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Equine Spinal Health: A Comprehensive Guide to Understanding, Treating, and Preventing Kissing Spine

Updated: Nov 29, 2023


horse running in arena test for kissing spine

In the dynamic world of equine health, one particular ailment that commands attention is kissing spine—a condition that affects the very foundation of a horse's mobility and well-being. Kissing spine, formally known as dorsal spinous process impingement, involves abnormal contact between the spinous processes of the vertebrae, often leading to discomfort and performance issues in our four-legged companions.


The significance of recognizing and comprehending kissing spine in horses cannot be overstated. Left unchecked, this condition can manifest in behavioral changes, altered gaits, and even hinder a horse's ability to perform at its best. Understanding the nuances of kissing spine is not just a matter of equine well-being; it's a crucial step towards maintaining the strength, agility, and happiness of our equine partners.


The aim of this blog is clear: to bridge the gap between equine enthusiasts and the intricacies of kissing spine. We embark on this journey with a commitment to deliver practical insights—information that horse owners and enthusiasts can leverage to identify, understand, and address kissing spine in their equine companions. Whether you're a seasoned horse owner or a passionate enthusiast, our goal is to equip you with knowledge that empowers and safeguards the health of the horses we cherish. Join us as we delve into the practical aspects of managing kissing spine in horses, enriching your understanding and fostering a deeper connection with these majestic animals.


Equine Spinal Architecture: A Foundation for Understanding Kissing Spine

To comprehend the intricacies of kissing spine in horses and to explore suitable treatments, it is imperative to acquaint ourselves with the intricate anatomy of a horse's back. The vertebral column of a horse is segmented into five regions: cervical, thoracic, lumbar, sacrum, and caudal. This spinal structure serves a multifaceted purpose, providing crucial support to suspend the weight of the gut, housing and safeguarding the spinal cord, and furnishing the necessary rigidity for the transfer of movement from the rear to the front.

horse skeleton can show signs of kissing spine

The equine spine, characterized by its considerable length, comprises an average of 54 vertebrae. The integrity of these vertebrae is maintained through the support of ligaments, tendons, and muscles, all working in harmony to facilitate the horse's intricate movements. Kissing spine, however, directs our attention specifically to the spinous processes that protrude from the top of the vertebral column.


The risk of kissing spine arises when the spaces between these spinous processes become narrow. This compression can lead to varying degrees of severity, causing mild to severe back pain and constraining the natural movement of the back. It is this delicate interplay of anatomy and function that lays the groundwork for understanding how kissing spine manifests and affects the equine athlete.


Fortunately, as veterinary medicine has advanced over time, a spectrum of new, effective, and minimally invasive treatment options has emerged to assist in restoring a horse's well-being. In the subsequent sections of this exploration, we will delve deeper into the telltale signs that may indicate the presence of kissing spine, explore the underlying causes, and examine the diverse array of treatment options available to ensure your horse regains optimal health and performance. Join us on this journey as we navigate through the nuances of equine spinal health, seeking both understanding and solutions for our cherished equine companions.


Factors Leading to Kissing Spine: Unraveling the Roots of Equine Discomfort

Understanding the factors that contribute to the development of kissing spine in horses is paramount to effective prevention and management. Several elements come into play, shedding light on the intricacies of this spinal condition.

quarter horses have shorter backs and are at risk of kissing spine
  • Shorter Back Structure: Horses with inherently shorter backs, such as Quarter horses and Andalusians, are predisposed to developing kissing spines. The limited space and a higher number of vertebrae in these breeds create an environment where the risk of impingement between spinous processes is heightened.

  • Genetic Influences: Research indicates that genetic factors play a significant role in the development of kissing spine, particularly in the offspring of affected horses. Understanding the hereditary aspects of this condition is crucial for breeders and owners aiming to mitigate the risk in future generations.

  • Training Practices: Unprofessional training practices emerge as a major contributor to the onset of kissing spine. When horses are not trained to balance with their heads up and backs properly arched, especially during their formative years, they become more susceptible to developing this condition. Proper engagement of core muscles is vital in preventing the compression of spinous processes.

