Oh, My Aching Back!  

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Article by Lillian K. Norminton

Back problems are a common cause of poor performance in horses. It has been estimated that as many as 40% of horses with back pain have a soft tissue injury. Identifying and treating back problems is often challenging. If the cause of the problem is not immediately apparent and easily resolvable, then professional diagnosis will be required. Treatment prospects are diverse, from traditional veterinary practice and surgery to alternative therapies such as chiropractic, diet, laser, massage and ultrasound.

Symptoms of a sore back are many and may include:

The signs of back trouble can also be read in performance: a dressage horse is no longer able to do flying changes and bend; a jumper has difficulty shortening his stride while maintaining impulsion, making tight combinations a problem. He may also start twisting behind, while he's still in the air over a jump or just refusing to jump. Though not infallibly so, these signs are the frequent petitions of a bad back, and by doing a bit of "reading between the spines," if you will, you can often detect the source of the pain, or at least narrow the possibilities before you call for your veterinarian's assistance.

Your horse may not present symptoms consistently on consecutive days. It may take a while to determine what type of program, or lack thereof, has contributed to the symptoms when they are present. If you suspect your horse may have a sore back on a given day keep notes on the horse's routine for that day and any subsequent days that your horse seems off and start ruling out causes, one by one.

Potential Causes of Back Problems

Injury sustained from turning out a cold horse or any horse that might hurt himself.

Muscle spasms or contractions from putting cold water on a hot back can also cause back pain. Poor shoeing, improper riding techniques, ill-fitting tack, uneven weight distribution and the excessive weight of horse or rider can all contribute to your horses' backache.

Back problems can also result from seemingly unrelated situations. Equine dental problems can extend their reach to involve a horse's back. In fact, anything that constrains a horse's head carriage--a bad bit, tooth problem, a ham-handed rider-can create back soreness and accentuate any troubles that already exist. If you suspect that your horse is suffering from either a backache or toothache, you can root out the exact source of the pain by riding in a hackamore for a few days.

Back pain may also be a by-product of other conditions -most typically hock problems in both hind legs. Half of the horses with serious back problems have hind-leg trouble. The percentage is even higher among show jumpers because so many of them are troubled by hock disease.

A minor influence but not a sole cause of a sore back is bilateral front-leg lameness. Occasionally, a mild form of this condition, though not severe enough to warrant rest, may cause horse to shift his weight to his back legs, thus accentuating hind-leg and back problems.

If the cause of your horse's sore back cannot be traced to any specific injury or other outside source, then a dietary or enzyme deficiency could be causing muscle distress.

Vitamin E and/or selenium deficiencies can contribute to muscle soreness. A diet too high in protein and/or carbohydrates also can adversely affect muscle function. You may wish to ask your veterinarian to evaluate your horse's food intake based on his age and other factors to be sure it suits his specific needs.

Polysaccharide Storage Myopathy (PSSM), sometimes referred to as Glycogen Storage Disease, is a recently diagnosed metabolic defect. An inherited enzyme deficiency, PSSM prevents normal metabolization of glycogen, a carbohydrate stored in muscles. Glycogen and polysaccharide accumulate and are stored in abnormal levels in the muscles running along both sides of the back. Horses with PSSM often have painful symptoms such as back pain and poor performance caused by muscle atrophy, muscle cramping (tying up), hind limb stiffness, exercise intolerance, sweating, weakness and respiratory distress.

A small muscle biopsy can help diagnose PSSM, and determine if it is causing back pain and poor performance. Contributing factors to painful episodes are excess grain, molasses and sweet feed in the diet and overexertion after a period of rest. Altering diet and training routines diminishes frequency and intensity of occurrences.

Researchers are trying to find the optimal diets to treat PSSM in different breeds. The University of Minnesota has been awarded a grant by The Equine Research Committee of the American Quarter Horse Association to study dietary contributions to PSSM. With a higher fat, lower soluble-carbohydrate diet and regular exercise, many horses with PSSM have gone on to successfully compete as hunters and dressage horses with a minimal recurrence of symptoms.

