Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment.
Authors: Story Melinda R, Haussler Kevin K, Nout-Lomas Yvette S, Aboellail Tawfik A, Kawcak Christopher E, Barrett Myra F, Frisbie David D, McIlwraith C Wayne
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Cervical spine pathology in horses remains poorly understood despite its significant impact on performance and behaviour, prompting this comprehensive review of current knowledge on neck pain and dysfunction across osseous, soft tissue and neurological components. Story and colleagues synthesised evidence on disease processes affecting the equine cervical spine, systematically addressing diagnostic approaches ranging from clinical evaluation through to advanced imaging modalities, alongside the corresponding treatment options available to practitioners. Key findings highlight the necessity of distinguishing between different types of neck pain—which can manifest as poor performance in some horses or dangerous behaviour in others—and the importance of methodical tissue-by-tissue evaluation to identify which structures are contributing to dysfunction in any given case. The review underscores that successful management requires individualised treatment selection rather than a one-size-fits-all approach, with outcomes dependent on accurately identifying the underlying pathological processes driving clinical signs. For farriers, veterinarians, physiotherapists and coaches, this work provides a practical framework for recognising cervical involvement in performance issues and supporting evidence-based decision-making in referral, diagnosis and rehabilitation protocols aimed at sustaining long-term soundness and wellbeing.
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Practical Takeaways
- •Consider the cervical spine as a differential diagnosis in horses presenting with poor performance or behavioral problems, as clinical presentations vary significantly depending on which tissues are involved.
- •Implement a systematic diagnostic approach including thorough clinical evaluation and appropriate imaging to identify the specific pathologic process before selecting treatment, rather than using a one-size-fits-all approach.
- •Recognize that cervical pain can involve bone, soft tissue, or nerve structures, each requiring different management strategies to effectively return horses to sustainable performance.
Key Findings
- •Cervical spine pathology presents with highly variable clinical presentations ranging from poor performance to dramatic and dangerous behavior.
- •Multiple tissue types including osseous structures, soft tissues, central nervous system, and peripheral nervous system can contribute to cervical pain and dysfunction.
- •Systematic evaluation using clinical examination combined with multiple imaging modalities is necessary to identify underlying pathologic processes in the cervical spine.
- •Treatment options for equine cervical pain must be individualized based on specific pathology identified during diagnostic workup.