Chronic Back Pain-Causes?

[Ottbaxel]

So, I’ve got an aging gelding that has come off half lease a few months ago so I am back to riding him full time.

This horse has always had chronic back pain - hence the reason why he was half leased out as I didn’t want to keep competing him and riding him so hard (added bonus that his leaser is shorter and weighs less than me!).

Now that winter is beginning to ease up and he’s off lease, I am considering pulling his hind shoes. He’s not competing anymore anyways, and it would save me some money. Plus, now that he isn’t leased I’m ok with him needing a bit of an adjustment period.

However! This horse has always had this back pain, and I am concerned that pulling the shoes will make it worse, which is leading me down the rabbit hole once more of “what is causing this pain?” I figured if he is NPA in his hind feet it could be contributing, so I am going to take some rads before changing his shoes.

But if he isn’t NPA, what else could be causing this? Any ideas? Could pulling his hind shoes really make his back pain worse? Here’s what I’ve tried/noticed thus far:
-Saddle fit evaluated regularly
-Palpates sore when in work and out of work, so riding doesn’t seem to cause it
-back rads taken, no kissing spine
-mild neck arthritis in C6/C7 (updated rads after 5 years with no changes, he has no neuro symptoms and does carrot stretches well)
-hock arthritis (injections every 9 ish months)
-palpates a bit sore around SI, done injections previously with no improvement
-scoped & treated for gastric ulcers

I’m sure the arthritis in general is contributing some, but during his last vet checkup a couple months ago my vet said he looked great, he stretches really well, has awesome range of motion so I am not totally convinced that’s entirely the cause. Are there any other obvious things I could be missing, or have I checked off all the major boxes?

[Simkie]

Really any pain lower can run “upstream” and create back pain. Consider how just walking differently nursing an ankle strain or holding your arm differently because of a tweaked wrist can cause your own back to hurt, especially the longer the issue persists.

A full lameness exam is probably a good place to start.

[Ottbaxel]

Yeah, I’ve had a bunch of lameness exams done on him. Aside from the hock arthritis he flexes fine, is super sound on straight lines and on the lunge, so we’ve tried a few different things (mesotherapy, SI injections etc) just to see if they help but otherwise it seems like we’d have to go body scan or something to figure it out since we don’t have an obvious starting point.

Since he’s 18 now and just being ridden to keep him moving more than anything at this point, I don’t want to spend thousands to dig into it. Maybe I won’t pull his shoes to avoid risking his back getting worse…ack!

[Simkie]

If keeping him shod hasn’t solved the problem, there’s not much risk in pulling the shoes. If he gets worse, you can always put em back on.

[crackerjack]

Like @Simkie said- start with a thorough lameness evaluation. Back pain can be a symptom of a lot of different things. That being said for mine if his hocks and/or stifles are sore he’ll get a sore back. Usually, it means he’s due for his injections. I know you said he got them. What are you injecting with?

Also, mine is a long 18 wheeler so his conformation works against him. His topline always needs to be worked on and his lower back is weaker. He is more susceptible to back pain due to the weakness- but I am constantly working on it!

[Annie10]

Hock arthritis can def cause/contribute to back pain

[Ottbaxel]

Yeah, I suppose it could just be his hocks. He’s just so loose with his hind end it seems like his hocks don’t really bother him-but maybe he is compensating so I don’t notice it directly in his hocks.

[Simkie]

Has injecting his hocks made any difference at all in his back pain to date?

If no, then it’s unlikely to be his hocks.

[Posting_Trot]

Steps that you’ve outlined–pulling his hind shoes and getting some rads taken of the hinds–seem like excellent ideas that might lead to some answers or at least help mitigate some of his discomfort.

But, it’s quite possible that it will take some adjustment time for him once the hind shoes come off. And then, if it turns out that he’s slightly NPA behind and your farrier takes steps to correct it, that may also take him some time to adjust. Especially given that he’s 18.

I guess all I’m saying is that, nothing you try is likely to be an immediate win. It may take several months to see if the interventions help or not. But that doesn’t mean they are not worth trying.

[beau159]

@Ottbaxel

So, I’ve got an aging gelding that has come off half lease a few months ago so I am back to riding him full time.

This horse has always had chronic back pain - hence the reason why he was half leased out as I didn’t want to keep competing him and riding him so hard (added bonus that his leaser is shorter and weighs less than me!).

Now that winter is beginning to ease up and he’s off lease, I am considering pulling his hind shoes. He’s not competing anymore anyways, and it would save me some money. Plus, now that he isn’t leased I’m ok with him needing a bit of an adjustment period.

However! This horse has always had this back pain, and I am concerned that pulling the shoes will make it worse, which is leading me down the rabbit hole once more of “what is causing this pain?” I figured if he is NPA in his hind feet it could be contributing, so I am going to take some rads before changing his shoes.