Precautionary Measures to avoid back injuries from normal activity

To lessen the chance that your horse will suffer a back injury as a result of his normal activity, the horse should have his back protected with a protective saddle pad that will absorb shock and dissipate pressure allowing the back muscles to relax and work freely.

Saddle pads

Saddle pads can provide critical protection for the comfort of your horse's back. Use the best saddle pads you can buy. A monogrammed saddle pad is nice but a saddle pad must do more then carry your number and your horse's name. A saddle pad must be comfortable, well fitting, absorbable, durable, and breathable. Sometimes, it takes more then one pad to do the job, especially if your saddle does not exactly fit the horse you are riding. We have come well beyond wool blankets and sheepskin, so your choices are many.

Gel pads are very popular and come in a variety of shapes and configurations with fleece covers. Gel has the multi-directional shock-absorbing properties of a liquid, eliminating friction sores. Some of the older pads had a tendency to tear and ooze gel. The Alfa-Gel pad is almost indestructible and hand washable.

Orthopedic foam is high-density open cell elastomeric foam that features controlled release air cell technology. Medically tested and proven. Its conforming slow air release design provides exceptional high-energy impact absorption and uniform weight and pressure distribution with virtually no rebound or bounce effect.

The Limpet foam pad is designed to be used directly on the horse's body. The horse's body heat causes the Limpet foam to bond with both the horse and the saddle eliminating saddle slip and reduces lateral and forward movement of your saddle. It is ventilated, allowing your horse's skin to breathe.

Professional's Choice orthopedic pads combine a contoured shape, orthopedic liners and a classic look in one pad, eliminating the need for additional half pads or liners.

Saddle:

If a rider only has one horse and has a new saddle especially made to fit the horse, then the saddle has a chance of fitting. Many riders, especially professionals, who ride many different horses in a day, need to make their saddles as comfortable as possible for each horse they ride.

As a saddle develops middle-age spread, it may sit too low at the throat, thereby resting uncomfortably on the horse's withers, which aren't suited to bear the weight. As a matter of fact, a properly fitted saddle does not hit the horse at any point along his backbone. Ideally, the pressure exerted by the rider is spread out over a wide, uniform area. You can see how well your saddle meets this criterion by sprinkling talcum powder on your horse's back, putting the saddle in place, pressing down on it firmly and then removing it. A look at the saddle's underside will show where it has touched the horse. A good-fitting model will have traces of talcum distributed over a fairly wide area. The more narrow and concentrated the talcum residue, however, the greater the propensity for the saddle to inflict back bruises.

In addition, most horses show some uneven, asymmetrical, conformation. Sometimes one shoulder or one hip is more developed then the other, which can cause more weight being placed on one shoulder or hip muscle from the weight of the rider in the saddle. No saddle is made to fit an uneven horse. This constant pressure caused by the unevenness can over-stimulate a muscle group, reducing muscle efficiency, especially in pelvic girdle muscles (rear end), forcing the horse to be more on the forehand, and favor leads and diagonals, among other things. When constant pressure is applied to any muscle group normal blood flow is decreased causing temporary anemia, or ischemia, in muscles. Those muscles cannot be used again until the normal blood flow resumes.

If all is seemingly well with the saddle, then perhaps the problem is the person sitting on it. Adopting a "softer" style and even shedding a few pounds will ease the burden the horse must bear. Some riders personify their horses' back pain, speaking of the need to ride through resistance.

Categorizing The Pain

In descending order of occurrence --and ascending order of risk--the five kinds of back injuries are:

Choosing a treatment can sometimes involve trying several therapies until the most effective one is found. It should be remember that non-invasive therapies are dependent upon consistent application. They cannot be expected to work overnight. Often the therapy is designed to be used in conjunction with prescribed exercise to rehabilitate any muscular weakness the horse may have. The non-invasive alternative therapies may also be prescribed in conjunction with conventional veterinary medicine.

Chiropractor

.Animal musculoskeletal manipulation has existed concurrently with human care, though less known. In history, musculoskeletal manipulation is documented in ancient China , is found in the writings of the Egyptians and in the writings of Hypocrites and Galen as well.

