Health & Wellness

Back Pain: Diagnosis & Treatment in our Equine Partners

By: Dr. Bob Peters, DVM
McKinlay & Peters Equine Hospital, Newman Lake, WA

My, oh my, how things have changed over the past 25 years of my career! One of my main areas of interest for the past 35-plus years has been lameness in horses. Before becoming a veterinarian, I was a full-time farrier for 11 years. That experience prepared and guided me towards a focus on lameness. A lifetime of knee problems myself has given me empathy for horses that are hurting. The changes over the past 25 years in how we diagnose and treat various lameness issues is mind-boggling. Perhaps, the greatest change has come in our approach to back pain in the horse. I vividly recall world-class, famous veterinarians saying that “primary back pain in horses almost never exists.” They taught my generation that if a horse had back pain it came from one of three possible sources: poor saddle fit, hindlimb lameness issues causing referred back pain, or a traumatic injury resulting from a fall or similar accident. The approach to treatment was similarly over-simplified: if the saddle is causing pain, change it; if the hocks hurt, inject them and the back pain will resolve; if the horse truly has a primary back problem from some traumatic injury, there is nothing we can do but give them a year off and hopefully it will heal itself.

Frankly, it is embarrassing to write that. For the first 15 years of my career, I virtually ignored back pain. Over the past 10 years, and especially the last five years, my approach to back pain has reversed course 180 degrees. The number one thing I do as a veterinarian is treat lame horses. Almost invariably the first thing I do when assessing any horse for lameness is to thoroughly examine the axial skeleton. Early in my career I never did that, unless there was obvious swelling or a wound. As a matter of a fact, I did thousands of lameness workups where I never addressed the axial skeleton at all. But now I start by palpating the neck, withers, lumbar, and sacroiliac regions. After I have done that, I return to my farrier roots and start from the ground up.

The focus of this article is not to expound on the massive list of things that can go wrong in the axial skeleton and its related structures; rather, it is to educate horse owners as to the prevalence of back, neck, and pelvic pain. Our hospital has invested heavily in both the tools and the training to assess, diagnose, and treat back pain. We have at our disposal the latest in digital radiography, more powerful x-ray generators, shockwave therapy, medical therapies, surgery, and physical therapy/rehabilitation protocols to help alleviate axial skeletal pain in the horse. Furthermore, we utilize resources outside of our hospital for the treatment of back pain: referral veterinarians who perform chiropractic and acupuncture treatments, as well as a local rehabilitation facility which utilizes multiple adjunctive treatment options including an underwater treadmill.

I still firmly believe that treatment without a diagnosis is essentially voodoo and could do more harm than good. It is a common trend in the horse community to immediately call an equine chiropractor or massage therapist if they suspect back pain in their horse. I see horses every week where the owner tells me their horse has had multiple chiropractic treatments, almost always from a non-veterinarian chiropractor, and the treatments are not helping. As just one example: for a horse with kissing spine lesions, chiropractic treatments alone are not adequate. As with any medical problem, an accurate diagnosis is imperative before any treatment begins.

Often our horses are not in heavy work during winter, making it the perfect time to evaluate and treat lameness and back pain. So, if your horse is painful, give us a call. We’ve got your back! Bob Peters, DVM

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