But if he isn’t NPA, what else could be causing this? Any ideas? Could pulling his hind shoes really make his back pain worse? Here’s what I’ve tried/noticed thus far:
-Saddle fit evaluated regularly
-Palpates sore when in work and out of work, so riding doesn’t seem to cause it
-back rads taken, no kissing spine
-mild neck arthritis in C6/C7 (updated rads after 5 years with no changes, he has no neuro symptoms and does carrot stretches well)
-hock arthritis (injections every 9 ish months)
-palpates a bit sore around SI, done injections previously with no improvement
-scoped & treated for gastric ulcers

I’m sure the arthritis in general is contributing some, but during his last vet checkup a couple months ago my vet said he looked great, he stretches really well, has awesome range of motion so I am not totally convinced that’s entirely the cause. Are there any other obvious things I could be missing, or have I checked off all the major boxes?

About a month after you have his hocks injected, how is his back?
If there is no difference, then his hocks would likely not have much to do with his back.

What about:
-putting him on Adequan
-putting him on Equioxx (when needed)

Neither are fixes or cures obviously, but might help him move better.

And/or anyone in your barn that has PEMF you can do regularly on him?

[Ottbaxel]

No, I’ve never noticed a difference in his back even after hock injections. He certainly feels better under saddle, but his back will still palpate sore. Even on Robaxin/Methocarbamol he still palpates sore. Equioxx doesn’t make a difference either.

I think I’m going to try Adequan for him this spring. I don’t know anybody with a bemer or PEMF or anything like that but I may look into it!

[Simkie]

If you want another thing to toss at the wall to see if it might stick, a month of gabapentin could be worth a shot.

[Showbizz]

I have this horse. Even when completely out of work for months, he’s backsore.

Back x-rays: Nothing
Hock injections: Didn’t change
Coffin joint injections: No change

He has an appointment for hind feet rads next week. There is nothing about the outside of his hind feet that make the farrier, vet, or I think he is NPA, but want to cross it off the list. My next thought is ulcers.

[Ottbaxel]

It’s so hard!

When he stopped competing I stopped babying it so much-that sounds awful, but he’s no longer doing hard dressage work or hillwork so I feel like hard work + heavy maintenance leaves him at pretty much the same discomfort level as light work + minimal maintenance.

I keep seeing that pulling their shoes makes their back worse-but it can’t possibly be true for every single horse out there?

[fivestrideline]

@Ottbaxel

I keep seeing that pulling their shoes makes their back worse-but it can’t possibly be true for every single horse out there?

A lot of horses do better with extra support behind in some form of shoes. That assumes the trim and angles are good.

I find horses with non-specific back pain tend to appreciate shoes behind. Not all, but a lot. Plenty are NPA at the root cause though, and I’ve found composites and sole pack to be the fastest way to address that. In theory, barefoot should do the same thing but I’ve just had more luck with shoes.

You can always put them back on if he doesn’t thrive.

[IPEsq]

Have you ever done an ultrasound of the back? Where does he get sore other than the SI?

Just asking because I have one with no kissing spines, but L5-L6 are fused, and I think the change in motion caused some arthritis at L1-L2 and some irritation in the lumbar IT joints as well. He maintains for the most part with regular bodywork (chiro, acupuncture, PEMF, massage) now after finding the right saddle fit and being mindful of how I exercise him, but he has needed injections in the past. He also had an acute SI injury that we treated and rehabbed and found the low back stuff as an incidental finding to that because nothing presented very obviously and I went down a rabbit hole imaging everything.

[awaywego]

EPM or Lyme or feet - or a combination of 2 or 3 of these - does it for mine every time.

[Ottbaxel]

I have actually! He was a guinea pig for a vet training course so he had his back ultrasounded. I didn’t get a full workup on it since he was just a free volunteer, but he didn’t have anything of note when they ultrasounded him.

[Ottbaxel]

Maybe I’ll test for EPM…I’ve always wondered about that. I’ve tested Lyme and Vit E a couple of times over the years and haven’t found anything there. Feet is up first it seems!

[gradytb]

I just learned that one of my OTTBs has extremely low magnesium levels. We just tested for it because his calcium levels were fine but he was getting thumps and hasn’t been in work. He also has always been kind of cranky, he came to me with notes about being tight across his back and he doesn’t like to be groomed much either. I went down a research rabbit hole on magnesium and found that those are often symptoms. So we’re now starting a magnesium supplement. I also had massage done on him for the first time about a week ago and he was almost a different horse. So I keep doing that, to the best of my ability. Hopefully I’ll see lessening of the irritability and back tightness, although it’s better already.