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Kissing Spines

My 7 year old Thoroughbred eventer was recently diagnosed with “kissing spines” in the area under the saddle. What causes kissing spines? How common is it? Does it affect certain breeds or horses that are doing certain disciplines more than others? What can I do to prevent it from getting worse? Are there any supplements I can feed my horse to make him feel better? What is the prognosis for his long-term performance and comfort? ES, Pennsylvania

Dear ES,

You’ve asked a lot of questions! Let me tackle them one at a time so you have a clear understanding of this condition and your options.

What causes “kissing spines?”

Known as “kissing spines” by horsemen and “overriding dorsal spinous processes” by veterinarians, in clearest terms the condition is spinal processes that touch or “kiss” one another at rest or in motion. The withers are an excellent example of these spinal processes, long thin bones that protrude upward from each vertebrae.

Although some cases are due to a fall or other injury, many times the conformation of the vertebrae themselves (narrow interspinal spaces) are to blame for the impingement. Spinal processes that rub together are not only painful to the horse, they create additional lesions such as bony remodeling and ligament inflammation.

How common is it? Does it affect certain breeds or horses that are doing certain disciplines more than other?

According to Jean-Marie Denoix, DVM, PhD, an expert in equine biomechanics, “kissing spines” occurs most often in young thoroughbreds or thoroughbred-crosses with short backs used primarily for jumping. Show jumpers appear to be the most commonly affected, although eventers and hunters suffer from this condition as well. Your horse falls into this category.

While some horses with “kissing spines” show clear signs of back pain, many don’t, and diagnosis can be a challenge. Other signs pointing to this condition include back stiffness, reduced jumping ability, resistance to work, change of temperament, resentment of grooming or picking up the hind feet. Horses with “kissing spines” may also be reluctant to lie down or roll.

What can I do to prevent it from getting worse?

Once an impingement is diagnosed, rest is prescribed along with medical treatment and physical therapy. Medical treatment may include local injection of steroids into the interspinal spaces, NSAIDs such as phenylbutazone, and mesotherapy, a pain-dampening technique that stimulates the mesoderm, the middle layer of the skin. Options for physical therapy range from magnets and massage to acupuncture and chiropractic to swimming and shockwave therapy.

Exercise is gradually reintroduced through handwalking, lunging, then riding, being careful to avoid any activity that seems to be painful to the horse while building and strengthening the muscles and ligaments of the back.

Are there any supplements I can feed my horse to make him feel better?

Because “kissing spines” is a condition with pain and inflammation that involves bones, ligaments and muscles, the supplement categories that may be helpful include anti-inflammatory, joint, tendon & ligament, and muscle mass. Specifically look for ingredients that help fight inflammation in tissue such as MSM, omega 3 fatty acids, and herbs like Devil’s Claw, Boswellia, Bromelain and Yucca. Actives like Glucosamine, Chondroitin sulfate and Hyaluronic Acid; Silica and Collagen; and the amino acids Lysine and Methionine may be beneficial to healing tissues.

What is the prognosis for his long-term performance and comfort?

Although many horses do well with a combination of rest, medical management and physical therapy, the clinical signs often return. This may mean decreasing the horse’s level of performance to avoid jarring the spinal processes together or, in severe cases, performing surgery to remove one or more of the processes.



Lydia F. Gray, DVM, MA SmartPak Staff Veterinarian and Medical Director Dr. Lydia Gray has earned a Bachelor of Science in agriculture, a Doctor of Veterinary Medicine (DVM), and a Master of Arts focusing on interpersonal and organizational communication. After “retiring” from private practice, she put her experience and education to work as the American Association of Equine Practitioner’s first-ever Director of Owner Education. Dr. Gray continues to provide health and nutrition information to horse owners through her position at SmartPak, through publication in more than a dozen general and trade publications, and through presentations around the country. She is the very proud owner of a Trakehner named Newman that she actively competes with in dressage and combined driving. In addition to memberships in the USDF and USEF, Dr. Gray is also a member of the Illinois Dressage and Combined Training Association (IDCTA). She is a USDF “L” Program Graduate and is currently working on her Bronze Medal. Find Dr. Gray on Google+

Posted in Diseases and Conditions, Lameness

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8 comments on “Kissing Spines
  1. Michelle Osgood says:

    Hello, I have a horse with severe kissing spines
    go to and learn his success story!

  2. Lesley Murie says:


    I have a horse 17 yr old boerperd mare with kissing spine disease, was advised to stop riding her, which I did. I have realised since retiring her that she has become very grumpy and does not seem happy retired? I still give her all the love and attention she got when ridden, but it feels like she thinks she is being neglected. Have started taking her out in hand for walks for a change of scenery, better for one day, but now grumpy again. Anything else I can do. Is massage or lunging an option, scared i may be doing more harm than good? Should she b on any medication?

    • SmartPak SmartPak says:

      Hi Lesley, we’re sorry to hear about your horse’s situation, and I give you a lot of credit for trying to find ways to keep her active and happy. The severity of kissing spines can vary by horse, and it might be possible that your horse could benefit from some body work and controlled activities, especially if riding has been ruled out. I think the best place to start is by talking with your veterinarian to determine if there are any specific medications or treatments that would be appropriate, as well as discuss an exercise program. Hopefully you can develop a program with your veterinarian’s help that will allow your horse to stay fit and comfortable, while also giving her a job to focus on. – Dr. Lydia Gray

    • Deborah says:

      I have a horse with kissing spine and with a vet’s advice tried a 1 inch felt pad. I went a step further and went to a western saddle as well. We can trail ride for hours and walk trot and canter as the western saddle displaces the weight of the rider over a greater area.

      Borrow a saddle and give it a try.

  3. Julia says:

    I am interested in feeding Boswellia to my 20-year old Tb. Is it fed as a powder or can horses eat the pieces as well? Which would you recommend?
    Thank you for this great article!

  4. Kirsten Lotter says:

    I think one of the most important things to do is to consult a vet whom specializes in KS treatment. The above article gives some misleading info in my opinion. The bone surgery does not remove any of the processes – it remodels the existing processes to make a larger space. My horse just had the traditional KS surgery by an expert in the field. I have high hopes for a very successful outcome.

  5. Jill says:

    My jumping horse recently started kicking out with his back legs whenever I ask him to canter. It started suddenly and by a week and a half he became basically unridably. He has been checked by the vet and is sound while lunging and had his hocks tested. I have injected his sacrum iliac and has had over three weeks off. No change and is almost worse. Any ideas?

    • SmartPak SmartPak says:

      Hi Jill,

      I’m sorry to hear that your horse is going through this. It sounds like you have done just the right thing by working closely with your veterinarian to try and determine the underlying cause. As you and your vet move forward, he or she may check areas such as: your horse’s tack fit, teeth, stomach health, diet and daily schedule, in addition to continuing the search for a particular musculoskeletal issue. These situations can certainly be a bit of a puzzle, but I wish you the best of luck and I hope he’ll be back to cantering comfortably soon.

      – Dr. Lydia Gray

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