The basic principles of chiropractic, as we know them today, are based on the power of recuperation that is innate in every living organism. These principles simply recognize that all organisms show attempts to restore their systems to homeostasis after an insult to the organism has occurred.

Chiropractic recognizes that the body's ability to maintain or re-establish homeostasis is affected by and integrated through the nervous system. Chiropractic, by positively addressing the nervous system, addresses the whole body. The primary goal and purpose of chiropractic, in a two-word summation, is to optimize health.

Maintenance of cellular and body functions are reflex based, whereby information is transferred from the cell level via the neurological system to the central nervous system through afferent pathways. That information is processed at the level of the spinal cord, brainstem, or brain and then the proper course of action is reflexively transmitted back to the cellular level. That is to say, the nervous system controls or coordinates all tissues and systems in the body, including hormonal and immune. As a result, a sense of well being is often a welcome result of chiropractic.

Any alteration of nerve function affects health. The most common and major source of nerve function alteration is associated with the lack of spinal joint motion. When spinal joints lack the appropriate motion the universal result is some degree of inflammatory response in the area of the nerve root, resulting in abnormal pressure or traction on the nerve.

Goals of Chiropractic

The clinical goals of chiropractic manipulation are to restore normal joint biomechanics and nerve function. Improvement in this category often provides pain relief to the patient. Pain, of course, is likely the reason we are called to see the patient. Other important goals include promoting healing, and reducing the likelihood, severity and frequency of recurrences. In addition, the optimizing of performance, especially in the equine, is often another reason the chiropractor is asked to see a patient.

Of extreme importance in chiropractic is the goal of reducing the progression of degeneration. A joint that does not move freely through its range of motion has abnormal biomechanics and will progressively degenerate, even in the absence of pain or other symptoms. Even recurring partial immobilization can lead to degeneration.

Chiropractic adjustment can be very helpful in preventing recurrences, but is highly dependent on client compliance in terms of allowing the appropriate number of visits, and allowing adequate time for complete healing before asking for full performance. Also, to prevent recurrence, it is most important to evaluate and correct such problems in the equine as shoeing, proper saddle fit (as well as other tack), dental problems and other aspects such as limb pathology that may have set up the need for chiropractic adjustment. In other words, as in all health care systems, it is imperative to address the whole animal as an integrated being.

Saying that chiropractic care is indicated whenever the vertebral subluxation complex is present can best summarize frequency of treatment and appropriate number of treatments. Animals do tend to "hold" adjustments better and to not require as many treatments as humans. Chronic problems that have been present for extended periods of time may logically require frequent visits.

Massage therapy

The basics of massage therapy for horses originated from the age old notion that physical touch can heal. Along with healing traumatized muscles it also can soothe, calm and relax a horse and rider alike. The equine massage therapist uses hands and body to manipulate soft tissue for the prevention and treatment of muscle injuries, thereby maintaining free motion and encouraging optimum performance in horses.

Massage therapy is a very valuable tool in preventative as well as remedial therapy. Sport massage therapy which is a branch of massage therapy specializes in preparing the muscles for exertion and easing the soft-tissue damage afterwards. Neuromuscular structural realignment, in which an unbalanced body is "re-educated" by eliminating the chronic pain response. These therapeutic techniques seek to release patterns of chronic tension through slow strokes and deep finger pressure on the contracted areas. Relaxing massage, on the other hand, relies on superficial strokes applied without reference to diagnosed soft-tissue injuries. Therapeutic massage improves soft-tissue health through several other mechanisms.

Equine massage can help reduce inflammation and swelling in the joints, thus alleviating pain. Massage promotes the healing process by increasing the flow of nutrients to the muscles, and aiding in eliminating excess fluids and toxins. So, the horse's performance is enhanced, and muscle injuries heal faster. There are several types of equine massage, using both eastern and western techniques.  Equine Sports Massage Therapy Massage" helps develop muscle tone and range of motion. It stimulates circulation by loosening knotted muscles.

