09/01/2026
🔷 Kissing Spines (Spinal Crowding Syndrome)
Both horses in the first photo have kissing spines.
The top horse shows what many people recognise as the classic back shape often associated with kissing spines. The bottom horse, however, has a back that looks better than many horses currently competing at local shows—yet he also has kissing spines.
This highlights an important point: you cannot diagnose kissing spines based on appearance alone.
The second photo shows the results of a 4 month carrot stretching program (discussed below) in a 14 year old thoroughbred. This was with stretching only, no riding. Top is after, below is before.
Kissing spines refers to a condition in horses where two or more of the dorsal spinous processes (the bony projections extending upward from each vertebra) are positioned so closely that they touch or rub against one another. This can lead to back pain, bone cysts, arthritic changes, and other secondary issues (Kentucky Equine Research).
Crucially, kissing spines is often secondary to another problem. It is frequently the end result of long-term dysfunction rather than the original cause. Horses that have not been ridden or strengthened correctly, or that have been compensating for chronic issues elsewhere in the body, may eventually develop kissing spines as part of a larger biomechanical picture.
The encouraging news is that many cases can improve—and even become functionally reversible—when managed correctly.
✳️ Recent Research
A study in 2022 used a genome-wide association approach to investigate whether kissing spines (overriding spinous processes) in horses has a genetic basis. By analysing radiographic severity scores and genetic data from performance horses, the researchers identified specific genomic loci on chromosome 25 that are significantly associated with increased severity of the condition. The findings support the conclusion that kissing spines has a heritable component, rather than being caused solely by training, conformation, or management factors.
❇️ Key interpretation
The identified genetic variants increase a horse’s susceptibility to developing kissing spines, but do not directly cause the condition; environmental, biomechanical, and management factors are still required for the disease to manifest.
Reference - Research in Veterinary Science (2022). Genomic loci associated with performance-limiting equine overriding spinous processes (kissing spines).
🔷 How Kissing Spines Affects Movement
A horse with kissing spines is typically reluctant to flex through the back and therefore cannot use its body to its full potential. To avoid discomfort, the horse alters posture and movement patterns, creating compensations that place excessive strain on muscles, joints, ligaments, and tendons elsewhere in the body.
🔷 Causes of Kissing Spines
Congenital or conformational factors
Incorrect rider-to-horse weight ratio
Weakness and instability in the multifidus muscle system
Incorrect or unbalanced riding and training
Lack of core strength
Poor postural stability
Starting horses too young, or doing too much too soon
🔷 Signs and Symptoms of Back Pain in Horses
Cold-backed behaviour
Fidgeting during grooming or tacking up
Nipping, biting, or kicking when the girth is tightened
Behavioural issues under saddle (bucking, rearing, kicking out, head tossing)
Dragging one or both hind toes
Difficulty striking or maintaining the correct canter lead
Awkward or resistant gait transitions
Shifting or inconsistent lameness
Stiffness to one side
Inability to flex, round, or collect
Many of these signs can occur with other biomechanical dysfunctions. However, if your horse is receiving regular bodywork from an appropriately qualified professional, the saddle fits correctly, and there is no improvement, then something deeper may be going on. At that point, veterinary assessment and diagnostic imaging are essential.
❌ A Note on “Cold-Backed” Horses
In 99.9% of cases, there is always a reason.
You cannot simply say, “My horse just does this.”
No—they don’t.
Cold-backed behaviour indicates discomfort somewhere, which may be related to:
Muscle tightness
Restricted vertebral motion
Ribcage pain
Gastric ulcers
Poor saddle fit
Kissing spines
Shoulder or limb pain
Incorrect rider-horse weight ratio
Insufficient strength through the back for the work being asked
🔷 Diagnosis
Diagnosis of kissing spines must be made by a veterinarian. It is based on a combination of:
Clinical history
Physical examination
Thermography (in some cases)
Radiography (X-rays)
The affected vertebrae are most commonly in the thoracic or lumbar region, particularly beneath the saddle area. In some horses, four or more vertebrae may be involved.
🔷 Treatment
🔹 Physical Therapy
As osteopaths, we take a holistic approach. Successful long-term management of kissing spines requires both hands-on treatment and a structured rehabilitation programme. This rehab work is not temporary—it must be maintained throughout the horse’s career.
The goal is to ensure the horse is functioning optimally throughout the entire body, minimising compensations that overload the spine. Treatment may include:
Spinal mobilisation
Myofascial release
Targeted soft-tissue techniques
Stretching
Cranial techniques
Whole-body rebalancing
🔹🔹 The Multifidus System & Carrot Stretches 🥕🥕
Beneath the spine lies a complex system of deep stabilising muscles known as the multifidus system. These are the horse’s true “core” muscles. They must be strong and functionally short to prevent spinal dipping and to maintain space between the spinous processes when carrying a rider.
Simply riding the horse more forward does not strengthen the multifidus—especially if the horse has already learned to move with a dipped or braced back.
As horses progress into more advanced work, superficial back muscles (such as the longissimus dorsi) may become increasingly tense in an attempt to protect the spine. Increased impulsion combined with this tension can actually worsen compression between the spinous processes. Over time, the vertebrae may become kinked, allowing the processes to touch or rub.
When the spine loses elasticity, force can no longer be absorbed through the horse’s centre and is instead redirected forward into the shoulders. This causes the base of the neck to drop between the shoulder blades, pushing the horse onto the forehand, reducing suspension, and creating heavy rein contact. In advanced cases, involvement of C6, C7, and T1 may contribute to significant bracing and resistance in the contact.
🥕 Carrot Stretches
Carrot stretches are one of the most effective exercises for activating the multifidus system. These dynamic mobilisation exercises encourage spinal mobility, core stability, and controlled postural strength.
🔶 Recommended Exercises
Perform 5 times per week for rehab
Perform weekly for prevention
Hold each position for 5 seconds before rewarding.
Repeat each exercise 5 times.
Sagittal (Flexion) Exercises
Chin-to-chest
Chin-between-knees
Chin-between-fore fetlocks
Thoracic/sternal lifts (stimulate lift and hold of the back)
Lateral Exercises (Both Sides)
Chin-to-girth
Chin-to-hip
Chin-to-hock
This programme is the human equivalent of approximately 45 abdominal crunches per day.
🔹 Gymnastic Exercises (When Riding Is Appropriate)
In milder cases where ridden work is still possible, gymnastic exercises can help maintain topline and core strength:
Long-and-low leg yield with the neck bent away from the direction of travel
Bend and stretch at walk on small circles
Turn on the forehand (start with quarter turns)
Walk pirouettes (progress gradually)
🔹 Saddle Fit
Changing or refitting saddles is often essential. Saddle fit should be reassessed regularly, as it will change as your horse’s musculature and movement patterns improve.
🔹 Medical Treatment
In less advanced cases, veterinarians often begin with conservative management to reduce pain and inflammation and break the muscle-spasm cycle.
This may include:
Corticosteroid injections
Non-steroidal anti-inflammatory drugs
Veterinary acupuncture
Therapeutic ultrasound
Shockwave therapy
Surgery may be recommended in severe cases or when conservative management fails.
🔷 Prognosis
Every case is different, but the majority of horses with kissing spines can return to work when diagnosed early and managed appropriately. Some horses return to their previous level of performance, while others may need to step down slightly to remain comfortable.
Even after formal rehabilitation ends, ongoing correct training is essential—working in self-carriage, encouraging back rounding, maintaining balance, and continuing multifidus activation exercises (such as carrot stretches) on a reduced schedule.
