Back pain is recognized as a common and important cause ofpoor performance in athletic horses, which has stimulatedresearch looking into the diagnosis and treatment of the

equine back. In the last few years, new research has been publishedto shed some light on this issue.

There are many different causes of back pain including musclespasms, (the most common cause), neurologic disorders and potentialvertebral joint or bone problems. While all horses experience varyingdegrees of back pain, it should be noted that your veterinarian shouldbe consulted to help identify the underlying cause and develop a treat-ment plan before recruiting other professionals. Mechanisms of mus-

cle spasm, conservative physical therapy methods and complementarytreatments are discussed here that can be used therapeutically and pro-phylactically for our horses’ backs.

There are two major functions performed by different groups ofmuscles in the back. One group acts as locomotor muscles to movethe back, such as the longissimus and iliocostalis muscles. The othergroup acts as stabilizer muscles to stabilize the vertebrae. These in-clude the multifidus and transversus abdominus. The multifidus mus-cles reside on either side of the vertebral column and connect eachvertebra to the one in front of it, while crossing the intervertebral joints.

In people, it is known that low back pain is associated with the sta-bilizer muscles of the back being persistently “turned off” - back painin horses follows this pattern as well. Within a few days after an injuryor lameness, the multifidi begin to shrink (known as atrophy), at theaffected area of the spine.

Atrophy results in the loss of the stabilizing influence of the multi-fidus muscles allowing micro-motion of the inter-vertebral joints,which can predispose horses to developing degenerative joint diseaseat these areas. The behavior of the multifidi is much different than theresponse of the longissimus muscle, which is the large more superficialmuscle that can be easily felt along the top of the horse’s back. Thelongissimus muscle sometimes spasms as it attempts to compensatefor the loss of spinal stability, but does not undergo inactivation andatrophy.

Interestingly, after an episode of back pain resolves, the atrophiedmultifidi do not usually resume normal activity and remain atrophied.The intervertebral instability persists unless specific therapeutic exer-cises are performed.

Exercises that combine stability and mobility have been developedand used clinically to manage back pain in people. Performance ofthese exercises has been shown to reduce the risk of recurrence within12 months after the first episode of acute back pain from about 80% to30%, and to reduce the risk of recurrence over the next 2-3 years from75% to 35%.

So what does this mean for our equine companions?Two studies have used ultrasound to show the benefits of using

baited stretches (also known as carrot stretches) in horses to signifi-cantly increase the size of the multifidus in response to performing thestretches regularly over a period of time. The stretches used in thesestudies were taken from the book “Activate Your Horse’s Core: Un-mounted Exercises for Dynamic Mobility, Strength & Balance,” byNarelle C. Stubbs & Hilary M. Clayton.

IS YOUR HORSE’SBACK PAIN A PAIN

IN YOUR NECK?by Lauren A. Zappitelli, D.V.M., C.V.A.

Arizona Equine Medical and Surgical Centre

Gilbert, Arizona(480) 962-6660

34 Arizona Horse Connection September, 2014

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The first study used eight school horses,and carrot stretches were used for three to fiverepetitions, five days per week for threemonths without any other exercise. The au-thors chose six different levels of the spine tomeasure, and all the horses showed significantincreases in the size of the multifidus, and sig-nificant improvement in spinal symmetry atall six sites (Stubbs et. al 2011).

In another study, significant increase in themultifidus was found in Thoroughbred race-horses in training after performing carrotstretches daily for six weeks. Thoroughbredsin the same training program that did not per-form the stretches did not show the same in-crease (Tabor et. al. 2012).

It seems that the old adage “Never stretcha cold muscle,” doesn’t apply to the stabilizermuscles, and that more benefit comes withstretching them before exercise. Given the ev-idence, adding carrot stretches to your routinecan help treat and prevent issues related tomuscular pain.

As mentioned before, the transversus ab-dominus also plays a role in stabilizing thespine. This muscle belongs to the abdominalmuscle group. Exercises shown to increaseabdominal tone in horses include working ona hill, especially while rating the horse’s speedwhile going downhill, and trotting over poles.

Other complementary techniques used torehabilitate muscles of the back include mas-sage, shockwave and acupuncture.

Acupuncture used in combination withelectrostimulation can be very effective in re-lieving muscle spasms and treating muscularatrophy. Electrostimulation works by sendingsmall waves of electrical current into the body

to stimulate associated nerves, causing subse-quent contraction and relaxation of the muscleand pain inhibition. While there are severalproposed mechanisms as to why Acupuncturecauses pain inhibition, the exact cause has notbeen elucidated, but many studies haveproven this effect.

Many techniques are available for helpinghorses with back pain. Some horses may havemore significant issues than just muscle pain,such as intervertebral joint inflammation orbony proliferation on certain parts of the ver-tebra, and may need more invasive interven-tion. I cannot stress enough the importance ofreaching a diagnosis before treatment withcomplementary therapies is provided. Yourveterinarian can help diagnose, treat andwrite rehabilitation plans and can assess otherfactors like nutrition and saddle fit. Your vet-erinarian should always be consulted in casesof moderate to severe back pain. o

Arizona Equine Medical and Surgical Centre islocated in the southeast Phoenix metropolitan areaand is the largest center of its kind in the southwest-ern states. Arizona Equine has some of the mostsophisticated diagnostic facilities available to equinemedicine today, including diagnostic ultrasonogra-phy, bone scan, endoscopy and abdominal x-rays.The surgical and treatment facilities are equally ex-tensive and include arthroscopy, colic surgery, lasersurgery and many types of soft tissue surgery.

36 Arizona Horse Connection September, 2014

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This month’s question...

I would like to open andclose gates on my horse.

What does my horse need to know to properly

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The first thing is your horse should be softin the face and give easily to the bit. Second,your horse needs to know how to side passleft and right. When you bump the calf ofyour leg or tap lightly with your spur in thecenter between your front and back cinches,he should move laterally with his bodystraight. His front legs should cross over andhind legs cross over with no struggle. Re-member to be patient as this could take daysto achieve properly.

Next go to your gate, sidepass so yourhorse is parallel to the gate and standing qui-etly.

Reach over and undo the latch. Keepingyour hand on the gate, proceed to open it andgo through. Depending on the size of thegate and how it is located, you can either sidepass all the way, back your horse through orwalk through. You then sidepass back withthe gate to close it. I then let my horse standthere for the count of 10 before I move himoff.

I am happy to speak with you about yourhorse issues or resolve problems for you. Ifyou have any questions. please contact me at623-293-7487 or jgiffo6719@peoplepc.com. o