Back Pain in Horses: Causes, Symptoms, and Solutions for Equine Back Pain

One of the most important body parts to keep pain-free in riding horses is their back. After all, there’s no horse “back” riding without a healthy back!

A horse can develop back pain for many reasons, so understanding the causes and ways to prevent it are key to keeping your horse pain-free. 

What Is Back Pain in Horses?

Back pain in horses is common and can contribute to poor performance. This type of pain can appear suddenly, due to overuse, or to another medical condition.

Because of the wide range of causes, it is very important to work with your primary veterinarian to pinpoint the exact cause of back pain in your horse.

Symptoms of Equine Back Pain

Symptoms of back pain in horses can be difficult to recognize, since signs may come and go.

Signs that suggest back pain may include:

• Poor performance

• Restricted movement

• Grumpy or bad behavior while being saddled or ridden

• Refusing to work

• Stiffness with specific maneuvers like turns

• Unwilling to change leads

• Loss of hindlimb propulsion (drive)

• Head tossing

Causes of Back Pain in Horses

Common reasons for equine back pain can be categorized into medical causes or management issues. 

Medical causes for back pain in horses include:

• Arthritis (degenerative disease of the spine): Arthritis can occur in the joints of the back just like it occurs in a horse's limbs. 

• Kissing spine syndrome: A condition where two or more bony protrusions on each vertebra touch each other. When this occurs below the saddle area, some horses will develop back pain. 

• Poor conformation: A horse with poor conformation may cause them to hold extra stress in their back, leading to pain.

• Injury:

  • Fractures: Horses that have gone through trauma, such as falling over backward, can fracture the upper portion of their vertebrae in the withers. 

  • Muscle or ligament strain: Damage to the soft tissues (muscles) of the back is the most common reason for soreness. These muscles are commonly strained while being ridden.

  • Sacroiliac injury, including dislocation, strain, arthrosis, Hunter’s bumps: The sacroiliac area on the horse is the region where the back attaches to the pelvis. Any type of medical condition in this area can lead to back pain.

Management reasons for back pain may include:

• Poor saddle fit: Poor fit of any saddle can put extra stress, pressure, or pinching on the horse’s back, not distributing the weight and leading to pain.

• Too much exercise for the horse’s condition or performance level: A horse in poor fitness condition will likely not have the muscle they need on their back in order to be ridden without causing strain, leading to pain. It is extremely important to slowly increase a horse's workload in order to slowly build muscle and not cause harm.

• Rider imbalance: If a rider does not sit evenly in the saddle, or hold even weight in the stirrups, this can lead to strain on one side of the horse more than another.

How Veterinarians Diagnose Back Pain in Horses

If you have concerns your horse may be showing signs of back pain, always call your veterinarian to help determine the root cause.  

Your vet will typically start by performing a physical exam. Depending on their findings, they may want to see your blanket and saddle on the horse to ensure it is properly fitted. They may also want to watch your horse moving on the ground or under saddle for further evaluation. 

After watching your horse move, further diagnostic testing such as X-rays, ultrasound, and local anesthetics may be used. Back pain can mimic symptoms of lameness, so working with your veterinarian to determine and address the proper issue is important.

Be sure to mention if there have been any recent changes in your horse’s exercises, equipment, daily routine, or diet.

How Do You Treat Equine Back Pain?

The treatment plan for back pain in horses varies depending on the cause and severity.  Common treatments that may be associated with back pain may include:

Medications

For some horses with back pain, medications may be prescribed to help relax the muscles and soft tissue that may be tight, as well as reduce pain and inflammation.

Some of the common medications that may be given include the following:

• Methocarbamol, a muscle relaxant

• Phenylbutazone, flunixin meglumine, or Equioxx for pain

• Steroid injections to help decrease swelling

Surgery

Surgery may be considered for conditions like kissing spine. Surgery is not common due to the expense and complications, but in severe cases it may be the best recommendation for pain relief.

Surgery can relieve back pain by removing pieces of bone that are reducing movement and leading to tension and pain.

Alternative Therapies

Your vet may recommend additional therapies in combination with medications to help with horse back pain.

• Chiropractic therapy: Working with an equine chiropractor can help to loosen joints (relieving scar tissue), relax muscles, and relieve back pain. Horse chiropractors may also be able to give you daily stretches and exercises to do with your horse to help engage and strengthen your horse’s core and back. 

• Shockwave therapy: This therapy uses acoustic waves to help improve circulation to the area that is sore and relieve muscle spasms.

• Aqua treadmill therapy: Hydrotherapy can help to strengthen your horse's back muscles and core. 

Saddle Fit and Exercise

It’s important to ensure a horse’s saddle is properly fitted. For horse with back pain, make sure to:

• Check and adjust a horse’s saddle to fit appropriately.

• Modify your horse’s exercise program to help build muscle in the back.

• Slowly increase work to prevent injury.

Supplements

In some cases related to back pain in horses, your vet may recommend:

• Joint supplements: Your vet may recommend joint supplements such as Cosequin or LubriSyn to help support healthy joint health.

• Muscle supplements: If your horse is in consistent or routine hard work, your vet may recommend a muscle supplement to help, such as Nano-E or Elevate.

Recovery and Management of Back Pain in Horses

When caught early, back pain caused by an equine maintenance issue can be mild and improve with changes in management, supplements, and pain medications.

Back pain due to medical causes can range from mild to severe and may require rest, pain medications, and supplements.

If the back pain is severe, resolution may not be possible. At this time, the horse’s quality of life should be considered.

Exercises for Horses with Sore Backs

Once your horse is recovering from back pain, your vet may recommend certain exercises to engage your horse’s core and strengthen their back. For example:

• Stepping over logs or poles on the ground or under saddle can be great for the back and core.
• Hill work and backing up can help with activated muscle of the back and hind end.

Prevention of Equine Back Pain

As a horse owner, you can try to prevent back pain in a few ways:

• Equipment fit: making sure your saddle fits properly

• Easing into exercise: only riding your horse at the condition they are prepared for and slowly building their work level

• Maintaining ideal weight: bearing too much weight can be hard on a horse’s joints and back

• Keep balanced: properly balance your body in the saddle  

• Annual exam: working with your primary vet to make sure your horse stays in good health