Kissing Spines

Kissing Spines, Also known as Over-riding Dorsal Spinous Processes (DSPs)

What is Kissing Spine?

Kissing spine, or over-riding dorsal spinous processes, occurs when the spinous processes (the bony projections at the top of each vertebra) are positioned too close together. In some cases, these bones may touch or overlap instead of being evenly spaced.

Kissing spine most commonly affects the thoracic vertebrae (the mid-back) but can also be seen in the lumbar region (lower back).

Signs of Kissing Spine

The signs of kissing spine can be subtle and vary from horse to horse. Some horses may only show a few symptoms.

Common signs include:

Signs of discomfort – weight shifting, facial expressions, sensitivity during grooming, or discomfort when pressure is applied to the back (for example, when saddled)
Difficulty when mounting – refusing to stand still, moving away, or showing discomfort when the rider’s weight is placed on the back
Difficulty working correctly over the back – struggling to work into the contact, stiffness through the back, preferring a hollow outline with the head held high, or discomfort through the neck
Struggling with paces and schooling movements – difficulty with transitions, changes in stride length, incorrect canter leads, reluctance to go forward, or difficulty engaging the hindquarters
Behavioural changes when ridden – bucking, rearing, or spooking that is out of character for the horse
Difficulty cantering – struggling to pick up or maintain canter, becoming disunited, or difficulty maintaining rhythm (as horses naturally lift their back in canter)
Loss of muscle mass, particularly over the topline
Pain or sensitivity on palpation
Tension through the back and compensatory areas
Reluctance to lift the back when asked via abdominal stimulation
Reluctance or difficulty walking backwards

Please note that many of these signs can also be associated with other medical conditions, training issues, or behavioural concerns. A thorough veterinary assessment is always essential.

Diagnosing and Treating Kissing Spines

Diagnosis of kissing spine is usually confirmed through radiographs (X-rays) taken by a veterinarian. The veterinarian will assess the imaging alongside the horse’s clinical signs to determine whether the findings are significant.

Treatment options will be discussed with your veterinarian and may include:

Steroid injections
Conservative management and rehabilitation
Surgical options, such as interspinous ligament desmotomy or partial removal of the dorsal spinous process

Not all cases of kissing spine require surgical intervention. Many horses respond well to appropriate veterinary management combined with a structured rehabilitation and physiotherapy programme.

Your veterinarian will guide you in choosing the most suitable treatment plan for both you and your horse.

Physiotherapy for Kissing Spines

Physiotherapy plays a vital role in the management of horses with kissing spines, both before and after treatment. It not only helps to relieve discomfort and pain, but also improves muscle strength, supports correct movement, and reduces the risk of further issues developing.

Using physiotherapy as part of both pre- and post-treatment care helps to build core strength and strength through the back, restore correct movement patterns, improve proprioception, and address any compensatory behaviours that may have developed.

A variety of physiotherapy techniques and interventions may be incorporated into a tailored rehabilitation programme, including:

Manual therapy
Electrotherapies
Mobilisation techniques
Stretching exercises
Kinesiology taping
Resistance band work
Pole work
Targeted exercises
Groundwork
Hydrotherapy (may be recommended off-site)

By working together, a structured and individualised plan will be created to ensure your horse receives the most effective treatment and rehabilitation possible, supporting long-term comfort, performance, and wellbeing.

Is Kissing Spines Career-Ending?

No. Kissing spine is rarely career-ending. Only a small number of horses need to retire due to kissing spine alone, and in many cases retirement is influenced by other factors alongside the condition.

Every horse is different, and each case will vary depending on the severity of the condition, the horse’s workload, and how early it is diagnosed and managed. One of the main aims of treatment and rehabilitation is to help the horse return to their previous level of work — and in many cases, to progress beyond it.

I have personally worked with horses that have undergone both surgical and non-surgical treatment for kissing spine, with successful outcomes. Many of these horses have returned to ridden work and gone on to continue or improve their performance with the correct management, rehabilitation, and ongoing support.