Finding and Managing Back Injuries and Pain

How do you locate the source of back pain in the horse? Once you find the source, how do you manage the pain? At the Western Performance Horse Forum held in Nampa, Idaho, on Feb. 15-17, a panel of three veterinarians discussed options for finding and managing back and sacroiliac injuries that create pain, lameness, and/or performance issues. Panelists were Robert Schneider, DVM, MS, equine orthopedic surgeon at Washington State University; Van Snow, DVM, from Santa Ynez, Calif.; and Chris Ray, DVM, MS, Dipl. ACVS, of Weatherford, Texas.

A concern when treating horses with back pain is the identification of any musculoskeletal issues that might be creating pain in the hock or stifle. That type of lameness problem will cause a horse to alter its limb movement, placing strain on the back. It is also important to address issues of farrier care. Sometimes shoeing requires a trial-and-error process to work out the best option. Also, with a complaint of back pain, it can be valuable to check or treat for gastric ulcers. The panelists further remarked that some mares demonstrated signs of back pain when they were cycling.

Saddle fit is an important feature to evaluate when assessing back pain. Mechanical pressure and bruising in the muscles from saddle pressure points can affect limb movement and willingness to lift the back, or can make the horse crouch when stopping suddenly.

Diagnosis of impingement of the dorsal spinous processes ("kissing spines") often comes through relief via treatment. Other problems are ruled out through careful examination and diagnostics, after which the area of concern is infused with corticosteroid and anti-inflammatory medications to gauge the therapeutic response with light exercise. Shockwave is also useful to desensitize pain associated with impingements and to help diffuse the medication. Injecting anti-inflammatory medications into the epidural space can also be effective and might target a larger portion of the back.

Rest programs for impingement of dorsal spinous processes vary. The horse should be in a paddock by day and stalled at night, given light hand walking for a month, then turned out on no more than two acres for another month. Serial exams and back palpation serve as a guide for when the horse can be put back to work. The horse might be put into light, but controlled exercise on a walker or could be ponied. He should be legged up for at least 30 days before he is saddled and mounted.

Sacroiliac problems use intralesional injection principles as well to limit inflammation. Specific technique was discussed to ensure direct injection into the joint when appropriate.

For more from the Western Performance Horse Forum click here.

About the Author

Nancy S. Loving, DVM

Nancy S. Loving, DVM, owns Loving Equine Clinic in Boulder, Colorado, and has a special interest in managing the care of sport horses. Her book, All Horse Systems Go, is a comprehensive veterinary care and conditioning resource in full color that covers all facets of horse care. She has also authored the books Go the Distance as a resource for endurance horse owners, Conformation and Performance, and First Aid for Horse and Rider in addition to many veterinary articles for both horse owner and professional audiences.

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