Equine Kissing Spine (Overriding Dorsal Spinous Processes)

This guide was created in collaboration with Somé Stander from Vet Physique, whose expertise and input were instrumental in its development.

Kissing spine occurs when the spinous processes of a horse’s vertebrae are positioned so closely together that they touch or overlap. This contact can be extremely painful and, if left unmanaged, may significantly impact the horse’s performance and quality of life.


Why Is It Painful?

Pain may arise from:

  1. Inflammation caused by trauma between spinous processes of the vertebrae
  2. Surrounding muscles
  3. Inflammation of the joint capsules and supporting ligaments

Which Horses Are at Risk?

Kissing spine is more common in:

  • Horses with short backs
  • Horses with poor core or back muscle development
  • Horses asked to work in inappropriate posture or with poor saddle fit

Management Options

1. Surgical Intervention
 There are a few types of surgery, most commonly:

  • Interspinous ligament desmotomy (ISLD): cutting the ligaments between the spinous processes to relieve pressure
  • Ostectomy: removing a portion of the bone to create space

Surgery is generally considered when conservative management has failed.


2. Conservative Treatment
 Many horses respond well to non-surgical rehabilitation when it’s consistent and guided by a veterinary team, including a veterinarian and veterinary physiotherapist.


What May  Rehabilitation Involve?

  1. Pain Reduction
    • Will likely involve veterinary-prescribed medication and rest
    • Regular physiotherapy sessions should occur to address muscular tension and improve comfort
    • Decreasing pain is instrumental to improving posture and appropriate muscle activation and subsequent strengthening. A painful horse will be unable to build the appropriate muscle strength to combat kissing spine. It is integral that a veterinarian is involved in the horse’s recovery process
  2. Encouraging Spinal Flexion
    • Your horse should be fed from the ground to promote a natural posture that encourages back flexion
    • This posture activates key supporting structures and helps reduce compression between spinous processes
  3. Core Strengthening
    • Static in-hand exercises (e.g., baited stretches, weight shifts) will begin
    • Thereafter it will progress to dynamic in-hand work (e.g., poles, hills, transitions) tailored to your horse’s stage of recovery
    • Strengthening of your horse’s core muscles is what enables kissing spine rehabilitation to ultimately be successful. This allows him the adequately support the spinal column, adopt a better posture, and stop the affected vertebrae from interacting
  4. Ridden Work
    • Once your horse is ready to carry a rider, frequent but very short sessions (e.g., 5–10 minutes daily rather than a long session once a week) will begin
    • Work that encourages proper engagement and self-carriage should be focused on, avoiding exaggerated extension of the spine
    • Quality of movement matters more than duration

Each horse will have an individualised rehab program created to their unique needs – which is why it is integral to follow the plan of a veterinarian and veterinary physiotherapist


Final Thoughts

Kissing spine can be managed successfully with a carefully tailored, consistent rehabilitation plan. Conservative treatment is a valid and often effective option — but it requires commitment and collaboration between owner, vet, and physio.

Consistency is key. With the right support, many horses return to full work and even competition.

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