Recognising Back Pain in Horses

• Snapping, pinning the ears back, restlessness when saddling or when grooming the saddle area
• Tail swishing
• Head tossing
• Teeth grinding
• Bad temper
• Changes while riding: a rigid back, irregular rhythm, lameness, refusal of certain exercises and gaits, reduced suppleness, problems with rein-back, ignoring aids that are otherwise well understood, rearing, bucking, sudden bolting

The annoying thing is: these behaviours can also indicate other conditions – dental problems, gastric ulcers, neurological disorders, joint inflammation in the legs, being overwhelmed, fear, and so on.

Veterinarians can, of course, achieve a somewhat more precise diagnosis – but even the objective assessment of palpation findings or X-rays can be difficult.

A palpation examination first reveals how well developed the back musculature is (less well-muscled horses tend to be more prone to back problems) and whether there are any palpable areas of hardening, swelling or atrophy. The examiner then carefully searches for pressure-sensitive spots on the horse's back. This so-called palpation can take up to 30 minutes and requires not only extensive experience on the part of the examiner but, ideally, also a certain familiarity with the individual horse and its temperament. Even so, there will not always be final certainty as to whether the horse's observed reactions (evasion, tensing, facial expressions and vocalisations) are pain responses or merely an expression of excitement in an unfamiliar situation: as useful as palpation is, its results are often not truly conclusive.

In any case, it is important to rule out any lameness of the hindquarters: pain in the limbs leads to compensatory posture and tension in the back musculature, which can easily be misinterpreted as a back problem.

In connection with palpation, a so-called diagnostic local anaesthesia can also be performed. For this, the problem zones identified as conspicuous during palpation are temporarily made insensitive to pain by injecting a local anaesthetic. If the horse shows no further conspicuous reactions during a subsequent second palpation, there is good reason to suspect that it does indeed have a back problem.

When diagnosing suspected back problems, the following imaging procedures can be helpful following palpation:

• X-ray: X-ray images can be used to diagnose deviations – or suspected deviations – from the normal appearance of the spine: primarily arthritis (joint wear), spondylosis (bony overgrowth) and abnormalities of the spinous processes (so-called "kissing spines")

• Scintigraphy: a scintigraphy of the spine can be used to diagnose inflamed areas – pain is often the result of inflammatory processes in the tissue.

Not only are the results of palpation examinations somewhat unreliable – there is a similar problem with X-rays in horses as in humans: abnormalities can occur in individuals who are not suffering from pain at all, and patients in pain do not necessarily show conspicuous X-ray findings. Scintigraphy is more sensitive here, as it can detect active inflammatory processes – however, its spatial resolution (i.e. assigning the site of inflammation to a specific structure) is not very good.

A combination of X-ray and scintigraphy is meaningful: if a structural irregularity diagnosed on the X-ray image can be spatially well matched to a site of inflammation identified by scintigraphy, it can be assumed with greater certainty that the X-ray finding is indeed relevant to the pain.

So far, so good – but such extensive diagnostics naturally come with considerable costs as well as logistical effort (only large equine clinics have the corresponding technology). Don't feel too guilty if you can't afford this for your family horse – the benefit is disputed even among experts.

If a horse appears to be suffering from back pain, it is definitely worth considering saddle fit as well: an ill-fitting saddle can be to blame for many back problems. And, unlike with back diagnostics, there are hardly any uncertainties in saddle diagnostics: an ill-fitting saddle is an ill-fitting saddle, and that is clearly a problem. Full stop. Money spent on saddle diagnostics is therefore always a worthwhile investment.

Some saddle properties can be assessed by laypeople themselves – for wither and shoulder freedom, for the correct width of the panel channel, and for the length and width of the saddle, there are rules of thumb that may not be the last word in wisdom in every case, but are nonetheless quite useful.

However, whether the saddle also fits well where you can't see or feel it can only really be determined by a saddler or equine physiotherapist. The same applies to the extremely important question of whether a good saddle fit also holds up with the rider in the saddle, and – of course, above all! – in motion.

Good old intuition has faced strong competition in recent years: today, various saddle diagnostic methods are available that can diagnose saddle problems and, in some cases, visualise them very well.

Measuring and moulding the horse's back – either mechanically with an adjustable "measuring frame" or special rulers, or digitally with a laser scanner – is typically the preliminary step for fitting a new saddle. At least in theory, however, the results can also be compared with an existing saddle to assess its fit. Such measuring systems are available in German-speaking countries under the brand names Equiscan, Horseshape, Tomax and Saddle-Check; they are now used by many good saddlers.

These measurements provide important indications as to whether the saddle fits. But if you really want to know exactly how your saddle is doing, you should consider a digital saddle pressure measurement. Here, sensors in a thin mat placed under the saddle provide a spatially and temporally precise image of the pressure distribution on the horse's back – when standing and in all gaits. The saddle's pressure profile is displayed on the screen of a computer or tablet and allows a very precise assessment of saddle fit under all conditions. Digital saddle pressure measurements are offered under the brand names SattelScan and medilogic.

A simpler, analogue system for visualising saddle pressure is the gel-filled impression pad, which is also placed under the saddle and, based on its deformation after a test ride, allows the pressure conditions under the saddle to be assessed – less precisely than with sensors, but still quite well.

If saddle diagnostics reveal problems with saddle fit, there is only one option: have the saddle refitted, if possible – or have a new one made. An alternative to full custom-making here is so-called made-to-measure production: the individual assembly of a well-fitting saddle from an adjustable synthetic saddle tree and prefabricated components.

Back problems are described in veterinary publications as a condition that commonly occurs in sport and leisure horses. However, no expert can be pinned down to more precise statements or even figures – nobody has ever determined this with such precision. Compounding the issue is the fact that in many cases the diagnosis of a "back problem" simply cannot be made clearly enough.

Some veterinarians consider back problems to be overdiagnosed. Others have the subjective impression that the issue has indeed increased among their patients.

Continue reading ... -> Possible Causes of Back Pain in Horses