Shockwave Therapy for Backs

[raisethebar]

Had anyone ever have any luck using shockwave therapy on their horse’s backs?

Long story & sorry if this is confusing - I have been working with an amazing new vet who has picked my horse a part and hasn’t really found any real issues, yet he continues to be sore throughout his back. Not lame sore, but just muscle sore. I have a custom well fitting saddle and we have done our homework w/robaxin and equioxx and worked with a couple prior vets before the most recent steps as well.

Upon recommendation from new vet, we injected his hocks which was a good starting point because that is what was showing up when flexed. He is a big-boned horse, had some straightness and power issues behind so we wanted to start there. After doing his hocks, I noticed him standing pretty funny in his stall while sleeping - elephant on a ball type of stance. I looked into it, called the vet and called my farrier and came up with a solid plan of action. We fixed his shoeing situation up front and he looks and goes so much better already and its only going on 2 weeks.

I believe he is now body sore from some changes with the shoeing & changing to how he is going, but surprisingly was way less sore in his back today, than when the vet checked him the first time - and I thought his back looked good when she checked him originally!

Her suggestion was to shockwave it but 1, due to limited funds, I wanted to wait and 2, he got bit on his back right where the saddle goes the day before in turnout and has a hematoma that is bothering him to the touch. I personally thought during the exam this morning, he felt the worst he has since we changed his shoeing up. Just my luck! I was very hesitant to pull the trigger because I wasn’t sure if she was seeing/I was feeling the discomfort of his hematoma or what. He felt amazing the whole week before too - swinging through his back and shoulder. I didn’t want to do too much too soon and not know what actually is working! I hope that was the right decision.

I asked her what could be causing the issue, the route cause of all of this drama happening with him, and she thinks it could be due to his conformation (a little long backed to begin with) and suggested putting him in a Pessoa system a couple times a week and have him work over cavalletis and really strengthen his core, especially in addition to the shoeing change we made. He’s had xrays done to rule out kissing spines, but this has been an ongoing battle with his back soreness since he came into “real work” and started doing more. I was tempted to pull the trigger today and tell her to shockwave it, seeing as its been going on for so long with no real diagnosis until now and seeing as she is leaving very shortly to go down to FL for the winter, but along with limited funds and his hematoma, I want to make sure I do my homework on shockwave therapy and actually know if that is what will be working. Overall, she commented on how sound he is but really thinks that this will severely help the back issues.

Could this horse benefit from Shockwave? I’ve read up on it and it seems like something that could work. How many sessions did you need to see/feel results? Did you need to do the series close to each other, within a certain time frame from each other?

[IPEsq]

I have not personally found the results to be worth the money for this type of issue. Tried it…twice one month apart as recommended by my vet. New vet agrees it’s not worth th the expense to repeat. Slow, careful PT through varied exercise, use of something like th Equicore system, doing belly lifts and butt tucks, pole work, backing up, and long and low does the best. I still hit a wall, though, with my horse even also doing Chiro, acupuncture, Rolfing, etc. While the exercise was helping with th muscle tone (more normal, less like a rock, more lift to the spine), the therapies lasted a few days at most. So, we went to a systemic steroid round, which he’s almost done with. That seems to have been the final push he needed, physically. We still have a ways to go to fix associated training issues, but at least he is more willing to move. I’ve also got him on a PSSM type 2 similar diet. Lots of amino acids and fat, plus magnesium and vitamin E.

[raisethebar]

Thank you @IPEsq ! That is really helpful I’m pretty hopeful that the new way he’s getting shod will help a lot. I just need to be patient with him now. I’m really glad I didn’t spend extra $ on having her do it and even paying for the exam fee just to say how sound and good he looks sort of sucks, but at least it’s a step in the right direction! He is already on a similar diet to your guy - I’m hoping to adjust even a little more.

An interesting thing the vet said was colon ulcers? When this whole thing started 2 years ago, I put him on a month’s worth of Succeed. I cannot remember feeling a huge difference in him. The vet tech mentioned ulcers as well… He isn’t an ulcery horse. He definitely doesn’t have an issue in the weight department, gets lots of turnout, lots of great hay… ugh!

[IPEsq]

I don’t know which comes first for my horse…back pain or hind gut pain. But I think they are related. My theory is something with the nerves and fascia. Anyway, I have my horse on Succeed now as well. I found I had to do the double dose for the whole first month not just the first week to 10 days. He’s on the single dose now, and he’s at the trainer’s so I’m not 100% sure how he feels, but I palpated him after a week of boot camp, and I thought his back felt similar to before starting boot camp, so that was encouraging.

[raisethebar]

@IPEsq Very interesting!!! I have been looking into Succeed again as well as SmartPak’s supplement’s as well. The interesting thing with my horse is that he use to hold his tail to the left a lot. Now that he is feeling better, he definitely isn’t doing it as much.

But, he also gets really gassy when he starts to relax and push from behind.This is normally towards the end of our ride where i let him go long and low and normally it is to the beat of his trot… could that potentially say something? my vet didn’t say anything about it further for whatever reason.

