Your horse has neck and/or back pain. The signs are obvious: sensitivity when grooming and saddling, resistance to rider weight, stiffness and pain when manipulating the neck and back, and a notable decrease in performance. But what is causing the pain, and what can you do about it?

"Despite being common and obvious in many cases, identifying the exact source of the neck or back pain can be complex," said Richard Mitchell, DVM, a private practitioner in Newtown, Conn., at the 12th Congress of The World Equine Veterinary Association, held Nov. 2-6, 2011, in Hyderabad, India.

According to Mitchell, "A thorough physical examination coupled with a complete therapeutic approach can frequently identify, then relieve symptoms of neck and back pain."

Lower limb problems that cause the horse to carry himself differently can lead to muscle stiffness and soreness. Thus, identifying and correcting lower limb problems could resolve neck and back issues.

Once lower limb problems are ruled out the veterinarian should perform palpation, passive and active flexion tests, jogging, longeing, and watching the horse move under saddle in a systematic fashion. If he or she identifies a "sore spot," radiographs (X ray), ultrasound, thermography (measuring body surface temperature and depicting inflammation by detecting and displaying heat), and possibly nuclear scintigraphy (bone scans) can be used to better characterize the underlying problem.

"This type of thorough physical exam and careful observation of the horse in motion can enable the practitioner to accurately assess the horse and address problems in an effective manner," relayed Mitchell. "A variety of techniques are currently available for horses with neck and back pain."

Examples of various treatments include:

• Injecting corticosteroids into painful joints such as the temporomandibular joint (jaw) or the joints between the individual vertebrae in the spinal column;
• Non-steroidal anti-inflammatory drugs (NSAID) to decrease inflammation;
• Muscle relaxants;
• Mesotherapy (injecting small volumes of corticosteroids and local anesthetics into the mesodermal tissue under the skin) to reduce discomfort and improve range of motion in cases of neck pain;
• Chiropractics, acupuncture, and therapeutic ultrasound to improve range of motion and comfort;
• Ensuring proper saddle fit;
• Estrone sulfate to help improve muscle tone;
• Extracorporeal shock wave therapy (ESWT); and
• Time off from performance in the case of trauma (e.g., fracture or severe ligamentous strain).

The exact treatment will depend on the underlying cause and must be determined by a veterinarian, potentially in concert with a qualified equine physical therapist.

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.