If your horse is being a pain in the neck- look at his back


Don’t be backed into a corner – find out about horses back pain.

Horse Back Problems & Pain

If your horse starts to display uncharacteristic tendencies such as dipping, flinching or nipping when groomed or tacked-up, a poor or reduced performance, unevenness or unlevel gaits, is crooked to ride, carries his tail to one side, is disunited or bucking into canter or rearing or bucking when mounted, it may be due to pain under saddle. Many bad backs in horses are a secondary problem, caused by postural changes adopted by your horse to alleviate pain elsewhere. So once pain in the back area is identified it is best to seek professional advice form your veterinary surgeon.

When testing for a normal reaction in a horses back run you fingers and thumb firmly down either side of the spinal process.

A normal horse should dip its back when pinched along the spine behind the saddle area; this is often misinterpreted as a sign of pain. A horse with back pain will fail to dip, instead their backs are tense and rigid to resist movement as it is painful to move

Equine back pain can have many causes so use a methodical approach to solve back pain problems.

The horse’s back is a large and complex structure with a multitude of physical functions to perform. It is centred around a long boney column made up of individual vertebrae, which house and protect the important nervous tissue of the spinal cord and act as the scaffold onto which the muscles and ligaments attach.

The spine can be divided into five main sections,

  1. the neck,
  2. the thoracic (chest) spine,
  3. the lumbar spine,
  4. the sacrum and
  5. the tail.

Here we will concentrate on the neck, the thoraco-lumbar region together and a little in the sacral region but pain can originate in any of the structures of the back; and we can see bone pain, muscular pain, ligament pain, nerve tissue pain or any combination of all four.

The neck

The neck is a very mobile part of the spine, acting to hold up the very heavy head of the horse and move it to all the positions necessary. (I never reaslised just how heavy until I fond a pony skull out on Dartmoor.  This is a small animal and the skull was nearly 15 kilos!)

This area involves a lot of muscular activity, therefore, muscular pain problems with the neck are common and show up easily. Also, because of the degree of movement required, any abnormality in the joints between the vertebrae in the neck (there are seven), will also show as obvious pain.

The thoraco-lumbar spine

The thoraco-lumbar spine is much less mobile than the neck. Its main function is to store and transfer the energy produced by the powerhouse of the hind-quarters to the front limbs, as well as providing the solid bridge on which a rider can sit and to support the heavy contents of the horse’s abdomen. The sacrum is a group of fused vertebrae which is the bit of the spine the pelvis is joined to by the sacro-iliac joint. This is a very strong joint which does not move, but the energy which it transmits from the hind limbs to the spine means any damage in this region can cause significant pain.


Finding out which part of the back is causing the pain can be very challenging. The process of diagnosis is often far from straight forward. Examination of the back will start with looking for signs of asymmetry in the muscle cover, followed by feeling for signs of pain in any particular area. The degree of mobility (movement) will be assessed directly, such as testing how far the neck can move or by checking the back dips, flexes and moves side-to-side, normally. Wise words, indeed from from Veterinary surgeon Julian Rishworth of the Minster Equine Veterinary Clinic,

Next, watching the horse move at walk and trot in a straight line and on the lunge, together with some specific moves such as turning tight circles on the spot and backing up, often gives clues as to the presence of back pain – as well as identifying any lameness which may be present. Vets will also pull sideways on the tail while the horse walks forward to assess the strength in the back and the horse’s ability to resist being pulled off track.

Apart from a few specific conditions such as over-riding dorsal spinous processes (kissing spines) it is not possible to block out regions of the back, such as can be done in the limbs, therefore, other techniques are required.

Scintigraphyor ‘bone scanning’

Scintigraphyor ‘bone scanning’ relies on radioactive markers highlighting areas of increased bone activity and is ideal for showing up problems with the bones of the spine, such as fractures, kissing spines or arthritis between the vertebrae. Bone scanning is also good at getting information from areas which are difficult to get images from using other techniques, due to their size, such as the pelvis and thoraco-lumbar spine.


X-rays are quite useful for the neck and the tops of the thoraco-lumbar spine, but the large amount of muscle and tissue surrounding the rest of the spine makes getting x-ray images difficult.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) would give great pictures of the horse’s back, however, the size of a horse means they do not fit in the machines which are made for humans. These techniques can be used for the upper neck in some cases.


Ultrasound scanning is much more frequently used in the horse’s back and can show changes such as arthritis in the joints between the vertebrae very well. Other soft-tissue injuries can also be detected with ultrasound like damage or cysts within the ligaments of the spine.

Equine thermography

Equine thermography, which is a relatively new form of diagnosis, can pinpoint where any issues are through heat mapping. Imagery from before and after exercise can indicate changes in bloodflow or poinpoint areas of inflammation.

Equine Thermography can help to identify the seat of the primary cause, so this can also be rectified, preventing reoccurrence of back issues.

Laboratory tests

Laboratory tests can be helpful to help diagnose some muscle problems, such as ‘tying-up’.


A lot of back pain can be attributable to spasm of the nerves and muscles and this can respond really well to appropriate physiotherapy. This sort of problem can occur on its own or it can be secondary to lameness in one or more limbs. Chartered physiotherapists will only work under veterinary referral and should the physio find problems which are not responding adequately or keep recurring, they will refer back to a veterinary surgeon to investigate the underlying cause.

Underlying causes

Poorly fitting tack can cause discomfort and some pain but in my opinion is over-used as a cause of equine back problems. It is, of course, important to ensure the tack fits correctly but for all but minor problems in the saddle area, be sure to explore the other possibilities rather than blaming the tack too quickly.


There are a lot of myths surrounding pain in the back, but when approached in a methodical way by qualified professionals the right diagnosis means the most appropriate treatment plan can be developed to give your horse the best chance of a full recovery.