Whinny’s Wisdoms

Springhill Equine Veterinary Clinic

Hi everyone, Whinny here! For horses to perform well as athletes, they must be able to use their whole body well. You’re probably familiar with the idea of taking care of your horses’ legs to keep him sound and able to ride – and you’re right, it’s super important. But have you thought about your horse’s neck recently? Despite being right there in front of us, problems in the neck may not be easily recognized because the signs may be subtle or hard to pinpoint. However, your horse’s neck is really important to his movement, balance, and comfort. Neck issues can happen to any horse – no matter his age or breed, or whether he’s a show horse or a backyard pet, so let me share with you what I learned about neck pain in horses!

Neck Anatomy (in brief)

A horse’s neck is a pretty complicated structure. There are seven large bony vertebrae that make up the cervical spine. Most of the spine is actually located lower down near the bottom of the neck, not up under the mane like people sometimes think. The neck vertebrae connect with each other through the main part of the bone, cushioned by the intervertebral discs, and also through joints at the sides called articular facets. The spinal cord runs through a channel in the middle of the vertebrae, and the cervical nerves travel through openings at the sides. There are a whole bunch of muscles, tendons, and ligaments to hold everything together – including the really big nuchal ligament that runs at the top of his neck, under his mane, from his skull to his back.

Signs of a Problem

So how do you know if your horse is having neck issues? It’s not always as obvious as you might think! To start with, let’s talk about normal. One of the most important things to know is that the muscles in a normal horse’s neck are smooth. Even a really fit, well-muscled horse like an Olympic showjumper should have a smooth neck. If you can see lots of lines and creases in your horse’s neck, it doesn’t mean he has great muscle development, it means there is muscle spasm! Those are called tension lines, and they’re often located in the brachiocephalicus muscle that runs along the lower neck over the spine. Here are a few examples:

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When you watch a normal horse walk towards you, you should see the head and neck moving in a gentle figure of eight pattern. If the neck is held very still as he moves, it’s often a sign of pain and stiffness. Can he turn his head easily in both directions? Or does he have less range of motion in one direction and tilt his head when he bends instead of turning smoothly.

Signs of neck pain can range from mild stiffness that limits performance to intense pain and muscle spasm. Your horse might just show a change in behavior or performance that doesn’t match his usual personality. You may notice that his neck muscles aren’t well developed. You may feel him bending or turning less easily to one side than the other or be less willing to raise or flex his neck. Some horses with neck pain prefer to hold their necks low and extended. There might be patchy sweating in one spot on the neck, caused by nerve irritation.

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Neck problems can cause ataxia (incoordination or wobbliness) when there is pressure on the spinal cord. Pain in the neck can even look like the horse is lame on one of his front legs, especially if the limping can’t be eliminated by nerve blocks. This is due to pressure on the nerves that travel from the vertebrae to the forelimbs.

Types of Disorders

Neck pain can occur in young and adult horses, and has a variety of causes, ranging from congenital issues, to wear-and-tear arthritis, to single traumatic incidents. Here are a few of the most common.

Muscle Soreness

Primary soreness and tension in the neck muscles can occur because of the way the horse carries his body and the work he is doing, especially if he isn’t working correctly. It might also occur secondary to pain in another site, such as his forelimbs or back. It’s important to figure out why it’s happening and not force him to continue working the wrong way, so it doesn’t lead to something worse down the line. His muscles will only develop normally if he’s able to use them correctly.


Osteoarthritis of the articular facet joints between the vertebrae is most often seen in middle aged sport horses such as jumpers or dressage horses. This is one of the most common types of neck pain my vets see. Like arthritis in other joints in the body, it is usually caused by wear and tear on the joints over time, causing degradation and bone proliferation. This results in joint pain, and in more severe cases, incoordination.

Wobbler Syndrome (cervical vertebral stenotic myelopathy)

This disorder usually affects young, fast growing, horses 6 months to 3 years old, but it can affect mature horses as well. It’s characterized by an abnormal gait, especially in the hind limbs, with incoordination and weakness. The horse may stumble or walk like he’s been given a sedative. It’s caused by a narrowing of the vertebral canal through which the spinal cord runs, and compression of the spinal cord as the neck moves. Surgical intervention to fuse the affected vertebrae can help some horses return to soundness, but Wobbler syndrome can be career ending in others.

Nuchal Bursitis

This is inflammation of the bursa that lies between the nuchal ligament and the first vertebrae of the neck, just behind the head. Horses may show neck stiffness, poor performance, or swelling around the poll. Most cases are the result of repetitive pressure caused by head position during training. In some cases it can involve a bacterial infection.


In order to successfully manage your horse’s neck pain, it’s important to get an accurate diagnosis. If my Springhill vet thinks something more than just simple muscle soreness is going on, she’ll likely recommend an X-ray or ultrasound. Sometimes diagnosis can be challenging due to the complex anatomy and the limitations of 2D imaging techniques. Advanced imaging, such as nuclear scintigraphy (bone scan) or computed tomography (CT) is occasionally needed to identify the source of pain and provide 3D visualization of the problem area.


After my vets have determined what’s going on with your horse’s neck, they can recommend a treatment to get him feeling as good as possible. If your horse is dealing with muscle soreness or joint stiffness without anything more serious going on, chiropractic and acupuncture treatments are great to improve flexibility around the joints and relieve muscle tension. My vets are trained in these techniques and love the results they can give.

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For osteoarthritis in the neck, treatment usually involves injecting the affected joint with corticosteroids, or an orthobiologic such as Platelet Rich Plasma. These injections are performed with an ultrasound to precisely guide the needle into the correct spot. Injections can be very effective in decreasing the pain and inflammation and returning the horse to competition, though the prognosis depends on how severe the joint damage is.

Other treatments may be used as well, such as mesotherapy (injecting through very small needles to stimulate the mesoderm nerve fibers and stop the pain spasm cycle) and medications such as muscle relaxants or anti-inflammatory medications.

While many horses with neck pain can be managed well with treatment, for some of the more severe cases with ataxia, like wobbler syndrome, the horse may unfortunately be unsuitable for riding. If the horse is incoordinated, he is more likely to trip and fall than a normal horse, and so is a safety risk to himself and to his rider.

Your best approach to taking care of your horse’s neck is to pay attention to his attitude, flexibility, and the feel of his muscles. If you notice anything amiss, give my vets a call! They can help you pinpoint the problem and get your horse back on the road to recovery.

That’s all for this week!


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Whinny’s Wisdoms is the official blog of Whinny the Clinic Mouse at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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