  • Saddle Fit and Duration of Use: Prolonged hours of training under an ill-fitted saddle can be detrimental to a horse's spinal health. An improperly fitted saddle not only disrupts the horse's posture but can also lead to chronic back pain, creating an environment conducive to the development of kissing spine.

  • Weak Back Muscles: If a horse's back muscles are inherently weak, the act of riding can exacerbate the condition. The constant pressure on a weak back can cause the spinous processes to overlap and press closely, resulting in considerable pain and discomfort for the horse.

rider technique can affect the horse and cause kissing spine
  • Rider Techniques and Saddle Placement: Incorrect rider techniques, particularly when the saddle is positioned directly over the thoracic column, can exert undue pressure, contributing to the development of kissing spine. Understanding proper riding techniques and ensuring appropriate saddle placement are crucial in preventing spinal issues.

Recognizing these contributing factors is essential for horse owners, trainers, and riders alike. By addressing these elements, we can take significant strides toward preventing the onset of kissing spine and fostering the overall well-being of our equine partners.


Recognizing the Whisper of Discomfort: Early Signs and Symptoms of Kissing Spine in Horses

Identifying kissing spine in its early stages is akin to deciphering a subtle language of discomfort. While the disease tends to be asymptomatic in its nascent phases, astute horse owners can unveil potential issues by paying close attention to a spectrum of signs and symptoms:

horse skeleton showing kissing spine between vertebrae
  • Pain Expression during Saddling: One of the earliest indicators is the horse's discomfort during the saddling process. If your horse reacts with signs of pain, such as flinching, shifting weight, or a change in demeanor when the saddle is placed, it might be a cue to delve deeper into the possibility of kissing spine.

  • Sensitivity to Brushing: Horses with kissing spine may exhibit aversion to being brushed along their back. If your equine companion reacts by pushing away, tensing up, or displaying signs of discomfort during grooming sessions, it could be indicative of spinal issues.

  • Unexplained Weight and Muscle Loss: Sudden and unexplained weight loss, coupled with a noticeable decrease in muscle mass, can be an early warning sign of kissing spine. Changes in the horse's physique, especially in the absence of other discernible factors, warrant a closer examination.

  • Frequent Irritation and Avoidance: An increase in overall irritability, coupled with avoidance behaviors, may signify underlying discomfort. Horses with kissing spine might express their discomfort through avoidance tactics, such as moving away when approached or displaying resistance during handling.

  • Limited Flexibility and Muscle Stiffness: Difficulty in stretching or bending due to stiff muscles is a common manifestation of kissing spine. Observing alterations in your horse's range of motion and flexibility, especially in the back and hindquarters, can be crucial in early detection.

  • Abnormal Gaits and Movements: Kissing spine can influence a horse's gait, leading to abnormalities such as cross cantering. If you notice irregularities in movement, it's essential to consider the possibility of underlying spinal issues.

  • Performance Challenges: Horses with kissing spine may exhibit difficulties in performance activities. This can include sensitivity to rearing, reluctance to jump, and instances of bucking during riding, all of which can be indicative of spinal discomfort.

  • Hind End Lameness and Back Soreness: Physical indications, such as hind end lameness and a sore back, are often associated with kissing spine. Monitoring your horse for signs of discomfort in these areas can provide valuable insights into their spinal health.

Due to improper and prolonged training, horses with a kissing spine will also have or may develop related diseases like:

  • Sacroiliac arthritis

  • Cervical vertebral compressive myelopathy

  • Neuroaxonal dystrophy

  • Hindgut ulcers

  • Limited movement due to pain

Vigilance and a keen eye for these subtle indicators empower horse owners to intervene early, facilitating timely and effective management of kissing spine.


Kissing Spine: The Crossroads of Breeds and Disciplines

While kissing spine is a condition that can affect horses across breeds, it does exhibit a predilection for certain types, often influenced by factors such as conformation, training regimens, and the specific demands of various disciplines.

  • Racehorses and Performance Horses: Racehorses and performance horses, with their rigorous training schedules and prolonged practices under the saddle, are particularly predisposed to developing kissing spine. The intense demands of these disciplines can contribute to the compression of spinous processes over time.