Acupuncture:

Acupuncture is based on the construct that health is determined by a balanced flow of energy (electrical, chemical and hormonal) through all tissues in the body. The general term used in Traditional Chinese Medicine for energy is Chi. According to the Chinese model, this energy circulates in the body along pathways called meridians. Each meridian is linked to specific internal organs and organ systems. A key element of diagnosis is to check the energetic activity at points along these 14 meridians. Treatment involves stimulation of appropriate points to enhance the flow of the appropriate form of energy. Stimulation of acupuncture points is provided by such means as needles, heat or laser light. The symptoms and causes of problems, such as musculoskeletal pain or internal medical problems can be ameliorated or eliminated by appropriate stimulation or sedation of points. Acupuncture helps in the leaning (crooked) horse, by loosening joints and muscles, enabling him to stand up straight.

Magnetic therapy

Magnetic therapy is nothing new. The effects of magnets on biologic processes have been discussed for over 2000 years! The idea that magnetic therapy could be used to treat disease began in the early 16th century with the Swiss physician, philosopher and alchemist Paracelsus, who used magnets to treat epilepsy, diarrhoea and haemorrhage. Magnetic therapy really took off in the mid-18th century when Franz Mesmer, an Austrian doctor who also helped began the fields hypnotism and psychoanalysis (and from whose name the word "mesmerize" was coined) opened a popular magnetic healing salon in Paris in 1777 to treat the untoward effects of the body's innate "animal magnetism." The Sears catalogue advertised magnetic boot inserts in the late 1800s. From there, in spite of intense condemnation from the scientific community, the race to use magnets to heal was on.

Biomagnetics is the application of solid-state, monopoled (able to use one pole at a time) magnets to the body to encourage the body to heal itself. The negative field is considered generally health promoting. Reported benefits include: pain relief, reduction of inflammation/swelling, infection and insomnia, improved ability of the body's cells to absorb more oxygen and maintain a healthy pH balance, and a general slowing down of the aging process.

There are two classifications of magnets, permanent (or static) magnets and pulsed electromagnetic field magnets (PEMF). Normally permanent magnets are taped over an effected area on an animal for a period ranging from a few minutes to a few hours to days. A relatively new addition to permanent magnets are bipolar magnetic strips or pads that can be taped on to a patient. Bipolar magnets are magnets where the north and south face are laid down parallel to each other side by side or in concentric circles. One manufacturer lays them down in checkerboard patterns. With all these patterns, both the north and South Pole come in contact with the skin. These strips usually have a field strength of 500 gauss. Each manufacturer often claims that their magnetic configuration is the best.

There are different theories as to what is the best approach to applying magnets. Some recommend placing one specific pole, north or south on the injury, north relating to the negative pole and south relating to the positive pole. Advocates of this approach recommend using the North Pole for healing injuries. Some practitioners report that the South Pole stimulates growth of living tissues, which includes bacteria and viruses or even cancerous cells. Hence, they feel that the South Pole should never be used. Though many people use the bipolar magnets, apparently without any problem.

Pulse Magnetic Therapy (PMT) is also known as pulse magnetic field therapy (PMFT) It is based on the principle that all cells in the body have a weak, natural electric current flowing through them. The currents are caused by electrically charged particles in the cells called ions. Ions affect the metabolism, or the work of the cell. PMT is a method of applying a magnetic field to the cell, which sends a weak electrical signal, influencing the interaction of the ions, and the flow of nutrients in the cell. Enhanced circulation and nutrient exchange is said to speed the healing process and reduce down time.

PMT has been used since the 70's to treat sore backs, sore muscles and stiff, arthritic joints. The newest form of this therapy, the Bio-Pulse tm Magnetic Therapy System has been available since 1994. Pulsing Magnetic Therapy penetrates completely through the joints and muscles. The Bio-Pulse blanket, with coils located at strategic locations on the horse, provides a strong, pulsing magnetic field. How does pulsating magnetic therapy differ from magnetic wraps and pads?

