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Neck and Back Pain in Horses

All owners want their horses to be happy, healthy and sound. Recognising when your horse isn’t performing as he should is key to his welfare. We know that neck and back pain has a negative effect on equine performance, but they can go untreated as they can be tricky to diagnose. However, with access to more diagnostic tools and targeted treatments, conditions in the neck and back can be treated successfully.

To help you learn more about the current thinking in this area, Equine orthopaedic surgery specialist Dr Jessica Kidd will be presenting an online CPD seminar – Understanding Orthopaedic Problems in the Horse and their treatment.

During this live one-day online seminar, Jessica will share her extensive knowledge and experience of dealing with orthopaedic issues in the horse. Topics she will cover include caudal neck pain, neuropathic pain and Wobbler’s Syndrome. Jessica will also discuss degenerative medicine and dispel myths about what works and what doesn’t including joint injections and stem cell therapy.

Having an understanding of the anatomy of the neck and back will help you recognise if something isn’t quite right and tell you that your horse may be uncomfortable. There are many signs that can indicate there’s a potential issue including unusual head carriage; a reluctance to bend the neck, becoming less supple, or an unexplained drop in performance.

In this blog we look at the anatomy and symtoms of pain and discomfort in the neck, back and sacroiliac regions.

The Cervical Vertebrae

equine Cervical vertebrae, horse, postioning and anatomy
Gillian presenting in Australia

The seven neck vertebrae (cervical) are the most flexible part of the spine and have considerable scope for movement. Within the neck itself most movement is seen between the head and the first and second neck vertebrae and between the caudal (5th - 7th) neck vertebrae. (Caudal is a directional term meaning towards the tail). The complex musculature of the neck as well as the shape of the vertebrae allow for flexion and extension, rotation and lateral flexion between the vertebrae but combinations of these movements also allow the horse to shorten and elongate the neck. Consequently the horse has many options for compensation in the positioning of the head and neck. When a horse is happy and relaxed in the head and neck, he is able move with freedom and expression.

To learn more about the anatomy, biomechanics, importance and positioning of the neck check out the on-demand webinar: Understanding the Horses's Neck

Due to the anatomical connections from the neck to the rest of the horse's body. Any pain, or discomfort in this area will have a huge impact on the horse both physically and psychologically. Symptoms of neck pain, however are not limited to unusual positioning of the head and neck but can include forelimb lameness, atypical forelimb movement, back pain or dysfunction and even altered hindlimb movement.

Problems in the neck vertebrae can include trauma, fracture, congenital malformation and arthritis. The challenge in the neck however is that these problems not only affect the bones, joints and soft tissue structures, but as there are so many important nerves in the neck they also commonly cause neuropathic (nerve) pain which can be harder to resolve.

The Thoracic and Lumbar Vertebrae

understanding the horse's back, thoracic and lumbar vertebrae,
Gillian presenting in Poland

The horse's back is made up of 18 thoracic and 6 lumbar vertebrae. It is the rigid nature of these sections of the spine that allow us to ride our horses. The limited movement available is mostly seen in the mid section of the back right underneath the area on which we sit.

To learn more about the anatomy, biomechanics and posture of the horse's back as well as how to improve it check out the on-demand webinar: Understanding Your Horse's Back

Pain in this area is fairly common and can present with similar signs as conditions in the neck. Again, diagnosis can prove difficult as the signs can be so varied. This is why it is vital to ‘know your horse’ – recognising any change in behaviour on the ground or when ridden and calling in the experts will hopefully mean a diagnosis and appropriate treatment.

Signs of Back Pain

There is a broad spectrum of clinical signs of back that may include:

  • A reluctance to lie down

  • A dislike of having rugs put on

  • Doesn’t like being groomed

  • Difficult to shoe

  • Being cold backed

  • Bilateral hindlimb lameness

  • Unusual head and neck position

  • Shortened strides

  • Lack of cadence in trot

  • A lateral or 4-time canter

  • Bucking

  • An unwillingness to go forward or downhill

  • Unwillingness to jump

Often these symptoms are worse when ridden.

Assessing pain and discomfort in horses
So much information can be gained from watching the way your horse rolls, lies down and get up again

During the seminar, Understanding Equine Orthopaedic Problems, Jessica will discuss in detail why a thorough clinical examination is required and the stages that she carries out that look at the horse’s conformation, palpation to assess pain followed by seeing the horse walk and trot up in-hand as well as seeing the horse ridden. She will also look at the role of diagnostic tools in reaching a diagnosis followed by the various treatment options.

Jessica will look at common problems that we see in the horse’s back including kissing spines, supraspinous ligament desmopathy and facet joint arthritis.

The Sacroiliac Region

sacroiliac ligaments, sacroiliac joint,  lumbosacral junction,, iliopsoas muscles, horse

The sacroiliac region is an anatomically complex area and one that can be a potential problem area for our horses. There are 2 important and very different joints in this area. One is all about stability while the other is all about flexibility.

  1. The Sacroiliac Joint. This is the joint between the wing of the sacrum and the wing of the ilium. It therefore connects the pelvis to the sacrum. It it the point where the hindlimb effectively joins the spine. The function of this joint is to transfer forces from the hindlimbs (the power house of the horse) forward and through to the back and the rest of the body. Consequently stability is really important for this joint. The sacroiliac joint has very little movement and is supported and stabilised by many strong sacroiliac ligaments.

  2. The Lumbosacral Junction. This is the point at which the sixth lumbar and first sacral vertebra meet. The function of this joint is to allow the sacrum and pelvis to tilt relative to the back. This joint is comparatively mobile. There is virtually no movement between the lumbar vertebrae in front of it and none at all between the sacral vertebrae behind it. The lumbosacral junction is a hinge joint with approximately 20 degrees of flexion and extension. As a hinge joint there is no rotation and lateral flexion available. This joint is the most flexible part of the spine after the neck and tail.

video course  and book about horse sacroiliac anatomy, biomechanics, problems and exercises to imrove

To learn more about the anatomy, biomechanics and dysfunction of the sacroiliac region, check out this video course and book.

Any issues in this area, whether as a result of trauma, repetitive strain injury, asymmetry or degeneration, will mean the horse is unable to move with freedom and in comfort. Symptoms may include:

  • Symptoms of back or neck pain

  • An unwillingness to canter

  • Bucking

  • Repeatedly changing behind in canter

  • Going disunited in canter

  • Lateral canter or 4-time canter

  • An unwillingness to jump or collect

  • Lack of power and strength from behind

  • Unwilling to go forwards

  • Unwilling to go downhill

Understanding the problems that can occur in this area including pelvis fractures, pain and dysfunction will be discussed during the seminar in greater detail. I hope you have found this article interesting. Please do share you comments and experiences below. If you can relate to any of the symptoms included in this article this seminar will be of interest to you!


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