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The Truth About Kissing Spines in Horses: Symptoms, Causes, Prevention and Management Tips

Updated: Apr 22

Kissing spines is a condition that affects the bony projections (spinous processes) that point upward from the main vertebrae. These spinous processes are normally spaced apart, but in some horses they can touch or overlap, causing pain and inflammation.

horse kissing spine rehabilitation exercises

Kissing spines is most common in the thoracic region, where the saddle and the rider's weight are located. The most frequently affected vertebrae are T13 to T18, with T15 being the most common.


The Causes of Kissing Spines

The main factor that contributes to kissing spins is a small amount of space between spinous processes themselves. The amount of space varies firstly by genetics, how much space the horse is born with. For example a cold blooded breed such as cobs have much larger spinous spaces and so are less likely to develop kissing spines whereas warmbloods and hot blooded breed such as thoroughbreds are more likely to develop kissing spines as they naturally have smaller spinous spaces. Secondly the amount of space reduces as the horse gets older and the back becomes more extended, but there are a number of factors that increase the risk of kissing spines forming as they cause the narrowing of the spinous spaces to reduce further and quicker. These include:-

  • Poor posture

  • Poor saddle fit

  • Inappropriate training

  • Weak core muscles

  • Trauma or injury



Recognising kissing spines

It can be difficult to diagnose kissing spines, the signs can be vague and nonspecific, and may be confused with behavioural or training issues, or other health problems. However, it is important to learn to recognise what is normal behaviour for your horse, and if this changes or your horse develops signs of back pain and poor performance it is time to get him checked over by your vet.


Signs may include:

  • Sensitivity when grooming, putting on a saddle, tightening the girth

  • Reluctance to stand still when mounting

  • Stiffness, hollowing, or head tossing when ridden

  • Resistance to working in an outline, or bend

  • Problems with striking off on the correct canter lead

  • Change in ridden behaviour such as bucking, rearing, napping

  • Loss of muscle along the topline

  • Poor performance


The diagnosis can be challenging and it's crucial that your vet carries out a thorough clinical examination and they gather information on your horse's history. There are a number of diagnostic tests that your vet will carry out to determine whether your horse has kissing spines.


Radiographs (X-rays) are commonly used to confirm the presence and extent of kissing spines, but they are not sufficient to make a diagnosis by themselves. Many horses with radiographic changes do not show any signs of pain, and some horses with signs of pain do not have radiographic changes. Therefore, it is important to correlate the X-ray findings with the clinical signs and other diagnostic tests.


Treatment of kissing spines

How the condition is treated depends on the severity of the condition and the response of the horse. Some improve with conservative management, such as:


- Rest and anti-inflammatory medication to reduce pain and inflammation

- Physiotherapy and massage to improve muscle tone and flexibility

- Exercise therapy to improve posture and muscle tone

- Corrective shoeing to balance the feet and improve posture

- Correct saddle fit

- Appropriate training and exercise program to strengthen the core muscles


Some horses require surgery of which there are a number of different procedures done depending on the horse.


The prognosis for horses with kissing spines varies depending on the individual case. Some horses may recover fully, while others may have limitations.


Kissing spines is a complex and challenging condition that requires a multidisciplinary approach and a tailored treatment plan. However, with proper diagnosis and management, many horses can enjoy a comfortable and productive life.


To help you understand more about this condition, whether you are an owner, trainer, saddle fitter or equine therapist, purcahse the recording here: Kissing Spines: Anatomy, Prevention and Rehabilitation


In this webinar with the help of anatomically painted horses, anatomical bones and real horse bones, discover what kissing spines are, what they actually look like, where and why they happen.


Gillian will also suggest exercises and tips to both prevent them happening and to aid the rehabilitation of horses with Kissing Spines.



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