The Horse Physio - Delivering care with expertise since 1992

10.12.2022 Should I operate if my horse has kissing spine?

I am sharing an in-depth blog on this subject on 13th December 2022 at, so for more detailed information, put that date in your diary.

But because it’s a question that I come across so often, and a subject that I am so passionate about, I thought I would share one simple piece of information here. In the vast majority of cases, I would want to see that the the problem behaviour that caused me to refer my horse to the vet in the first place, has resolved as a result of that specific area of the back being nerve blocked, before I would consider operating. It’s essential to work with your team to figure out what’s best for your horse, and your team will hopefully include not only yourself and your vet, but also your coach, physical therapist, farrier, and saddle fitter.

Many horses (some studies suggest around 75%) will show an element of kissing spine on x-rays, and so being able to see on an x-ray that your horse has kissing spine does not necessarily mean that that kissing spine is causing a problem. There are lots of reasons for back pain in horses, and just because your horse has back pain, does not mean that he has kissing spine. Equally, just because your horse has kissing spine, does not necessarily mean that this will cause back pain. A horse can be sore through his back because of poor saddle fit, or because of low-level lameness (whether or not that lameness is visible), or potentially for a variety of other reasons.

It is the presence of a ridden or in hand behavioural or performance problem, that goes away when the relevant area of the spine is blocked, that would lead me to consider treatment for kissing spine. If kissing spine is found to be the root cause of the problem, there are various treatment options available, which are likely to include rehabilitation, with or without medication, and with or without surgery.

In the vast majority of cases, there is good cause for hope if your horse has kissing spine. Often, it is not the end of the world for your horses ridden career, despite how terrifying the diagnosis can feel. However, it does very commonly occur in combination with other skeletal issues, and if these are not resolved, then the situation may be more serious. First and foremost, in relation to this, is recognising whether there are concurrent, musculoskeletal concerns, and accurately diagnosing them so that you can come up with the most appropriate treatment regime.

Look out for my blog from Dr Sue Dyson, on 13th December 2022, for more information.

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Other books by Sue Palmer M.Sc. MCSP:

‘Horse Massage for Horse Owners’

‘Understanding Horse Performance: Brain, Pain or Training?’

© Sue Palmer, The Horse Physio, 2022

December 10, 2022
Sue Palmer