I see a whole lot of things from the front porch here at Springhill Equine. I hear a lot of things, too. One of the more common things I hear is “My horse has a sore back.” Seems simple and straightforward. The back is sore. Fix where it’s sore. Alas, these are horses we speak of, so nothing is simple. Back soreness ranks up there with how the Hadron Super Collider works: pretty complicated. So, let’s talk backs: How my Docs evaluate a back-sore horse, why it’s very often not the back, and what the treatment options are.

It hurts when you push here

Whew! The ways in which back-sore horses present themselves can be the subject for an entire textbook, but I’ll be generous and give you the short version. Cats can be generous, occasionally. The two most common ways my Docs get presented a back-sore horse are: 1) obvious pain when you push on the back somewhere, and 2) bucking. The bucking almost always involves cantering or loping in some way. 

This isn’t the only way back-sore horses present though! From poor performance, to an obvious lameness in one leg, back soreness can show up in a whole lot of ways. This is why my Docs always talk to you humans before and during their exam. They’re like Sherlock Holmes: looking for clues to the cause of the crime. It’s also why my Docs evaluate the entire horse during a lameness exam, and why they may ask for videos of your horse doing it’s job, and why they may want to see all your tack on your horse. It can be a complicated task figuring out if back pain is a saddle, pad, or even rider issue, or if it’s a horse issue. 

Why it Hurts

Okay, let’s talk about why horse’s backs hurt. 

• Tack fit. Notice I didn’t just say saddle. It’s really important to evaluate how your tack fits your horse. Get help from a saddle fitter if needed, change things up to see if your horse has preferences, and evaluate all the tack, not just your saddle. 
• Sore front feet. Number One reason horses get sore backs is sore front feet. This can be due to things as varied as navicular problems to poor foot balance. If your horse’s front feet are sore, they’re going to carry themselves weird, and that’s going to cause back pain. Pro Cat Tip: it works the same in people. If your back hurts, ask a physical therapist to point out how crooked you are. 
• Sore back legs. Number Two reason. Put number one and number two together and you have around 90% of the causes of sore backs. That says something about leg lameness and backs! Hocks get blamed for this a lot, but any hind limb lameness can lead to back pain for the same reasons any forelimb lameness can: when your legs hurt, you walk weird and that messes up your back, even if you’re a quadruped.
• Actual sore backs. Yes, this does happen. I’m not here to tell you it’s only an Urban Legend on par with walking colics (just don’t, please don’t walk your colics). There are things that can go wrong with the back to cause back pain. The most common one is affectionately called kissing spines. This happens when the big fins off the top of the spine touch each other. This causes them to rub up against each other as your horse moves, and that hurts. These horses are almost always worse when ridden, because adding a human and some tack makes the back sink which leads to more intense “kissing.” There are some other issues in the back as well, including arthritis and low back pain, usually around the sacroiliac joint. 
• Sore necks. This one is sort of just an extension of the back, but hey, gotta include all the parts. These horses usually have trouble turning their heads side-to-side, and their back pain is present, but not horrendous. Managing the neck issue usually fixes the back issues.
• Miscellaneous. Ah, my favorite category. It’s a category made for cats. I included this one because lots of things can contribute to back pain so it’s important to evaluate the entire horse (even the teeth!) when there’s back pain. 

What to do

The first step to managing back pain is figuring out the real cause. That’s a simple sentence that does little to capture how difficult this can sometimes be. For example, a horse comes in with back pain. On evaluation, there’s some hock pain going on. My Docs inject the hocks, and give you some exercises. Two weeks later the back pain isn’t better, but when my Docs check your horse, the hock pain is gone. This happens all the time, and is usually pretty quickly remedied by helping the back figure out it’s new normal. My Docs have a number of ways to do this including FES (Functional Electrical Stimulation), spinal manipulation (chiropractic), and acupuncture. It very much depends on each horse’s symptoms to decide which one of these is the correct answer, and sometimes it’s all three. Have I mentioned Spa Day? I’m mentioning it now. This is the greatest gift ever for the hard working horse. It’s an FES session, acupuncture, and spinal manipulation all at one great price. Seriously, what horse wouldn’t want this??

I sort of hit step two up there in step one, but step two is helping the body get back to normal. This is done through a combination of rehab exercises, and therapies like acupuncture and spinal manipulation. The back is whack so we gotta help it get unwhack. Just like in human PT, this will often involve exercises for you, the human, to do with your horse. Common ones are shoulder-in, walking over poles, and backing uphill (finding a hill is sometimes the hardest part). These exercises typically evolve into a base set of things your horse needs to work on forever. Just like you humans are better with a left or right paw, horses are stronger on one side or the other. Helping them build even strength will help avoid lamenesses and back pain. 

Step three is believing in your feelings. No, I’m not getting all mushy on you. I’m saying believe yourself when you feel something isn’t right with your horse. Back pain, in particular, can cause very subtle signs. If your horse is doing something new and different, call my Docs for a conversation. Heck, shoot a video. You humans all have those things you call a phone but only use for pictures and videos anyway. Sometimes watching a video really helps you see what’s going on.

Back pain can be a real pain in the, well, you know where. With a solid team approach, you and your horse can get back to great rides in no time!

Until next week,
~Tony

P.S. My docs talk about this stuff on their podcast a lot. And to take it a step further, they’ve created videos on some of the exercises I was talking about for Official Patrons of the podcast. That’s a pretty sweet perk! If you aren’t listening to the podcast, you’re missing out on some great horse doctor knowledge. There’s a lot to know about your horse, and you can find it over on the Podcast Page. It’s what all the cool cats are listening to these days!