  • Thoroughbreds: Thoroughbreds, renowned for their athleticism and speed, frequently find themselves in the realm of racing and high-performance events. The demands placed on their backs during training and racing make them more susceptible to the development of kissing spine.

  • Quarter Horses: The versatile Quarter Horse, often engaged in activities such as barrel racing, roping, and other performance events, is not immune to the risks of kissing spine. The strain placed on their backs during quick and dynamic movements can contribute to the development of this condition.

warmblood horse grazing has kissing spine
  • Warmbloods: Warmbloods, admired for their athleticism and suitability in various equestrian disciplines, can also be affected by kissing spine. The demands of training and competition may lead to the narrowing of spaces between spinous processes in these breeds.

  • Friesian Horses: Friesians, known for their elegance and strength, may also face the risk of kissing spine. Their distinctive conformation, combined with certain training practices, can contribute to the development of this condition.

  • Baroque Horses: Baroque horses, characterized by their shorter backs and unique conformation, are prone to developing kissing spine due to the shorter spacing between spinous processes. This anatomical predisposition increases the likelihood of impingement.

  • Hunters, Jumpers, and Event Horses: Horses engaged in hunter, jumper, and eventing disciplines often undergo rigorous training and perform complex movements. The combination of athleticism and specific training demands can elevate the risk of kissing spine development in these equine athletes.

While these breeds and disciplines may be more predisposed to kissing spine, it's crucial to recognize that the condition can manifest in horses across the spectrum. Furthermore, not all horses that develop kissing spine show overt physical symptoms, making regular veterinary check-ups and proactive management essential for maintaining the spinal health of horses, regardless of breed or discipline.


Diagnosing Kissing Spine in Horses: Navigating the Complexity of Detection

Detecting kissing spine in horses is a nuanced process, given the subtlety of early signs and the often asymptomatic nature of the condition. To safeguard your horse's well-being, it is strongly recommended to consult a veterinarian for a comprehensive examination at the first suspicion of kissing spine.

x-ray showing kissing spine in horses
Photo credit: Tad Coffin Saddles

The diagnostic journey commences with a thorough examination of the thoracic area, particularly focusing on T13-18, where signs of inflammation, cystic lesions, and bone cysts may be indicative of kissing spine. Employing imaging techniques is pivotal in uncovering abnormalities, and X-rays stand out as a primary diagnostic tool. X-rays provide detailed insights, measuring bone density and assessing the spacing between spinous processes, offering a foundational understanding of the spinal landscape.


However, the challenge with X-rays lies in their inability to directly correlate with physical pain. False diagnoses can occur due to variations in the angles at which X-rays are taken, influencing the perceived distance between spinous processes. Complementary diagnostic methods, such as ultrasound and thermography, play crucial roles in identifying the precise location of inflammation and highlighting areas of concern that may not be evident through X-rays alone.

nuclear scintigraphy of horses kissing spine
Photo credit: AZ Equine

Nuclear scintigraphy, commonly known as a bone scan, introduces a higher level of precision to the diagnostic process. This involves injecting a radioisotope into a vein, allowing it to circulate to areas with high blood supply or bone turnover. A Gamma Camera is then employed to detect inflammation and abnormalities in the vertebral column. This advanced technique enhances the diagnostic accuracy, providing a more comprehensive understanding of the condition.


It is imperative to approach the diagnosis of kissing spine with a broad perspective, considering various factors that could contribute to back pain,. Pinched ligaments, lack of exercise, issues with core muscle movement, and compressed nerves are among the myriad possibilities. Thorough examination is crucial to rule out other conditions and ensure an accurate diagnosis.


Once the comprehensive diagnosis is complete, a tailored treatment plan can be formulated. This personalized approach considers the specific needs and condition of the horse, aiming to restore mobility, alleviate pain, and enhance overall well-being. The journey from diagnosis to treatment is a collaborative effort between horse owners and veterinary professionals, prioritizing the health and vitality of our equine companions.