Laser/LED's

Generally used for soft tissue injuries. LED's (Light Emitting Diodes) are used for superficial skins, wounds and muscles, while low level lasers are used for deep tissue work. A hand-held laser combined with deep massage will help to breakup the knotted muscles and accelerate treatment of scar tissue, cartilage wear and muscle atrophies. According to Dr. Melyni Worth of Foxden Equine Nutrition and Therapy (www.foxdenequine.com), these therapies help reduce pain and inflammation, increase immune system response, assist in healing arthritic lesions, stimulate acupuncture points and encourage repair of tendons and ligaments.

The action of laser light on tissue is quite similar to photosynthesis in plants. Photons of light from a laser penetrate deeply into tissue and power the synthesis of adenosine triphosphate (ATP). ATP is a molecule that is a major carrier of energy from one reaction site to another in all living cells. Increases in ATP as a result of laser light increases the energy available to the cell so that the cell can take in nutrients faster and get rid of waste products quicker.

Laser light is also beneficial in the production of Collagen. Collagen is the most common protein found in the body. It is estimated that 80% of a horses body is made up of this important fibrous protein. Collagen is the essential protein required to replace old tissue or to repair tissue injuries.

Research has indicate that laser light is capable of doubling the size of the lymphatic ducts and thus increasing the rapid removal of protein wastes from areas of swelling. Many types of treatments will increase blood flow but laser light will also significantly increase the formation of new capillaries in damaged tissue. Centurion System makes their units available for sale or rent.

Microcurrent

Every cell in the body functions on the basis of electricity. Each cell has an electrical membrane potential. As the electrical potential shifts, the membrane depolarizes. It is this electrical energy shift that is responsible for the entry of nutrients into the cell and likewise provides the means of removing the metabolic waste from the cell.

The magnitude of the currents at cell membranes (existing for the purpose of transmitting information and material to and from cells) are very small. They range within a few hundred millionths of an ampere (microamps). In the case of some cells, the current is measured in the billionths of an ampere range (picoamps). Thus, in the case of a mammalian body's use of electricity, we find that "less is more."

Higher levels of current may have some beneficial effects, but may be deleterious. For example milli-amperage (thousandth's of an ampere) may help control pain but may delay actual healing.

All cells, when damaged through trauma, toxicity, etc., change their electro-vibratory rates. The ability of the cell membrane to act as a transfer mechanism for nutrients and waste products then changes for the worse. Cells cease to function at a normal level. To state it metaphorically, each cell acts like a tiny battery. Damage can be likened to a weak battery that cannot power the unit.

Application of minute amounts of current through sick and injured cell areas stimulates the cells to function again in a normal manner. When damaged or weak cell are even momentarily electrically stimulated, cellular function commences and healing and regeneration are stimulated. That is to say, with a little help, the body works to restore itself to balance/homeostasis.

Tiny structures in each cell produce the fuel that the body runs on. That fuel is called Adenosine Triphosphate (ATP). Cells that are toxic or otherwise injured produce very little ATP. One of the most important values of microcurrent applied to the tissues is that the cells so stimulated produce increased amounts of ATP.

Another known valuable effect of appropriately applied microcurrent is an ability to increase micro-circulation (a proliferation of tiny blood vessels). Increased circulation bathes the cells in more oxygen and nutrients. Additionally, microcurrent enhances protein synthesis, enhances the contraction of muscle (both skeletal muscle and smooth muscle) and helps combat inflammation and infection. As mentioned, the changes that are created in the cell membrane permeability promote regeneration of those cells. Each treatment with microcurrent builds on previous treatments until the tissues are progressively able to operate once again on their own.

We use microcurrent in acute trauma cases, post surgical situations and chronic long-term problems such as degenerative joint disease (bony arthritis).

This type of therapy was originally used to treat human beings with kidney stones, by breaking up the stones without the need for invasive surgery. More Extracorporeal shockwave therapy?

Extracorporeal shockwaves are high-pressure, low frequency sound waves, generated by a device outside the body and applied to the recently, shockwaves have been used to treat a range of orthopaedic conditions in both human beings and animals.

When the shockwaves meet tissue interfaces of different densities, the energy contained in the shockwaves is released and interacts with the tissue. The shockwaves appear to relieve pain and accelerate healing within the injured tissue, although the mechanism for these effects is unclear.

