Got your back
March 6, 2013
There are many types of back injuries in horses, including acute and chronic problems and repetitive injuries caused by simple use. Any of these can hinder a horse's ability to perform. Tia Nelson, a veterinarian and farrier from Helena, MT, says back problems can cover a wide spectrum of situations and present a variety of signs. "The horse may simply not be performing as well as you'd expect him to, or he may suddenly change behavior and start bucking. He may be reluctant to take a certain lead, or refuse to jump (if he's a hunter/jumper) if his back is sore. He may not want to go downhill. A sore back can be very inhibiting for an athletic horse that is working," she says.
"Some horses resent being saddled because they know the saddle is going to cause more pain. They become cold-backed or sour about having a saddle put on their back," said Nelson. Identifying the problem and pinpointing the source of it can sometimes be a challenge, though.
The horse's back is very long, with many regions at risk for injury, strain and pain. "I see a lot of lower back pain due to strain, and also a lot of saddle fit issues. I saw one horse years ago – before I went to vet school – that I was looking at as a farrier because the horse was starting to become club-footed on one front foot. The horse was also resenting work. The rider had changed saddles, and when he changed back to the saddle he'd used earlier, the horse's feet improved, and so did the horse's attitude," she says. When his back no longer hurt, the horse walked more normally again.
Back pain can be due to something as simple as improper saddle fit or as complicated as being kicked or wrenching the back when slipping/falling. "The back can be readily injured if a horse pulls back and the rope breaks and he tumbles backward," says Nelson.
“Some horses resent being saddled because they know the saddle is going to cause more pain. They become cold-backed or sour about having a saddle put on their back.”
Tia Nelson, a veterinarian and farrier from Helena, MT
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"If a horse's front feet are too long in the toe, with or without underrun heels, his lower back may show compensatory pain. If one part of the body hurts, you try to protect it by taking the weight off that part. A horse trying to put less weight on the heels of his front feet will be using his lower lumbar spine too much, trying to shift more weight to the rear legs. We see a lot of horses that are back sore because they are actually foot sore. As soon as we correct the foot issues, the back pain resolves," she says.
Nelson uses a variety of treatments for sore backs, including chiropractic manipulations and acupuncture. "There are some sore-backed horses whose owners ask me to do chiropractic or acupuncture on them, that I know are sore from feet issues. In these instances I prefer to address the hoof imbalances before I work on the back and upper body problems."
"I probably use chiropractic methods more often than acupuncture because it's a modality I am more comfortable with. I do motion palpation along the back and identify spots that are not moving the way they are supposed to move. Then I bring the joints into some tension and give a thrust and adjust the back. It's amazing how much difference this can make for the horse. Sometimes it takes more than one visit, depending on how much is wrong," she says.
She uses acupuncture more often when there is muscle pain rather than a bone/joint problem. "If I am palpating and I feel that it's a muscle problem, acupuncture seems to help," says Nelson.
"I generally talk to people when I am working on their horse, and explain what I am feeling and what my goal is with the chiropractic adjustment I plan to make. Sometimes I also use non-steroidal anti-inflammatory drugs on a back injury (to help relieve swelling, inflammation and pain) and sometimes I use steroids. It's important to identify the problem and figure out if it's an acute injury or a chronic problem. With some horses it can be difficult to resolve chronic pain from an old injury," she says. But it may be possible to make the horse more comfortable. "I discuss this with the client and try to determine what we can actually expect. Sometimes it's something we can't fix." This can be discussed, and then the owner has some idea about the horse's chances for recovery or pain relief.
Dr. Tim Holt, Colorado State University, works with many equine patients that come into the large animal hospital with lameness issues. "We've found that about 80 percent of lame horses have back pain as well. Often we can take care of the lameness, but the horse still doesn't want to perform. So we've been looking more closely at these horses to try to figure out why they still have pain and don't want to go back to work," he says.
"We start looking for back problems in some of these horses, looking at sore muscles and all the facet joints in the back." The horse has many small joints along the backbone – several between each vertebrae.
"I do a lot of physical therapy, acupuncture and chiropractic work on some of these horses to try to rehabilitate them back into training," says Holt. People often don't think a person can pop a horse's back and get the joints back into place like we do with humans – since the horse is so much larger, with thicker/stronger back muscles. Indeed, it would be hard to manipulate the horse's back the way a chiropractor manipulates a human back.
"I work on each individual muscle, and each individual joint within the vertebral bodies. I am not working on the whole back; I take it at each segment – a little part here and there that needs some help," he explains.
These horses have usually already gone through the entire traditional lameness workup with nerve blocks, palpation, etc. "I am usually called in when that doesn't lead to a diagnosis and people still cannot figure out the lameness problem," says Holt.
He tries to pinpoint the problem and then rehabilitate the horse, via acupuncture and chiropractic manipulations. "I put this all together in what I call Manual Therapy," he explains.
This type of examination – and assessing the most important acupuncture points – can help identify pathology (showing regions of pain or loss of motion) in specific areas of the body, and determine which points may be needed for specific treatments. A thorough Manual Therapy evaluation utilizes pressure, palpation and touch of more than 200 diagnostic acupuncture points, observing the horse's reaction.
"It is important to not make a diagnosis just from one reactive point. You need to put the entire clinical picture together, utilizing the history of the horse, the present complaint and clinical signs, physical findings, lameness exam, and an accumulation of all the reactive diagnostic acupuncture points," explains Holt. "We put this all together to help us focus on the area(s) of concern."
There may be painful areas due to restricted motion in a certain joint or joints. The back has several sections, with different types of vertebrae in each section. There are 18 vertebral bodies in the thoracic area, for instance. "Each one of those has 12 different facet joints. Thus there are about 360 small joints in the horse's back," Holt says. It's no wonder the horse suffers back pain at times.
"In my examination I try to isolate joints in the back that are not moving correctly. If there is even one joint that is not moving, the one in front of it and the one behind it have to work overtime to compensate. Then the muscles around it get sore. My job is to find that spot and try to stimulate that joint to move correctly," says Holt.