can happen during riding, play, or while in the stall. The compression of the nerve results in sharp, shooting pain, stiffness, and limited movement.

  • Cast in the Stall: A horse getting cast (lying down with its legs against the stall wall and unable to rise) is a common scenario in stables. During such incidents, the horse may inadvertently compress a nerve, leading to pinched nerve symptoms.

  • Course of a Passing Object: Sometimes, a horse may be struck by a hard object while moving or playing. The force of impact can compress a nerve, resulting in severe pain, muscle weakness, and reduced mobility.

The clinical signs of a pinched nerve in horses can vary, but common symptoms include pain, stiffness, muscle atrophy, and difficulty moving or maintaining balance. Veterinary evaluation is essential to diagnose and determine the exact location of the pinched nerve.

Treatment for a pinched nerve may include pain management, rest, physical therapy, and, in some cases, anti-inflammatory medications. Rehabilitation exercises can help the horse regain mobility and alleviate discomfort. Early intervention and a comprehensive treatment plan are crucial to improving the horse's quality of life and preventing long-term complications.

Secondary Causes of Back Pain in Horses

It may happen that your horse is suffering from one disease that impacts the back. For example, the following conditions can result in secondary back pain.

  • Lameness of Hind Limb: Lameness in one or both hind limbs can significantly impact a horse's gait and overall posture. When a horse compensates for lameness by shifting its weight or altering its movement, it can place excessive strain on the back. Over time, this compensatory behavior can lead to back pain and discomfort.

  • Poor Posture: Horses, like humans, can develop poor posture habits. Whether it's due to discomfort, muscle imbalances, or lack of proper training, poor posture can contribute to back pain. Horses with incorrect carriage or posture during exercise or rest may experience muscle tension and discomfort.

  • Extended Stable Rest: Prolonged periods of stall rest or confinement can have various physical and psychological effects on horses. Lack of movement can lead to muscle stiffness, reduced circulation, and overall muscle weakness. These factors can predispose horses to back pain when they resume activity.

  • Incorrect Hoof Care: The health and balance of a horse's hooves play a crucial role in its overall comfort and soundness. Incorrect hoof trimming or shoeing can lead to gait abnormalities and musculoskeletal issues, which, in turn, can result in back pain.

  • Dietary Imbalance: Diet plays a vital role in a horse's overall health. Nutritional imbalances or deficiencies can lead to various health issues, including muscle weakness and discomfort. Horses that do not receive adequate nutrition may experience reduced muscle tone and increased susceptibility to back pain.

  • Emotional Stress or Hormonal Imbalance: Horses are sensitive creatures, and emotional stress can manifest physically. Stress or hormonal imbalances can lead to muscle tension and contribute to back pain. This may be observed in horses undergoing changes in routine, social dynamics, or competition-related stress.

The list of secondary causes of back pain is indeed extensive and multifaceted. Each of these factors can have a cascading effect on the horse's musculoskeletal health, potentially leading to discomfort, pain, and compromised performance. It's crucial for horse owners and caretakers to be attentive to these secondary causes and work closely with veterinarians and equine professionals to address any underlying conditions or contributing factors that may be impacting the horse's back health. By addressing these secondary causes, owners can help ensure their horses enjoy a life of comfort and optimal well-being.

How to diagnose back pain in horses?

Early diagnosis is paramount when it comes to identifying back pain in horses. In cases where a horse is experiencing discomfort in its back, timely diagnosis becomes the linchpin for initiating prompt treatment. The urgency of treatment hinges on the swiftness of diagnosis, and two primary approaches can be employed to ascertain the presence of back pain in horses: physical examination and applied techniques.

Physical Examination

The foundation of diagnosing back pain in horses lies in a thorough physical examination. This involves the careful evaluation of the horse's body, paying close attention to signs of discomfort or irregularities in the back area. A hands-on assessment can reveal crucial information about muscle tension, sensitivity, posture abnormalities, and other physical indicators of back pain.

Behavioral Clues

You can easily notice back pain in your horse by observing the behavioral clues. The following are the clues you can observe in your horse.

horse pinning ears may have back pain
Photo credit: Mary Debono
  • Ignores or evades the contact during grooming

  • Horse becomes unresponsive to your aids while riding

  • Arches his back and frequently looks back

  • Horse may restrict rolling on the ground, or he may roll violently

  • Horse may be unable to concentrate, tense, and fidgety

  • Horse may pin his ears or bite you while you saddle

  • Difficult to catch

  • Rear, buck, or sink while you mount

  • Horse may resist backing up or develop annoying habits during riding

Applied Diagnosis Techniques

While the initial physical examination sets the stage for identifying back pain in horses, applied diagnostic techniques serve as invaluable tools for unraveling the precise nature and extent of the issue. These techniques encompass a range of advanced approaches designed to provide comprehensive insights into the condition of the horse's back.