Have you looked into SmartGI in comparison to Succeed? I compared them side by side and SmartGI has so much in it that Succeed doesn’t have but is missing the Psyllium. Not sure if something like SmartGI would be something that could potentially help hind gut?

[Laurierace]

Not an answer to your question but sore backs are always caused by feet until proven otherwise in my experience so I would start there and make sure you have the feet really right before moving on to other therapies because if the feet are the cause any treatment you try won’t work.

[halt]

@Laurierace

Not an answer to your question but sore backs are always caused by feet until proven otherwise in my experience so I would start there and make sure you have the feet really right before moving on to other therapies because if the feet are the cause any treatment you try won’t work.

This is very true - I think usually the culprit in that case is negative palmar angles behind… you can see it most obviously in TBs that have more extreme “race angles”, they will stand under themselves with their backs pinched and their pelvis propped up. Here’s a good example of a horse that is visibly backsore (that also has NPA among other issues): [image]

That is not to say feet are the only thing that lends to backsoreness, there’s also old SI injuries, stifle issues, conformation especially kissing spine, cervical arthritis, and suspensory injuries.

[PNWjumper]

I’ve posted many times about shockwave making a huge difference on my horses’ backs. The two that we’ve done it on both had SI issues and the shockwave was what allowed the horses to hold the chiropractic adjustments being done by my vet. Huge positive difference. But it was in the context of horses that were a) under the care of a really talented farrier, b) in a good conditioning program, and c) in the midst of a bodywork program that was effective on its own. If any of those pieces had been out of whack (especially the farrier), I don’t think the shockwave would have been as effective. In other words, the shockwave was a really useful tool in the context of a larger plan - not the sole thing that “fixed” the problems.

[islgrl]

My student has a horse that has had back soreness issues most of his life. Without going into endless detail about what had been done in the past suffice it to say she had done all the right things to try and fix it. New vet suggested shock wave. I was skeptical but it was her money so whatever. It changed his life. He was treated three times a month apart, after the first treatment he was so markedly better she continued with the other two treatments. Now he gets it as needed which has been less than once a year. I am a HUGE believer now.

[halt]

@islgrl

My student has a horse that has had back soreness issues most of his life. Without going into endless detail about what had been done in the past suffice it to say she had done all the right things to try and fix it. New vet suggested shock wave. I was skeptical but it was her money so whatever. It changed his life. He was treated three times a month apart, after the first treatment he was so markedly better she continued with the other two treatments. Now he gets it as needed which has been less than once a year. I am a HUGE believer now.

Do you know what the underlying cause for back pain was? That’s pretty important.

I’d expect shockwave to make a huge difference for a horse that has KS or SI issues… but not so much a horse that has very bad feet, or a horse that has c-spine issues that are causing all of the soreness.

Raisethebar, has your horse’s back been x-rayed? You also mention he is straight behind and has been found in the stall in a funny stance… has EPSA/DSLD been ruled out?

[IPEsq]

I think the gassiness is s good sign… at least mine will hold his tail stiff and elevated and want to park out and show back pain signs and act like he’s having some trouble moving things along. When he is freely gassy, he seems much more comfortable.

I have experimented with so many gut things. I had put off Succeed because of cost, but it seems to be helping. He is already on Platinum Balance and Equishure. But I have been able to reduce his Equishure dose. I hope to maybe get him back off of it at some point.

[SonnysMom]

My horse has kissing spine and I did the mesotherapy and one treatment of shockwave on the same day. Huge difference.
In the past I had issues with his hocks that caused his SI to be really sore. We decided to inject that hocks and inject the SI. The vet also did B12 injections along the length of his back on the same visit. Once I kept up with his hock maintenance the SI problem has not returned. Compensating for the hocks inflammed the SI. Have you considered an SI injection or is it more generalized back pain?

[Abbie.S]

I’d also recommend not jumping to Shockwave right now. Let the hematoma heal - if he’s got swelling and it’s painful to the touch…that’s a pretty good reason to be back-sore. So is a drastic change to shoeing.

Shockwave is something I’ve done only when I have a definitely diagnosis as to why the horse is having pain OR you’ve exhausted everything on the planet, had full diagnostic work-ups done including imaging and have no answers. If you don’t have a diagnosis, you run the risk of dropping several thousand bucks (in my area, it’s around 1K per treatment not including the farm call and they usually recommend no less than three treatments) with no relief. In the case of having no diagnosis but having exhausted everything, at that point it’s usually a Hail Mary.

You said this has been an ongoing battle since the horse came into “real work” - what does “real work” constitute in this case? Based off that, I’d be inclined to think that the horse is being asked for too much too soon, even if it seems like a reasonable schedule to you. I’d be going back to lots of walking, hill work, incorporating poles and physiotherapeutic exercises like belly lifts, tail pulls, etc.

[raisethebar]

@Laurierace

Not an answer to your question but sore backs are always caused by feet until proven otherwise in my experience so I would start there and make sure you have the feet really right before moving on to other therapies because if the feet are the cause any treatment you try won’t work.

