Page 802 - Adams and Stashak's Lameness in Horses, 7th Edition

768 Chapter 6

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Figure 6.6. Digital pressure on the dorsal process of T16. Both Figure 6.8. Provocation test for sacroiliac joint pain. The left hand
index fingers are located on the dorsal process with strong of the examiner is on the right tuber ischium, and the right hand is
downward pressure to place load on the intervertebral ligament, on the tuber coxae, making rocking motion in the cranial direction.
facet joints, and the intervertebral disc.

Figure 6.7. Digital pressure on the right tuber sacrale. Pressure
is placed downward and slightly to the median so pressure is placed
on the bone, dorsal sacral ligaments, and sacroiliac joint.

spine that stems from limb lameness. In humans, contrary
to the belief that secondary back pain is very common, Figure 6.9. Pain provocation test for sacroiliac joint pain, making
a rocking motion in the caudal direction.
there is little literature on this topic other than some papers
on the influence of leg amputation or secondary back pain
due to tumor metastasis in the spine. One can assume that indicates significant trauma to the spine, resulting in later
specific changes in gait in humans can eventually lead to symptoms of back pain. In the author’s opinion, these are
(over)compensation in the spine, resulting in secondary clear cases of primary back pain. When the pathology is
pathology in the spine. However this requires a consider- located more in the soft tissues of the spine, with strain of
able duration of time to occur because this phenomenon spinal ligamentous structures or muscles, it is more difficult
typically presents in people in their 50s. One could to assess whether this is primary or secondary back pain.
question whether secondary pathology of the spine has Complete physical examination is necessary to evalu-
time to develop in horses, since most performance horses ate the complete condition of the horse and assess poten-
are much younger, between 4 and 16 years of age. tial sources of coexisting limb lameness (primary or
In the author’s experience, in cases with clear pathology of secondary). In the author’s experience, when no clear
the spine such as facet joint osteoarthritis, pathology of the pathology is found in the spinal structures and coexist-
intervertebral disc, desmopathy of spinal ligament structures, ing limb lameness is present, back pain is secondary.
and sacroiliac disease, as well as cases with fractures of spinal When the coexisting limb lameness is treated, the accom-
structures, very often in the history, there is an incident that panying back pain diminishes or dissolves.