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EQU INE BACK PA IN
SUMMER 2012 ISSUE
EQUINE MATTERS
4
A normal horse should dip its back
when pinched along the spine
behind the saddle area; this is often
misinterpreted by owners 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
for them to move.
1: Assessing back mobility
Over-riding Dorsal Spinous Proceses
(Kissing Spines) These are a common
diagnosis but convincing findings on
x-rays should be combined with good
response to the local infiltration of local
anaesthetic to ensure they are the only
or significant contributing factor to the
back pain. Treatments can involve local
injections of anti-inflammatories such
as steroids, shock wave therapy and in
severe cases surgery may be required.
2: Kissing spines
Chartered Physiotherapists are fully
qualified human physiotherapists.
Those with extra training to deal with
animals should be members of ACPAT
the Association of Chartered
Physiotherapists in Animal Therapy.
It is important to use only appropriately
qualified people who will also have
proper insurance in place.
3: Chartered physiotherapists
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 that the most
appropriate treatment plan can be
developed to give your horse the
best chance of a full recovery.
Finding out which part of the back is
causing the pain can be very challenging.
The process of diagnosis is often far from
straightforward. 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 normally (see box 1).
Next, watching the horse move at walk
and trot in a straight line and on the lunge,
together with some specific moves such as
tight circles on the spot and backing up, often
gives clues as to the presence of back pain -
as well as identifying any lameness that 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 - see box 2) it isn't possible to block
out regions of the back, such as can be
done in the limbs, therefore, other techniques
are required.
Scintigraphy or '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 that 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 images difficult.
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 don't 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.
Laboratory tests
can be helpful to
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 (See Box 3) will
only work under veterinary referral and
should the physio find problems that are not
responding adequately or keep recurring,
they will refer back to a veterinary surgeon
to investigate the underlying cause.
Poorly fitting tack can cause discomfort
and some pain but in my opinion is
over-used as a source for 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.