Kissing Spine: More Than Just a Bad Back – A Modern Approach to Management

As a horse owner, few things are more distressing than seeing your horse in pain. A drop in performance, changes in behaviour, or signs of discomfort can make diagnosis worrying. One often misunderstood cause of equine back pain is Impingement of the Dorsal Spinous Processes, called "Kissing Spine." This term sounds painful, but with modern diagnostics, a multi-faceted approach, and advanced rehabilitation, many horses return to comfortable, active lives.

At Somerset Equine Water Treadmill & Rehabilitation, we believe in empowering owners with knowledge. This article clearly explains what Kissing Spine is, how it's diagnosed, and evidence-based strategies for managing it. Key takeaway: With diagnosis and the right plan, many horses can return to strong, pain-free activity. We'll show how a structured rehabilitation plan, particularly with the equine water treadmill, forms the backbone of successful management.

Let's start with what's actually happening in your horse's back when Kissing Spine is present.

To understand Kissing Spine, it's helpful to visualize the horse's spinal column. Running along the top of the vertebrae are bony projections called dorsal spinous processes; these are the bumps you can feel along your horse's back and withers. In a healthy spine, these processes are evenly spaced. Kissing Spine occurs when two or more of these processes are too close together, causing them to touch or "kiss." This impingement can lead to inflammation, bone remodeling, and significant pain, particularly in the area under the saddle.

It is important to note that many horses have radiographic evidence of Kissing Spine without ever showing clinical signs of pain. For instance, studies suggest that a significant percentage of horses, possibly over 75%, can have visible lesions in diagnostic images yet remain symptom-free. However, for others, the condition can manifest in various ways. This underscores why a proactive assessment is crucial. Even if your horse shows no overt symptoms, seeking veterinary advice as soon as Kissing Spine is detected in diagnostic images is essential. Early intervention can prevent potential issues and ensure your horse maintains a high quality of life. Recognizing the signs and knowing when to act are the first steps toward getting your horse the help it needs.

Common Signs and Symptoms

The signs of Kissing Spine can seem vague and are often mistaken for training or behavioural issues. Watch for:

Reaching a Diagnosis: A Multifaceted Approach

If you suspect your horse is suffering from back pain, a thorough veterinary examination is crucial. Diagnosing Kissing Spine isn't just about taking an X-ray; it's a process of elimination to ensure other potential causes of pain, such as lameness, saddle fit issues, or gastric ulcers, are not the primary problem.

A typical diagnostic process includes:

Early and accurate diagnosis is key. It allows for timely intervention that prevents the condition from worsening and greatly improves the long-term prognosis.

Modern Management: Beyond Box Rest

In the past, a diagnosis of Kissing Spine often meant a long period of rest, which we now know can be counterproductive, leading to muscle wastage and a weaker back. Today, the focus is on a dynamic, multi-modal approach tailored to the individual horse.

Conservative Treatment Options

For most cases, a combination of non-surgical treatments is the first line of defence:

• Pain Management: Strategic use of anti-inflammatory medications and targeted corticosteroid injections can break the pain cycle and reduce inflammation, making the horse comfortable enough to begin rehabilitation.
• Physiotherapy and Core Strengthening: A qualified equine physiotherapist can use manual therapies to release muscle tension and prescribe a specific program of groundwork and exercises (like carrot stretches and pole work) to strengthen the horse's core and back-supporting muscles.
• Saddle Fit: A poorly fitting saddle is a major contributing factor to back pain. A thorough evaluation and adjustment by a qualified saddle fitter is non-negotiable. However, there are simple checks owners can do before calling in a professional. Ensure the saddle sits level on the horse's back and does not tip forward or backward. Check for even contact across the panels by running your hands between the saddle and the horse. Look for signs such as dry spots or uneven sweat patterns after riding, indicating pressure points. If you notice these signs, consulting a saddle fitter is essential.

Surgical Intervention

For more severe cases, or when conservative management fails to provide relief, surgery may be recommended. Procedures like an Interspinous Ligament Desmotomy (ISLD) or bone shaving aim to create more space between the spinous processes, relieving the impingement. While surgery can be highly effective, its success is critically dependent on the quality of the post-operative rehabilitation.

The Cornerstone of Recovery: Rehabilitation and Long-Term Care

Whether a horse is managed conservatively or surgically, a structured rehabilitation program is the most important factor in achieving a successful outcome. The goal of rehabilitation is to rebuild the muscles that support the spine, particularly the topline and core, to create a strong, stable "internal brace" for the back.

This is where the equine water treadmill plays a transformative role. It provides the perfect environment for a horse to rebuild strength and fitness without the concussive forces of ridden work or the strain of carrying a rider.

The Benefits of the Equine Water Treadmill

The water treadmill offers a unique combination of properties that make it an unparalleled tool for rehabilitating Kissing Spine:

An Encouraging Outlook

A diagnosis of Kissing Spine can be daunting, but it is manageable. With a dedicated team, modern management, and proper rehabilitation tools, your horse can overcome back pain and return to a happy, athletic life. The journey requires patience and commitment, but the positive results are worth it.

If your horse is struggling with back pain or you are navigating a Kissing Spine diagnosis, don't lose hope. The right support can make all the difference. There are a few simple daily management strategies you can employ to support your horse:

Ready to create a tailored rehabilitation plan for your horse? Contact Somerset Equine Water Treadmill & Rehabilitation today to book a consultation and find out more about our services.