What Are Kissing Spines?

We explain what kissing spines are, the treatment options and rehabilitation post-treatment.

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We answer your questions about kissing spines and the treatment options available to your horse.

What Are Kissing Spines?

The top of the vertebrae of the spine that comprise the back, are known as the dorsal spinous processes. In kissing spines the gaps between these processes become smaller, and the bone starts to get closer together and can rub or interfere with each other causing pain.

This can be identified by radiographs, but not all horses with kissing spines on x-ray require treatment, some normal horses have changes on x-ray that are not causing the horse a problem. The more dramatic changes on an x-ray do not necessarily correlate with the amount of pain the horse appears to show.

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Back pain caused by kissing spines is not uncommon, however other causes of back pain such as lameness (causing the horse to develop secondary back muscle pain) or pain in the supporting ligaments of the spine. Therefore it is important to make a definite diagnosis before embarking on treatment, this is likely to involve careful examination, x-rays, scans and response to nerve blocks. Sometimes the response to medical treatment with anti-inflammatory injections can help confirm the diagnosis.

What Are The Treatment Options?

There are two options available to your horse:

  • Medical treatment
  • Surgical treatment

Medical Treatment

Some horses respond well to anti-inflammatory corticosteroid injections injected directly into the space to make the horse temporarily more comfortable. This is then followed with a program of rehabilitation to encourage the horse to use its back more normally and ‘open up’ the spaces between the vertebrae.

Some cases do not require any further treatment.

Surgical Treatment

There are various surgical options available depending on the changes present in the individual horses back.

These vary from a minimally invasive surgery to cut the ligaments between the impinging processes (desmectomy) to complete removal of some of the dorsal spinous processes.


Many horses rehabilitate very well, with appropriate aftercare. This includes plenty of ‘pilates’ type groundwork and physiotherapy.

Some horses, especially young horses, require further intensive rehabilitation as they may not have an established way of going, and may never have been comfortable in ridden work prior to the surgery.

Read our case study that describes such a horse, and her progress following treatment.

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