Navigating Treatment Paths for Kissing Spine: A Multifaceted Approach to Equine Well-being

Once a diagnosis of kissing spine has been established, a diverse array of treatment options becomes available, each tailored to the specific needs of the horse. These treatments encompass a spectrum ranging from invasive surgical procedures to non-invasive methods, all aimed at alleviating pain, enhancing mobility, and fostering the overall health of the equine patient.


Surgical Treatment

  • Mesotherapy: Mesotherapy, an invasive treatment, has demonstrated efficacy in addressing kissing spine. This technique involves injecting small amounts of medication directly into the affected areas, targeting pain and inflammation. Mesotherapy is often employed to complement other surgical interventions.

  • Interspinous Ligament Desmotomy: Another surgical approach involves interspinous ligament desmotomy, a procedure that aims to release tension and alleviate impingement between spinous processes. By carefully intervening in the ligamentous structures, this technique contributes to reducing discomfort.

  • Standing Wedge Ostectomy: Standing wedge ostectomy is a surgical method designed to modify the bony structures of the spine, specifically addressing the compression seen in kissing spine. This procedure involves reshaping the spinous processes to alleviate pressure and restore a more natural spacing.

  • Medication: Following surgical interventions, medications such as muscle relaxants (e.g., Robaxin) and joint injections containing corticosteroids are often prescribed. These medications play a crucial role in managing pain and inflammation, facilitating the healing process post-surgery.

Non-surgical Treatments

  • Rehab and Physical Therapy: Non-surgical approaches emphasize pain management and the overall comfort of the horse. Rehabilitative exercises and physical therapy play a pivotal role in enhancing flexibility, strengthening core muscles, and promoting overall spinal health.

  • Injections (Steroids): Injections containing steroids can be administered to reduce inflammation and alleviate pain. Targeting the affected areas, these injections contribute to mitigating the symptoms associated with kissing spine, offering relief to the equine patient.

  • Shock Wave Therapy: Shock wave therapy is a non-invasive technique that employs acoustic waves to stimulate healing and reduce inflammation. This method has shown promise in enhancing tissue repair and promoting overall well-being.

  • Laser Therapy: Laser therapy harnesses the power of light to stimulate cellular activity, reduce inflammation, and accelerate the healing process. Non-invasive and gentle, laser therapy is an effective adjunct to comprehensive treatment plans.

  • Medications like Tildren: Tildren, a bisphosphonate medication, is utilized to modulate bone metabolism. It can be beneficial in managing conditions like kissing spine, offering a pharmacological avenue to address underlying factors contributing to the condition.

  • Red Light Therapy: Red light therapy emerges as a natural and non-invasive option for pain relief and inflammation reduction. Harnessing the healing properties of specific wavelengths of light, this therapy promotes cellular repair and aids in the overall recovery process.

In navigating the treatment landscape for kissing spine, a holistic and collaborative approach involving veterinarians, equine specialists, and attentive horse owners is paramount. Each treatment modality contributes to the collective goal of restoring the horse's mobility, alleviating pain, and fostering a life of vitality and well-being.


Navigating the Path to Equine Spinal Health: Management and Prevention of Kissing Spine

Equipping oneself with the knowledge of long-term care strategies and preventive measures is instrumental in fostering the spinal health of horses, especially those susceptible to or diagnosed with kissing spine. Let's delve into the key facets of management and prevention to ensure the well-being of our equine companions.


Long-term Care Strategies for Horses with Kissing Spine

horse in rehabilitative exercise for kissing spine
  • Rehabilitative Exercises: Engaging horses in rehabilitative exercises forms the cornerstone of long-term care. Tailored physical therapy and exercises designed to strengthen core muscles and improve flexibility contribute to the overall health of the spine.

  • Regular Veterinary Check-ups: Scheduled veterinary check-ups are essential for monitoring the progress of horses with kissing spine. Regular assessments enable early detection of any potential issues, facilitating prompt intervention and adjustment of the care plan as needed.

  • Balanced Exercise Routine: Maintaining a well-balanced exercise routine is crucial. Avoiding excessive strain or overexertion and incorporating varied activities contribute to the overall fitness of the horse without placing undue stress on the spine.