Advanced Imaging Methods

To delve deeper into the diagnosis, veterinarians often employ advanced imaging methods, including X-rays and ultrasonography. These techniques offer a meticulous view of the horse's spine and its associated structures. X-rays reveal the skeletal components, allowing for the detection of fractures, bone abnormalities, or degenerative changes. Ultrasonography, on the other hand, delves into the soft tissues, providing vital information about muscles, tendons, and ligaments. The combined use of these imaging tools helps ascertain the exact location and nature of the back pain.

Specialized Palpation and Mobility Assessments

In addition to imaging, specialized palpation and mobility assessments form an integral part of the diagnostic process. A skilled veterinarian or equine chiropractor will use their hands to palpate the horse's back, observing the horse's reactions closely. This hands-on approach provides invaluable insights into areas of tenderness, muscle tension, and discomfort. Furthermore, mobility assessments are conducted to identify subtle misalignments or movement restrictions within the spine. These assessments aid in pinpointing the underlying causes of back pain.


Radiography, commonly known as X-ray imaging, plays a pivotal role in the diagnostic journey. By obtaining detailed radiographic images, veterinarians can not only confirm the presence of back pain but also rule out other possible underlying conditions. This non-invasive procedure allows for the precise localization of areas of concern within the spine, facilitating a more targeted approach to treatment.

Through these applied diagnostic techniques, a comprehensive picture of the horse's back health emerges. The physical examination, combined with advanced imaging and hands-on assessments, allows for a meticulous evaluation of the horse's condition. This multifaceted approach ensures a more accurate diagnosis, enabling veterinarians and equine professionals to formulate tailored treatment plans that address the specific needs of the horse and pave the way for a path to recovery and comfort.

How to Treat and Manage Back Pain in Horses

Treatment and management of back pain are based on the cause of pain. In different conditions, veterinary professionals apply different techniques. First of all, the cause of pain is eliminated or treated, and then supportive therapies are used. Pain can be managed with anti-inflammatory drugs, but can have side effects causing gastrointestinal issues or kidney damage.

Veterinarians administer targeted injections into the site of pain – joints of soft tissues. The injection is mostly corticosteroids or regenerative agents like platelet-rich plasma. Another technique is mesotherapy which has shown significant results in reducing muscle spasms. In this technique, veterinarians administer the injection into the muscle to achieve muscle relaxation. This condition is preferred because it is a less invasive approach than other traditional therapies.

Medical management also involves the systemic administration of drugs responsible for reducing inflammation and pain. Commonly, non-steroidal anti-inflammatory drugs, corticosteroids, and muscle relaxants are administered to counter inflammation, pain, and muscle tonicity.

Among the all-applicable procedures, the best method is non-invasive, red-light therapy.

Red light therapy, uses near infra-red and red light on the affected area to reduce the pain and inflammation. Red light therapy is a safe and effective approach to achieving our goal. A practitioner can locate and target the specific areas of pain.

Red Light Therapy as a Natural Pain Relief

horse with red light therapy for back pain

In the contemporary world of healthcare, red light therapy has emerged as a non-invasive and increasingly popular method for promoting healing and well-being. This innovative technique harnesses the power of near-infrared and red light waves to stimulate the body's natural regenerative processes.

Understanding Near-Infrared and Red Light Waves:

Near-infrared and red light waves fall within the non-visible portion of the electromagnetic spectrum. Unlike ultraviolet light, which can be harmful to the skin, these wavelengths are safe and carry unique therapeutic properties.

Infrared light is often described as the gentle heat that we perceive when exposed to sources of warmth. What's intriguing is that our skin emits infrared light continuously throughout the day as a natural part of its functioning. When these infrared wavelengths interact with our body, they transfer energy to our cells, a process often likened to providing a vital spark for cellular rejuvenation.

Red light therapy leverages this inherent capacity of infrared light to facilitate cellular self-healing. By exposing specific areas of the body to near-infrared light of a particular wavelength, experts have devised a method to enhance the body's natural healing mechanisms.

Key Benefits of Red Light Therapy:

  • Cellular Regeneration: The energy transferred by near-infrared and red light waves empowers cells to regenerate and repair themselves more efficiently. This can accelerate the healing of various injuries and ailments.

  • Pain Management: Red light therapy has been found effective in relieving pain, particularly in conditions such as muscle soreness, joint pain, and inflammation. By reducing pain, it enhances a person's overall comfort and mobility.

  • Skin Health: Red light therapy is also renowned for its positive effects on skin health. It can stimulate collagen production, minimize the appearance of wrinkles, and promote a youthful complexion.

  • Wound Healing: For wounds, both acute and chronic, red light therapy can expedite the healing process. It stimulates the formation of new tissue and encourages better blood circulation to the injured area.

