Kissing Spine Rehabilitation for Horses | Oklahoma Equine Clinic
Kissing spine is one of the most misunderstood and underdiagnosed sources of back pain in performance horses. Many horses labeled as difficult, resistant, or behaviorally challenging are actually dealing with the chronic discomfort of kissing spine — and with the right rehabilitation program, many of them can return to comfortable, productive work.
At Advanced Equine Recovery near Oklahoma City, we specialize in kissing spine rehabilitation for performance and competition horses. Whether your horse is recovering from surgery or being managed conservatively, our structured programs combine advanced therapeutic technology with targeted strengthening exercises to reduce pain, rebuild topline, and support long-term soundness.
What Is Kissing Spine?
Kissing spine, formally known as overriding dorsal spinous processes (ORDSP), occurs when the bony projections on top of the vertebrae — called spinous processes — come too close together or make contact, causing pain, inflammation, and in chronic cases, bone remodeling.
The condition most commonly affects the thoracic spine in the region under the saddle, though it can occur anywhere along the back. Some horses are born with conformation that predisposes them to the condition, while others develop it over time as a result of poor posture, weak core muscles, or repetitive strain.
Kissing spine is classified by severity:
Grade 1 — spinous processes are close but not touching
Grade 2 — spinous processes are touching
Grade 3 — spinous processes are overlapping with bone remodeling
Grade 4 — severe overlapping with significant bone changes and chronic inflammation
Diagnosis is confirmed using radiographs. Some horses show clear clinical signs with mild radiographic changes, while others show severe radiographic changes with surprisingly subtle symptoms.
Signs of Kissing Spine in Horses:
Back soreness or sensitivity when groomed, blanketed, or saddled
Pinning ears, biting, or behavioral resistance during tacking up
Bucking, crow-hopping, or resistance shortly after being mounted
Difficulty engaging the hind end or pushing from behind
Stiffness through the back and reluctance to stretch or bend
Shortened stride or loss of impulsion
Dropping away from leg aids or resistance to collection
Unexplained drop in performance without obvious lameness
Because these signs overlap with many other conditions, it is important to have a full veterinary evaluation including back radiographs before beginning any rehabilitation program.
Why Professional Kissing Spine Rehabilitation Matters
Kissing spine rehabilitation is not simply a matter of rest. In fact, prolonged stall rest without targeted strengthening often makes the condition worse — weak back and core muscles leave the spine without the muscular support it needs, increasing pressure on the spinous processes.
Successful kissing spine rehabilitation requires:
Targeted exercises that build topline and core strength without aggravating the affected vertebrae
Therapies that reduce inflammation and pain throughout the back
Equipment that allows controlled, low-impact movement during early recovery
Progressive return to ridden work on a carefully managed schedule
Coordination with your veterinarian to determine whether conservative management or post-surgical rehab is appropriate
Our All-Inclusive Equine Rehab program provides every therapy your horse needs throughout kissing spine rehabilitation, structured around your veterinarian's recommendations.
Kissing Spine Therapies at Advanced Equine Recovery
Our kissing spine rehabilitation programs combine multiple therapies selected based on the severity of the condition and the horse's current stage of recovery.
Class IV Laser Therapy
Our America Cryo Class IV laser penetrates deep into the soft tissues surrounding the affected vertebrae, stimulating cellular repair and significantly reducing inflammation and pain along the back. Laser therapy is one of the most effective tools for managing kissing spine discomfort and is used throughout the rehabilitation process.
MagnaWave PEMF Therapy
MagnaWave PEMF therapy improves circulation throughout the back muscles and soft tissues surrounding the spine, supporting healing and reducing muscle tension that often develops as a result of compensating for back pain. PEMF is particularly helpful for horses with chronic kissing spine that have developed secondary soreness through the hindquarters and neck.
Shockwave Therapy
Shockwave therapy delivers targeted high-energy pulses to the affected area of the back, stimulating the healing process and reducing chronic inflammation associated with kissing spine. It is commonly used both before and after surgical intervention.
Water Treadmill Therapy
Our Horse Gym USA underwater treadmill encourages active engagement of the back and core muscles in a low-impact environment. Water treadmill work is an essential part of the strengthening phase of kissing spine rehabilitation — it builds the topline and core support the spine needs without the concussive loading of ridden work.
Cryotherapy
Targeted cryotherapy using our America Cryo Gun manages acute inflammation and soreness following therapy sessions or exercise, keeping the horse comfortable throughout the rehabilitation process.
What to Expect During Kissing Spine Rehabilitation
Recovery timelines depend on the severity of the condition and whether the horse is recovering from surgery or being managed conservatively. A general progression looks like this:
Weeks 1–4: Pain and inflammation management, early laser and PEMF therapy, hand walking only
Months 2–3: Introduction of water treadmill conditioning and shockwave therapy, careful monitoring of back comfort
Months 4–6: Progressive strengthening exercises, gradual return to light groundwork and lunging
Months 6+: Return to ridden work on a carefully managed schedule under veterinary guidance
Conservative management cases may progress faster than post-surgical rehabilitation. Every program is adjusted based on the horse's response and regular veterinary rechecks.
Kissing Spine Rehabilitation Near Oklahoma City and Norman
Advanced Equine Recovery is located at Rein Maker Ranch in Wayne, Oklahoma — just south of Norman and Oklahoma City. We regularly work with performance horses brought in from across Oklahoma, Dallas, and North Texas for specialized rehabilitation care.
If your horse has been diagnosed with kissing spine or is showing signs of back pain and resistance, contact us to discuss your horse's condition and learn how our rehabilitation programs can help.
You may also want to explore our bowed tendon rehabilitation, suspensory injury rehab, and stifle injury rehabilitation programs.
Frequently Asked Questions
Can horses recover from kissing spine?
Many horses with kissing spine improve significantly with the right treatment and rehabilitation plan. Outcomes depend on the severity of the condition, whether surgery was needed, and how consistently the rehabilitation program is followed. Horses managed with a structured professional program generally do better than those managed with rest alone.
What are the signs of kissing spine in horses?
Common signs include back pain, resistance or behavioral changes during saddling, bucking, difficulty bending, reluctance to move forward, poor topline development, and reduced performance. Because these signs overlap with many other conditions, a proper veterinary diagnosis including radiographs is essential before beginning rehabilitation.
What is the difference between conservative management and surgical treatment?
Conservative management involves rehabilitation, therapy, and carefully managed exercise without surgery. Surgical treatment — typically interspinous ligament desmotomy or bone removal — is recommended for more severe cases. Both approaches benefit significantly from a structured professional rehabilitation program afterward.
How long does kissing spine rehabilitation take?
Most kissing spine rehabilitation programs run 4–8 months depending on severity and whether surgery was involved. Post-surgical horses generally require a longer, more structured rehabilitation period before returning to ridden work.
Can a horse with kissing spine return to performance?
Many horses successfully return to riding and competition after kissing spine treatment and rehabilitation. Building genuine topline and core strength is the key to long-term soundness — horses that complete a full strengthening program are far less likely to experience recurring symptoms.
Do you work with my veterinarian during rehab?
Yes. We coordinate closely with your horse's veterinarian throughout the rehabilitation process and build the program around existing diagnostics and vet recommendations.