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Recognising Horse Back Pain - Part 3

Part 1 looked at facial expressions and posture, Part 2 examined movement and behaviour, now in Part 3 we discuss response to touch and treatment for back pain.


Muscles should feel warm, plump and full, with soft give, not stiff, tight, hard, twangy, excessively hot or cold.

Lack of topline, flat atrophied muscles.

Healthy back shape, soft plump muscles.

In acute pain the horse may be hypersensitive to touch or brushing, even dipping dramatically as muscles spasm or twitch. In chronic cases you might see sweat patches or hair rubs in the saddle area.

Clinicians will thoroughly assess the horses response to pressure along each segment of the back muscles. Bear in mind it is possible to make any horse dip by firmly running a finger along either side of the spine, as there is a normal hollowing and rounding reflex that can be elicited, (much like when a doctor hits the tendon below your kneecap and your leg jerks automatically). So it is the quality, amount of movement and the facial expressions that accompany this that may indicate pain. A horse that doesn't move much may be really stiff or braced with muscle spasm and pain. Whilst a horse that moves a lot may be really flexible and supple. Also consider the starting point, if your horse is already in a hollow posture (see part 1) there may not be much more movement into extension available.

Have a look at this video of reflex spinal movement from eastern states based Physios Emma and Kristin. It demonstrates normal extension, 'dipping' away from pressure.

The more of these indicators present the more likely your horse has back pain and would benefit from seeing a Physiotherapist. Don’t leave it until your horse is really suffering and showing extreme behaviours. As you get better at recognising the subtle signs of back pain you can get onto helping your horse sooner to prevent the back pain escalating. Horses are skilled at compensating so the longer a problem is left untreated the more of the body becomes involved and the longer the recovery takes. When recognised early, treatment and recovery will likely be quicker and your horse will be their happy athletic self again sooner.

Once you have recognised there is a problem we can work towards finding a solution.

Treatment for Equine Back Pain – How to get rid of back pain and prevent it coming back

Working with a Physiotherapist, Veterinarian, Saddle fitter, Coach ... can help bring to light the reasons why your horse developed back pain and formulate a treatment plan to not just get rid of the back pain now, but to help prevent it returning. There are many treatment techniques that can relieve pain in the short term, but to prevent it coming back a few weeks or months down the track takes a thought out program that progressively builds resilience and restores balanced function to the whole horse so the back doesn’t become overloaded and irritated again. The back is made up of a chain of joints, ligaments, muscles and nerves, further assessment will help determine the irritated structures and stiff directions of movements, therapy can then be specifically targeted to those tissues.

Rehabilitation may begin with hands on work then progress to exercise therapy.

Rehabilitation may begin with hands on work to desensitise local tissues, then broaden to look at muscle chains, and global systems, progressing through exercise therapy to restore strength, co-ordination and load tolerance to the highest level required. The biggest mistake many people make is not being progressive and specific enough with graded exercises. Once acute pain has settled it is far too easy to skip steps and return to riding or competition before the body has regained optimal function. Pushing the horses body to do tasks it is not yet ready for results in cheating and compensation patterns which subtly limit progress and performance beginning a downwards spiral until signs of dysfunction again become big and obvious enough for us to notice. Short cuts or quick fixes do not work in the long term.

Many horses suffer back pain, just because it is common, it does not mean it is normal. Back pain should be taken seriously and attention sought promptly. Remember we sit on the horse’s back, and if mild back pain is ignored it can escalate to serious behaviours that affect not just performance but also your safety. If you are concerned your horse is in pain consult your Veterinarian and Physiotherapist as soon as possible.

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