Oh my achin' back!
Your horse's back is the bridge that holds the whole body together. It provides suppleness, responsiveness, exhibits 4 way flexion and extension and contributes to overall athleticism. Just like in people, back pain is very common in horses and it is a leading cause of poor or decreased performance in the athletic horse. Back pain can either be the primary issue causing poor performance, or it can be a secondary issue due to compensation from pain in another location.
Our veterinarians are highly skilled at determining the source of the back pain and selecting the correct treatment and post treatment exercises to return your horse to their peak performance. We will start with a review of some of the most common treatments we utilize for back pain.
Sacroiliac Injections:
The sacroiliac is the ligamentous junction of the horse's spine to his pelvis and is critical to the horse's ability to engage his hindquarters. This region is where all the power from the hind end is collected and sent forward to propel the horse through all athletic movements. This area takes a huge amount of stress during jumping and "sitting" movements in collected flat work. When this region becomes fatigued and painful, the horse will hold the pelvis flat and and not engage the hindquarters. Horses with painful SI joints struggle jumping especially in combinations, struggle to collect or "sit" in flat work and drive from the hind end, They may swap hind leads at the canter or buck/kick out at the canter. SI pain tends to be secondary in nature as a result of compensation for other areas of pain, most typically the hocks and suspensories, but can be primary in nature. SI pain tends to be secondary in nature as a result of compensation for other areas of pain, most typically the hocks and suspensories, but can be primary in nature. SI injections are performed with ultrasound guidance to ensure accurate placement of the medication. Either steroids or biologics can be used.
Dorsal Spine injections:
"Kissing Spines" or Impinging Dorsal Spines is unfortunately a very common cause of back pain and poor performance, especially in the jumping horse. The cause of this condition is likely genetic, but poorly fitting saddles and a lack of adequate back muscles can significantly exacerbate this condition. Horses with this condition often are reluctant to work in a frame and would rather drop their back and keep their head high. We also see these horses jumping very "flat" over fences, and riders note a lack of engagement from the hind end. The diagnosis is made by careful palpation of the back and X-rays. There are many treatment options for this condition, but most often we begin with an injection between and around the painful spines. A blend of corticosteroids (Cortisone) and anti-inflammatory medications are injected in between the spaces of the dorsal spines to relieve pain and inflammation. Relieving this pain will allow the horse to relax over his back, bring his back up to the saddle and again work in a correct round frame. Often these horse experience compensatory muscle spasm in the back that also requires treatment. Altering and optimizing training protocols are critical to maintaining back muscle and decreasing spasm in these horses. Functional Electric Stimulation (FES) can also be indispensable in helping to decrease spasm and build muslce in chronically affected backs.
Lumbar facet Injections:
Facets are small joints on the side of the vertebra that give the horse the ability to bend right and left through the neck and back. Pain and arthritis in these joints are quite common in performance horses, especially in the dressage horse where an even bend through the back is important. If you notice that your horse is pushing his haunches to the outside of the circle or you require a lot of outside leg the keep him round through the circle, your horse could have lumbar facet pain. These horses also feel locked up in the back and very stiff behind the saddle. There is often secondary muscle spasm in the back as the horse is trying to reduce the motion in the back to reduce pain in these joints. Due to the small size of these joints and their deep location in the back, ultrasound imaging is used to directly visualize the injection, ensuring accurate placement of the medication. Either steroids or biologics are useful treatments.
Chiropractic:
Technically termed ‘Spinal Manipulation’ in veterinary medicine, this modality has proven to be a valuable integrative therapy in horses of all ages, disciplines, and abilities. Both Dr. Nostrant and Dr. Branscomb are certified in equine spinal manipulation. Chiropractic treatment aims to restore normal biomechanical motion to the horse through improved nerve function and circulation at joint surfaces. In addition to restoring and maintaining comfort and peak performance in your horse, this therapy is often included as an important part of the rehabilitation treatment plan following an injury.
Acupuncture:
Our own Dr. Shen performs acupuncture with a focus on the treatment and management of the performance horse. Acupuncture is an excellent treatment for horses with back soreness and Dr. Shen often uses Electro-Acupuncture to reduce the spasm and pain in the muscles of the back. The results is a supple, relaxed, and pain free horse. Most horses benefit from a once a month treatment, though more intensive treatment may be helpful in the beginning depending on the level of back pain. Routine acupuncture treatment can also increase the time between more in-depth treatments for back pain.
Shockwave Therapy:
Shockwave is an excellent non-invasive treatment for back pain, in particular with dressage horses and jumpers. Shockwave therapy causes relaxation of muscles and blocks the painful spasm in these muscles. It is a very effective treatment for secondary back pain resulting from compensation for pain in the hock, stifle or SI joint. Shockwave is also utilized when pain and muscle spasm result from an increase in work, especially, we have found, in dressage horses that begin training at a higher level or prior to a competition. Many horses tolerate their back being shockwaved without sedation.
Mesotherapy:
This technique involved injections of small amounts of medication into the dermal skin layer of the horse and facilitates a "resetting" of the feedback arc that causes the painful muscle spasm in the horse's back. As with shockwave, this treatment is a very good option for mild primary back pain or secondary muscle spasm and stiffness due to sore joints or a poorly fitting saddle. Mesotherapy blocks the painful muscle spasms by temporarily numbing the muscular nerves that exit out of the spinal cord, track through the muscles to just under skin over the back. Additional anti-inflammatory medications provide sustained relief of the muscle spasm. Mesotherapy, like shockwave, can be done repeatedly at short intervals of a few weeks if needed, but most horses only require one treatment.
Functional Electric Stimulation:
In conjunction with other treatment plans, FES is proven to improve range of motion, muscle size and strength, and muscle symmetry. Reducing muscle spasm and hypertonicity allows the horse to use the back more effectively and with less pain.
Methocarbomal:
Commonly known as "Robaxin," this medication is a mild muscle relaxant that can provide relief from minor back tightness related to heavier bouts of work. We use this drug to relive back soreness and tightness often seen during showing and increases in work. Methocarbamol should only be used short term (7-21 days) and is subject to specific withdrawal times for USEF competition.
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