Back Pain in Sport Horses

laser treatments. Photo courtesy of Meadow Lane Equine Clinic

Usual therapy is one to three weeks of back free exercise, topical or oral nonsteroidal anti-inflammatory drugs (NSAIDs), and careful saddle fitting. In our clinic, we routinely use laser therapy and/or light therapy with acupuncture to help relieve some of the tension that has developed. 

Diagnosis & Treatment: This condition can be suspected in horses with pain on palpation, saddling, walking, trotting, and commonly in the canter. It can be diagnosed and graded by the lesion seen with radiographs, ultrasound, or gamma scintigraphy (bone scan) and by the presentation clinically (mild, moderate, severe). Interestingly, the radiographic findings often don’t support the clinical findings. This individual variation is seen often and can be confusing for owners. Some horses may have severe signs with only one area of abnormality on radiographs, and other horses will have moderate to severe radiographic findings with mild clinical signs

Diagnosis & Therapy: Ultrasound is the diagnostic technique of choice, and examination with careful evaluation of this fibrous/ligamentous structure that runs from the top of each dorsal spinous process and has a wave-like undulation along the back.

The horse should be rested for up to four to six weeks, with non-riding exercise allowed. Topical and oral NSAID treatment should be given until signs of pain and inflammation have subsided. The injury can be also treated concurrently with shockwave and RLT in addition to local therapy depending on the acute/chronic nature (ice/heat). 

Thoracolumbar Facet Joint Pain (Osteoarthritis)

Osteoarthritis is a relatively common finding in sport horses but rarely discussed or diagnosed. It can present as acute or chronic pain arising from the thoracic/lumbar facet joints (the small interlocking joints that allow rotation in the back). Loss of performance, decreased rideability, and behavioural issues when ridden are all possible manifestations.

Diagnosis & Treatment: This condition is diagnosed by ultrasonographic evaluation of the joint just off midline.