  • Proper Nutrition: Ensuring a balanced and nutritious diet is fundamental for horses with kissing spine. Adequate nutrition supports overall health, aiding in muscle development, bone strength, and the general well-being of the equine athlete.

  • Comfortable Living Environment: Providing a comfortable and stress-free living environment is paramount. Ample turnout time, proper bedding, and social interaction contribute to the mental and physical well-being of horses, positively impacting their overall health.

Preventive Measures for Reducing the Risk of Kissing Spine

horse conformation evaluation can help prevent kissing spine
  • Conformation Evaluation: Conformation evaluation plays a pivotal role in identifying horses predisposed to kissing spine. Understanding the conformational nuances of different breeds aids in early recognition and preventive measures.

  • Regular Veterinary Assessments: Regular veterinary assessments, even in the absence of apparent symptoms, contribute to early detection and preventive management. Proactive monitoring allows for timely intervention to address any emerging issues.

  • Appropriate Training Practices: Adopting appropriate training practices is key to preventing kissing spine. Ensuring that horses are trained to balance with their heads up, arch their backs properly, and engage their core muscles helps minimize the risk of spinal issues.

  • Varied Riding Activities: Incorporating a variety of riding activities can be preventive. Avoiding prolonged sessions of repetitive movements and incorporating diverse exercises contribute to the holistic development of the horse without overburdening specific areas of the spine.

Importance of Proper Saddle Fit and Riding Techniques

  • Saddle Fit Assessment: Regular assessments of saddle fit are crucial. Ill-fitted saddles can contribute to the development of kissing spine. Ensuring proper saddle fit alleviates pressure points and promotes comfort during riding.

  • Correct Riding Techniques: Employing correct riding techniques is paramount for spinal health. Rider posture, balance, and the application of aids should be in harmony with the horse's natural movements, preventing undue stress on the spine.

  • Regular Professional Guidance: Seeking regular guidance from equine professionals, including trainers and saddle fitters, ensures that riding techniques and equipment align with the well-being of the horse. Professional insight contributes to a holistic approach to riding and training.

By integrating these long-term care strategies and preventive measures into the management of horses with kissing spine or those at risk, we pave the way for a life of comfort, mobility, and vitality for our equine companions. It's a journey guided by proactive care, informed decisions, and a commitment to the enduring health of our cherished horses.


Unlocking Relief: The Effectiveness of Red Light Therapy for Equine Kissing Spine

Red light therapy being used on a horse with kissing spine

Red light therapy emerges as a promising solution for alleviating back pain caused by kissing spine in horses. This therapeutic approach harnesses the power of red and near-infrared light at specific wavelengths, artificially produced by various lamps, lasers, and light panels. The objective is to stimulate the horse's natural healing processes, offering a non-invasive and effective method for managing the challenges associated with kissing spine.


Red light therapy serves multiple purposes, with its core objectives being to enhance healing, diminish pain, reduce inflammation, and improve circulation. The methodology involves the use of light waves at specific wavelengths that penetrate the skin, prompting the body's innate healing responses. Concerns about safety and efficacy are addressed by utilizing LED light diodes, ensuring a safe, non-invasive, and no-heat application of light therapy.


Notably, Poll to Pastern employs red light therapy with LED light diodes, strategically delivering the most effective wavelengths for healing. The lights penetrate deep within the skin to target areas of discomfort, offering a therapeutic touch without inducing heat. Beyond addressing back pain associated with kissing spine, red light therapy proves beneficial for an array of ailments, including arthritis, tendon injuries, skin conditions, inflammation, and tissue repair.

Embark on a journey to enhance your horse's well-being by scheduling a red light therapy session today. Additionally, for sustained healing benefits, inquire about the possibility of renting red light therapy pads for your horse, offering the convenience of regular therapeutic sessions—3 to 4 times a day. The path to equine comfort and vitality awaits, guided by the gentle yet potent glow of red light therapy.

horseback riding with a good saddle fit to prevent kissing spine



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