Thank you so much! I truly feel like this could totally be a huge part of what is going on

[raisethebar]

@PNWjumper

I’ve posted many times about shockwave making a huge difference on my horses’ backs. The two that we’ve done it on both had SI issues and the shockwave was what allowed the horses to hold the chiropractic adjustments being done by my vet. Huge positive difference. But it was in the context of horses that were a) under the care of a really talented farrier, b) in a good conditioning program, and c) in the midst of a bodywork program that was effective on its own. If any of those pieces had been out of whack (especially the farrier), I don’t think the shockwave would have been as effective. In other words, the shockwave was a really useful tool in the context of a larger plan - not the sole thing that “fixed” the problems.

Thank you! I’m really glad I looked into this instead of jumping the gun. Now that he is getting shod differently, I think it is very wise that I waited to get it done. I think horses need time to adjust to something like that, and then I can start adding in other things from there that when they are all used together, create a harmony.

[raisethebar]

@halt

Do you know what the underlying cause for back pain was? That’s pretty important.

I’d expect shockwave to make a huge difference for a horse that has KS or SI issues… but not so much a horse that has very bad feet, or a horse that has c-spine issues that are causing all of the soreness.

Raisethebar, has your horse’s back been x-rayed? You also mention he is straight behind and has been found in the stall in a funny stance… has EPSA/DSLD been ruled out?

I don’t necessarily think he is straight behind, it is just how he was standing after getting his hocks done - elephant on a ball type of stance. He has had his back xrayed, no kissing spines. I haven’t actually heard much about EPSA/DSLD, I just did some basic research on it. So far it doesn’t look like he has any of those symptoms but I will look into it further! He has great feet, I just think the angles were all wrong. New farrier had to undo what the old farrier did that he wasn’t happy with. This new farrier is very reputable and well known and does a great job with my horse. Thanks for your suggestions!

[raisethebar]

@SonnysMom

My horse has kissing spine and I did the mesotherapy and one treatment of shockwave on the same day. Huge difference.
In the past I had issues with his hocks that caused his SI to be really sore. We decided to inject that hocks and inject the SI. The vet also did B12 injections along the length of his back on the same visit. Once I kept up with his hock maintenance the SI problem has not returned. Compensating for the hocks inflammed the SI. Have you considered an SI injection or is it more generalized back pain?

I have been told by multiple vets that SI issues are secondary to primary issues which normally are the hocks. I got his hocks done last month, so I’m hoping that maybe has contributed to the decrease in soreness throughout his back. Right now, I think it might be more generalized. His SI’s don’t flex sore at all. I have been doing a lot (and need to increase the amount) of PT work to strengthen this area. As I am aware, the SI is a tough area that needs to be strengthened.

[raisethebar]

@Abbie.S

I’d also recommend not jumping to Shockwave right now. Let the hematoma heal - if he’s got swelling and it’s painful to the touch…that’s a pretty good reason to be back-sore. So is a drastic change to shoeing.

Shockwave is something I’ve done only when I have a definitely diagnosis as to why the horse is having pain OR you’ve exhausted everything on the planet, had full diagnostic work-ups done including imaging and have no answers. If you don’t have a diagnosis, you run the risk of dropping several thousand bucks (in my area, it’s around 1K per treatment not including the farm call and they usually recommend no less than three treatments) with no relief. In the case of having no diagnosis but having exhausted everything, at that point it’s usually a Hail Mary.

You said this has been an ongoing battle since the horse came into “real work” - what does “real work” constitute in this case? Based off that, I’d be inclined to think that the horse is being asked for too much too soon, even if it seems like a reasonable schedule to you. I’d be going back to lots of walking, hill work, incorporating poles and physiotherapeutic exercises like belly lifts, tail pulls, etc.

Thank you! I think I’m going to consider it in the spring when my vet returns from FL if I can’t rule out anything further and allow time and strengthening to help.

Real work for my guy = He is 6 and we started him at 4 into a slow show program (4 hacks a week, focusing on forward and straight, and 1 light jump school, literally max 2’6"). I wouldn’t say anything was rushed or pushed at all. It’s a really long story beyond just what I have written down and it gets really confusing and hard to type out every single detail, but the time this problem came into play, was the very same time we moved him to this “show barn”. Highly reputable for their training, but unfortunately don’t believe in some things that I now know is fundamental to overall health and happiness – ex: feeding local mill’s sweet feed for every horse, no grass due to too many horses on farm, turnout time was ok, but again, small paddocks with no turnouts. I thought, “well if “Betsy’s” $120,000+ horse survives here in the program, my guy should be great too!”… FACE. PALM.

I’ve learned A LOT in the past two years, lets just say that. I know we have all made mistakes with our horses, but I want to make it right for this guy. I am determined to. Since leaving the “show barn” we are at a beautiful barn and I would say that we have turned him around a complete 180 from when he left, we just have some other lingering issues to figure out and get rid of.