Could This be Back Pain?

My mare appears to be in pain particularly in the withers, shoulder, and stomach areas. She used to round her back, but has since stopped. She squeals when she is touched. She has been checked for ovary problems, bladder problems, lameness, and her blood test came back normal. Is it possible that she has a pinched nerve? Is there anything else I can check out for her?                 Carolyn, via e-mail

Often the biggest challenge in dealing with horses with chronic back pain is differentiating physical pain from a learned behavioral response to the chronic pain. An example of this is when a horse with a chronically poor-fitting saddle problem pins its ears and runs to the other side of the pasture when you bring the saddle out of the tack room.

Chronic, generalized pain involving the withers, shoulder, and abdominal areas is likely due to an abnormal or heightened response to chronic pain (also called sensitization). The history of having a rounded back (also called a roached back or kyphosis) is a common indication of a back problem. However, your horse's back has now straightened out, which indicates a resolution or adaptation to the primary injury. It is possible that your horse has developed a learned response to the actual or perceived presence of pain, as indicated by her squealing when she is touched. Assuming that the squealing is a new behavior, it might be indicative of physical pain, the fear of potential pain, or a possible dominance issue. For example, she no longer considers you to be the lead mare, and she is telling you so.

Back or neck problems can be categorized into three types of injures: soft tissue (muscle or ligament), bone or joint, and nerve injuries. Horses with muscle injuries often have palpable muscle spasms and elevated muscle enzymes. Vague back problems involving the vertebrae or spinal joints are best evaluated with radiographs or nuclear scintigraphy (a bone scan). The diagnosis of spinal cord or peripheral nerve injuries ("a pinched nerve") requires a detailed neurologic evaluation coupled with advanced diagnostic techniques.

Work with your veterinarian to try a high dosage of non-steroidal anti-inflammatory drugs (such as phenylbutazone) for four to five days to rule out physical pain or inflammation. If there is a positive response, then it's likely that there is persistent pain that needs to be treated. If there is no response to the pain medication, then it is more likely that you are dealing with a behavioral issue, and a behavioral specialist should be consulted.

Chiropractic, acupuncture, massage therapy, and physical therapy approaches to musculoskeletal injuries offer unique perspectives to chronic problems and can be beneficial when utilized in conjunction with veterinary supervision and care. Remember, get a firm diagnosis prior to initiating any therapy.

About the Author

Kevin K. Haussler, DVM, DC, PhD

Kevin K. Haussler, DVM, DC, PhD, is with Colorado State University's College of Veterinary Medicine and Biological Sciences.

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