In summary, red light therapy harnesses the power of near-infrared and red light waves to provide the body's cells with the energy they need for self-healing and regeneration. By safely and non-invasively exposing specific body areas to these beneficial wavelengths, red light therapy has become a promising avenue for promoting well-being, pain management, and overall health in the modern world.

Acupressure for Back Pain Relief

equine acupressure practitioner touching back for relieving back pain

According to ancient Chinese texts, the body's cells are said to possess a vital life force known as "chi" or "qi." When these cells experience a deficiency in chi, they become susceptible to disease and dysfunction. Conversely, when their chi is abundant, they exhibit the innate capacity to counteract abnormalities and promote self-healing. Red light therapy plays a pivotal role in this context, as it serves as a conduit for replenishing the cells with the essential chi required for self-repair and the restoration of balance.

Unlocking the Power of Photopuncture:

The marriage of red light therapy with acupressure points introduces a synergistic approach known as "photopuncture." This technique combines the therapeutic benefits of both modalities, enhancing their overall effectiveness.

In the realm of equine health, the harmonious blend of red light therapy and acupressure can serve as a complementary adjunct to modern medical treatments. This combined approach proves particularly valuable in addressing various conditions that afflict horses, including but not limited to:

  1. Tendon Injuries: The targeted use of red light therapy and acupressure can aid in the healing and rehabilitation of tendon injuries, facilitating a quicker return to peak performance.

  2. Muscle Injuries: These modalities can effectively alleviate muscle injuries, reducing pain and promoting muscle tissue repair.

  3. Bruises: For equine bruises, the dual approach of red light therapy and acupressure can expedite the resolution of bruising and minimize discomfort.

  4. Arthritis: Horses afflicted with arthritis can benefit from the combination of red light therapy and acupressure to manage pain and enhance joint mobility.

  5. Fractures: While not a replacement for traditional fracture treatments, this approach may aid in the supportive care and recovery process for horses with fractures.

  6. Ligament Injuries: In cases of ligament injuries, the integrated use of red light therapy and acupressure can support the healing process and reduce the risk of re-injury.

  7. Wound Healing: These modalities are valuable tools for expediting the healing of wounds in horses, promoting tissue regeneration, and minimizing complications.

By incorporating red light therapy and acupressure alongside modern medicinal therapies, horse owners and caregivers can create a holistic and well-rounded approach to managing pain, accelerating recovery, and enhancing the overall well-being of their equine companions.

Other Modalities for Back Pain Relief

Both acupressure and red light therapy are complementary to vet care and other helpful modalities. Your horse can also enjoy equine massage, chiropractic, and PEMF for back pain. There are many helpful practices for helping relieve back pain in horses.

How to Prevent Back Pain in Horses

Back pain in horses can manifest in various ways, ranging from subtle signs to more apparent symptoms such as lameness or a sour disposition. To safeguard your horse from the discomfort and potential complications associated with back pain, it's imperative to take proactive measures. Here are some valuable guidelines to prevent the development of back pain causes:

horse exercising to prevent back pain
  • Regular Farrier Visits: Consistently maintain a schedule with your farrier to address hoof care. The hoof's length and angle should be closely monitored, as even slight alterations can lead to significant problems. Proper hoof maintenance is a crucial aspect of preventing back pain, as it influences the horse's gait and overall posture.

  • Structured Exercise Regimen: Implement an exercise program tailored to your horse's needs. Start with short and manageable training sessions, gradually increasing intensity and duration as your horse builds strength and endurance. Ensuring your horse achieves the appropriate activity level is essential. Regular exercise not only contributes to physical fitness but also helps maintain healthy back musculature.

  • Weight Management: Pay close attention to your horse's weight. It's vital to maintain a healthy weight within safe limits; neither over nor underweight. Excess weight can place undue strain on the back and joints, potentially leading to discomfort and musculoskeletal issues. Consult with your equine veterinarian or a nutritionist to establish an appropriate diet and feeding plan.

  • Regular Veterinary Checkups: Enlist the services of a qualified veterinarian for routine checkups to assess your horse's overall soundness. Regular veterinary examinations can help prevent the development of abnormal conditions and enable early diagnosis and treatment of potential issues. A vigilant approach to healthcare ensures that any concerns related to the horse's back are identified and addressed promptly.

By adhering to these preventative measures, horse owners can take a proactive stance in preserving their equine companion's well-being. Regular hoof care, structured exercise, appropriate weight management, and vigilant veterinary oversight collectively contribute to the prevention of back pain, ensuring that your horse enjoys a life of comfort, soundness, and optimal performance.

Final Thoughts

The good news is that many horses affected with back pain when diagnosed on time and treated well, returned to their previous activity level. Therefore, you don't need to worry but consider certain precautions and take better care of your lovely horse.

horse painted with the muscles on his coat

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