An introduction to back pathology in the horse

Summary

# Editorial Summary: Back Pathology in the Horse Back pain remains one of the most frequently encountered yet diagnostically challenging presentations in equine practice, occurring either as a primary condition or secondary to pathology elsewhere in the locomotor system. Henson's 2020 review synthesises current understanding of equine back pathology and proposes a systematic investigation framework designed to answer three critical clinical questions: does the horse genuinely have back pain, what is its underlying aetiology, and what treatment approach is most appropriate. The article emphasises that establishing a definitive diagnosis is often complicated by the interplay between biomechanical dysfunction, muscle pathology, and skeletal involvement, requiring integration of clinical examination findings with imaging and palpation techniques. By outlining the principal primary back conditions affecting horses—including sacroiliac joint pathology, kissing spines, and muscular dysfunction—the framework provides equine professionals with a structured approach to case management rather than empirical treatment. This systematic methodology is particularly valuable for the multidisciplinary team, as it clarifies when referral for advanced imaging or specialist assessment is warranted and helps align farriery, physiotherapy, and veterinary interventions around an evidence-based diagnosis.

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Key Findings

• •Primary or secondary back pain is commonly diagnosed in horses but establishing exact cause remains challenging
• •A systematic framework for back pain investigation should address three key questions: does back pain exist, what is the cause, and how should it be treated
• •Overview of common primary back pain conditions provided to guide clinical assessment

Conditions Studied