Page 95 - August 2022

Diagnostic nerve blocks of the limbs (if trying to track down a limb unsoundness issue) or in specific areas of the back or spine are helpful to achieve an accurate diagnosis.
Further diagnostic testing may evaluate the innermost portions of the spine and
back muscles. This may be achieved with radiography, nuclear scintigraphy, diagnostic ultrasound, and thermography, although each has its limitations to identify problems in the deeper structures. Blood chemistries reveal muscle damage that elevates muscle enzymes.
WHAT CAN BE DONE?
The key to successful management and treatment of equine back pain depends entirely on an accurate diagnosis. All efforts should be made to obtain this information to implement an appropriate therapeutic plan.
Some horses are asked to perform activities that are inappropriate for that individual’s particular conformational attributes. A short- backed horse often is restricted in its flexibility and may be more at risk of vertebral lesions whereas a long-back horse is more at risk of muscle or ligament injury. Asking a horse
to perform tasks difficult for his genetic constitution can put considerable strain on the entire body, often resulting in problems with poor performance and attitude. A rider should carefully evaluate, with the help of a professional, the recreational pursuit their horse is best at undertaking; it may be necessary to shift a horse’s career to a different equestrian sport.
Saddle fit is easily remedied by acquiring correct-fitting tack. This often involves time and expense but pays dividends in a horse’s comfort and performance. While a poor-fitting saddle is not always the cause of back pain, it certainly can exacerbate an existing condition.
Collaboration with a qualified farrier goes a long way to improving quality of gait and to relieve undue stress on the horse’s back.
Proper conditioning for the task at hand and/or terrain (firm versus sandy footing; flat versus hill work) is an excellent preventive tool for minimizing back soreness. Spending time with a professional trainer helps a rider achieve optimal performance from the horse.
In many cases, a period of rest may be advised to allow time for healing of acute muscle or ligamentous strain. The horse is then returned to work slowly and in gradual
increments before being put back into full intensive work. Increasing the walking time along with some canter work should precede asking a back-sore horse for trot exercises.
Physical therapy and stretching exercises that increase range-of-motion and flexibility are helpful to supple all body parts, including the back. Daily turnout and free play further improve a horse’s flexibility and muscle tone.
Extracorporeal shockwave therapy (ECST) may relieve pain for horses with spinal osteoarthritis. In selected cases of severe
bone inflammation and bone resorption identified through imaging, bisphosphonate treatment may be indicated where allowed
and if not conflicting with drug testing regulations or horse age. Also, for soft tissue back pain, mesotherapy (multiple injections of homeopathic or pharmaceutical substances into tissue or fat just beneath the skin) has proven beneficial by blocking sensory pain fibers that pass through the skin to the back muscles.
Anti-inflammatory medications – non- steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids – are often palliative, although in many cases these medications may abbreviate the pain cycle enough to enable healing in addition to relieving muscle spasm.
Relieving tension in back muscles helps to accommodate more space between vertebral processes in cases of “kissing spine” lesions. Examples of alternative modalities, like acupuncture, chiropractic treatment, or muscle massage provided by certified and qualified practitioners may help to relieve back tension and alleviate muscle soreness. These techniques may also be preventive to developing back pain.
For problems such as osteoarthritis
within the vertebral joints, injection of anti- inflammatory medications using ultrasound guidance may curtail pain and inflammation. Some cases of severe kissing spines require surgery to relieve the impingement.
Chiropractic therapy should only be implemented following a careful veterinary evaluation that localizes the source and reason for pain. Chiropractic should not be the first line of diagnostics or treatment, as more often than not, the source of the problem goes unidentified and only the secondary clinical signs (back pain) are addressed. Acupuncture is helpful to relieve myofascial tension and pain, regardless of the source of the problem.
Many areas of acute or chronic muscle pain or spasms respond well to acupuncture, particularly when coupled with electrical stimulation that relieves spasms.
Massage helps to alleviate muscle pain or increased muscle tension. However, situations like myositis (tying up) must first be ruled out before applying muscle massage as this could worsen damage deep in affected muscles.
Stretching exercises are useful to improve flexibility and to relieve muscle tension and
to improve joint mobility. Stretching exercises are best done before exercise and are especially valuable once the horse has warmed up with
5 – 10 minutes of light exercise. Stretching exercises also include mounted work using
a long and low frame, cavalleti poles, and lateral exercises, all aimed at stretching the horse’s top line. As a horse improves in his rehabilitation, exercises can be incorporated to increase strength in the abdominal muscles and back, and to increase flexibility of the spine. Strength-training exercises then protect a horse against future injury.
Having a qualified farrier goes a long way to improve quality of gait and to relieve undue stress on the horse’s back.
Extracorporeal shockwave therapy (ECST) may relieve pain for horses with spinal osteoarthritis.
Chiropractic therapy should only be implemented after a careful veterinary evaluation to localizes the source and reason for pain.
VETERINARY VIEWS
“Asking a horse to perform tasks difficult for his genetic constitution can put considerable strain on the entire body, often resulting in problems with poor performance and attitude.”
SPEEDHORSE August 2022 93