09/08/2026
I work with more horses with kissing spine than I can count. Then when we include horses with chronic back pain, that number skyrockets even higher.
These horses have numerous overlying similarities, but ultimately, all unique.
How it presents with one, may be entirely different than the next.
No two bodies are exactly alike.
Everyone is their own storybook💜
We get wrapped up in the bony structures, particularly the dorsal spinous process, I think it is easy to forget about the other structures that lie around the vertebrae.
At the end of the day, it’s easy to do. It makes sense when you think about it.
Kissing Spine = Overriding Dorsal Spinous Processes
Spinous processes could be -
Barely touching
Overriding
Fusing
Etc.
Naturally, the focus gets so honed in on that, and often, only that. What is the severity of how much the spinous processes are “kissing” / touching… But, then we tend to neglect the rest of the story. Not always, but often. Very often. That is truly only the tip of a very large, very important iceberg beneath the surface.
Soft tissue
Nerves & the spinal cord
Fascia
Blood vessels
Ribs
Facet joints
Intervertebral discs
And then, we need to appreciate all the spinal nerves exit at each vertebrae below the spinous processes…. Truly. Let’s really think about that. And where nerves run, so does blood. If nerves become affected, likely so does blood flow. And vice versa. The more and more research-led dissections I am apart of, the more strongly I feel about this.
Many (most) of these structures cannot be fully evaluated on a standard radiograph…. But they are essential for maintaining balance within the body and normal function throughout the back.
This is where I struggle. We often fail to fully respect these delicate, and extremely important, structures.
So, we use all the tools we have available to mask pain and decrease inflammation to get back to performance… But at what expense? Maybe this sounds blunt. And, yes, every case is unique. That’s really important here. But, truly, when the radiographic findings and what the horse is truly trying to communicate do not match, we need to listen.
When one system fails, and a domino begins to fall, so does another. And another. And another. Because the body is so intricately connected.
In some cases, those structures are affected minimally. Other times, the consequences become detrimental.
Radiographic severity, and reading further into the rest of the story, are not always the same.
We need to fully respect what the horse is communicating.
Their behavior.
Their muscle development and posture.
Their movement.
Their compensation patterns.
The diagnosis and imaging findings should be only the beginning of the conversation.
#𝙐𝙣𝙡𝙤𝙘𝙠𝙂𝙧𝙚𝙖𝙩𝙣𝙚𝙨𝙨
