At some point in their careers, many equestrians have heard of or been exposed to “Kissing Spine,” a medical condition that can cause back soreness, mild lameness, incorrect carriage, sloped hooves, and quarter cracks. According to Dr. Liz Maloney, DVM¹, the definition of Kissing Spine is “[T]he impingement of the dorsal spinous processes … a diagnosis made through evaluating radiographs of a horse’s back. The condition occurs in the dorsal spinous processes, which are the tips of the spine that you can feel if you press down on the horse’s midline. When they touch or overlap this is considered to be ‘kissing.’”
In severe cases, Kissing Spine can cause the inability to perform. According to Dr. Phillipe Benoit, DVM², of France, almost all of back soreness in equines is a direct result of bony issues, which go hand-in-hand with soft tissue damage. By ‘bony issues,’ he is referring to arthritis between vertebrae, or bony fractures of the spine.
The symptoms of Kissing Spine are commonly misdiagnosed as fitness or training issues, and the syndrome is far more common than horse owners realize. In addition to perceived training issues, the imbalance of the hooves can be seen in some cases, which is caused by unequal weight distribution between the hooves as the horse may be seeking to relieve pressure in its spine. As a result, the hooves can become unbalanced, causing irregular slopes and uneven pressure.
Research suggests that core weakness in equines can begin the onset of a condition known as “Spinal Crowding Syndrome” (SCS), which can eventually lead to the dreaded Kissing Spine diagnosis. Similar to Kissing Spine, SCS is also often overlooked, as it can be perceived as heaviness to one side or the other, greenness in youngsters, or simply a training issue, as mentioned above.
In reality, any equine athlete, like any human athlete, needs core strengthening to support bone structure, muscles, and soft tissue in the neck, spine, and haunches. Proper strengthening can help avoid the onset of Spinal Crowding Syndrome, often found in inverted or hollow-backed horses. The vertebrae are more likely to be crowded and the spinal canal to be narrowed if a horse is swayed downward through the back—If one can lift the horse off the forehand and engage the hind end, horses will naturally lift their back while carrying themselves forward.
Knowing the symptoms of back pain is important, but even more significant is knowing how to address the pain and knowing how to perform the exercises that will lessen the chance of the symptoms recurring. Research suggests that core weakness in equines can begin with the onset of Spinal Crowding Syndrome in mild to moderate cases of back soreness, and there is an overwhelming amount of information and helpful tools one can use to contribute to a strong, healthy back.
To begin, there are a number of different therapies that equine veterinarians can employ to help with back soreness, such as mesotherapy, chiropractic adjustments, cortisone injections, NSAIDS to decrease inflammation, shockwave therapy and a variety of treatments.
In more severe cases, there are aggressive regimens that involve a multi-step process. Carla Francheville, DVM, of Florida, offers a unique treatment for Kissing Spine that has delivered tremendous results. She uses a combination of acupuncture, Chinese herbs, shockwave therapy, and intravenous Tildren® (tiludronate disodium) treatment for bone- and cartilage-related problems. In simple language, Dr. Francheville explains that she injects intravenous Tildren®, which is an FDA-approved treatment that targets areas of inflammation and helps to smooth bone. Although this regimen is not the least expensive option, positive results have been seen. Dr. Francheville utilizes this treatment not only on the spine, but also other equine joints, including hocks.
Research and experience suggest that a few different core-strengthening exercises can help alleviate Spinal Crowding Syndrome, strengthening muscles and soft tissues surrounding the joint. Every training technique should consist of two primary components: straightness and impulsion from the hind end (back to front). Keeping that in mind, one can use the following four exercises to enhance core strength and ultimately decrease the likelihood of back soreness in the horse.
(1) Stretch – Many equestrians enjoy spoiling their partner after a successful ride. Instead, look to engage the horse with a healthy treat upon arrival into the barn before exercise. Use the treat as a training mechanism and an incentive to perform. Ask the horse to elongate his or her muscles by stretching their neck once to the right and once to the left for 15 seconds and once to their chest for 10 seconds. Repeat these exercises as needed. These exercises will elongate neck and back muscles while increasing range of motion and relieving joint pressure before riding begins. If the rider has more time, they can complete this exercise a couple of times as well, adding time for shoulder and leg stretches.
(2) Allow Free Movement – This begins with a properly fitting saddle. The horse should never feel restricted to move forward. Horses should move swiftly off your aids without restriction and have a trusting relationship with their partner.
(3) Core Strengthening – Think of lifting the horse’s rib cage to help build his core muscles in addition to engaging core groups such as the hind end, shoulders, and neck.
(4) Correct education – This is hard work, especially for an equine that has not been introduced to these movements early in its career. One can help horses learn how to properly move and bend by supporting their movements with our aids, rewarding proper movement by lightening the aids, and most importantly, finishing on a good note where the horse feels confident as does the rider.
Some additional therapies that are proven in helping horses with back soreness can be found in liniments and wearable horse apparel. Using herbal based liniments that are all natural and free of counterirritants will prevent the horse’s skin from burning or blistering. Traditional liniments that include counterirritants such as capsaicin, menthol, alcohol, Methyl salicylate, or benzoin resin irritate the skin in an effort to increase vasodilation and subsequently increase evaporative cooling. Natural liniments utilize the compounds in herbs to enter the dermis and muscular system to relieve pain and inflammation. Because there is no irritation created by these natural liniments, they can be used prior to exercise and under equipment to help loosen and relax muscles before your horse begins work.
Wearable horse apparel that utilizes ceramic and magnetic therapies pair well with natural liniments. While natural liniments are reducing pain and inflammation, ceramic and magnetic therapies can increase circulation and supple soft tissue. Wearable therapies can be used prior to, during, and after exercise and can be used for extended periods of up to 12 hours. Rubbing natural liniments along a horse’s spine and the surrounding muscles before riding, and riding with a ceramic wearables can help reduce the pain and inflammation associated with Kissing Spine and keep soft tissue relaxed for the most success in managing Kissing Spine.
¹ Maloney, Liz DVM (2011, November 23). Q&A Dr. Liz Maloney Explains ‘Kissing Spine’. Retrieved from offthetrackthouroughbreds.com
² Benoit, Phillipe DVM (2015). Horse Back Pain. Retrieved from smartpakequine.com
Additional photo credits to Kat Chrysostom.