Shockwave therapy has been successfully used to treat Suspensory ligament injury, Tissue calcification, Fractures or joint ankyloses , Fatigue injury to bone , Back pain for impingement of dorsal spinus processes and soft tissue inflammation, Navicular disease, Bone exostosis.

Therapeutic Ultrasound:

Ultrasound therapy creates deep heat beneath the horses' skin surface and is proven to increase cellular activity and circulation in damaged muscles, tendons, and ligaments by stimulating blood flow, breaking up calcium deposits and controlling swelling. There is also a reduction in muscle spasms and an increase in connective tissue mobility. Ultrasound combined with stretching exercises will elongate muscle and reduce scar tissue restriction thereby increasing the healing process in deep muscle, tendon and nerve tissue. HBS Equine Therapy, Inc. makes affordable, portable ultrasound equipment.

Each of the above therapies has one thing in common, that being the increase in blood flow and removal of toxins, which allow the body to heal itself.

Management Strategies

Where the prognosis and treatment of sore-backed horses are concerned, the reviews are decidedly mixed, with horses that are less sore after work enjoys a better prognosis than those for whom riding increases pain. Considered in too, more than half the horses affected by back problems will recover and stay recovered if given sufficient rest and nothing more. The amount of rest depends on the severity of the horse's condition and sometimes on his schedule. Three to six months' rest is usually recommended for horses with a history of chronic back pain. Horses with acute strain involving the point of the croup require four to eight months' rest after the pain subsides to minimize the possibility of recurrence. Not surprisingly, rest will help the least severe injuries--muscle problems and minor ligament problem- the most. The more severe injuries such as ossifying spondylosis will recur with return to work.

In many cases, the average horse ridden by the average rider with an undemanding schedule may not even need to be rested if he suffers only from muscle strain or bruising. A hunter can tolerate a little back pain if his rider compensates by posting on one diagonal all the time. There are plenty of horses with bad backs who are entirely adaptable to normal trail riding.

Good horsemanship, training and dressage will often minimize and sometimes eliminate minor back conditions without the need for rest. As happens with people who have bad backs, some horses can be kept pain free with a good exercise program. For others, this will help, but it won't be enough. Finally, there are some horses whose backs are so bad it makes no difference what is done with them in terms of exercise.

These are the most vexing cases-the chronic, recurrent spinal diseases which generally involve supraspinous ligament strain and/or kissing spines. Ironically, even in these categories, most horses, if rested, will recover completely or improve significantly. The trouble occurs --or recurs--when they return to work. Sometimes the problem will persist for the horse's entire working life. Other times it will last for a couple of years and then inexplicably disappear. There is no way to predict, only to cope.

Coping involves meticulous cooperation between rider and veterinarian, and considerable talent from both. As a horse's back problem becomes more serious, there comes a point where the average rider simply isn't skilful enough to use that particular horse any longer. Some people have a lighter riding style than others. They ride in a half seat. They don't sit down a lot. They can coax a horse with a bad back to jump or to do other strenuous activities, whereas somebody who may be a good rider, but who tends to sit heavy in the middle of a horse, will have difficulty getting the horse to do the same things. Horses with supraspinous ligament strain or kissing spines or both may still be serviceable to a non-professional rider. In fact, 70 to 80 percent of a recent sample of horses that were presumed to be clinically normal and who showed no pain were found upon necropsy to have some evidence of kissing spines.

Management is also important in helping a horse to cope with a bad back. He will be more comfortable if he's protected from chills by adequate blankets and quarter sheets, provided with an infrared heat lamp in his stall and rubbed with warming liniments prior to exercise. Warm-up periods are also essential prior to use. A jumper may need to be schooled several hours before competing, longed immediately before a class and jumped with a minimum of warm-up. After competition, a horse with a bad back needs sufficient time to recover from whatever job he has been asked to do. Otherwise, his condition will be aggravated. A racehorse may have a sore back for a week to 10 days after a race. Still, he can be raced every two weeks without problems. But if he's run again every seven days, he won't have sufficient time to recover and his back soreness will become exaggerated. The more stressful the activity, the more important recovery time becomes.

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