How to diagnose and treat back pain in the horse.

Abstract

Back pain results in decreased range of motion and limited flexibility of the thoracolumbar spine, and it leads to performance issues in the equine athlete. Ancillary therapeutics and alternative therapies are often administered to patients with back pain. Such treatments without an accurate diagnosis fail to provide sufficient pain management in the affected horses. It is critical to obtain a complete performance history and assess each horse’s back through detailed palpation and visual inspection at rest and in motion. Specialized imaging techniques such as nuclear scintigraphy with digital radiography are able to diagnose and direct management of equine back disorders. The treatment of affected horses aims to alleviate discomfort and muscle spasm to make the horse as comfortable as possible to perform while promoting muscle function and strength. Some of the most effective therapies performed in our clinic for successful management of back pain include extracorporeal shockwave therapy (ESWT), mesotherapy, injections with corticosteroids, and systemic tiludronate therapy. At our practice, these non-invasive to minimally invasive medical treatments have been favorable for return to athletic use. This manuscript discusses multiple therapeutic options for thoracolumbar inflammation after diagnosis by moving, clinical, and imaging evaluation.