The most common cause of back pain and reduced performance in competition horses remains impingement of the dorsal spinous processes (IDSP’s) in the mid and lower back. The colloquial term “kissing spines” is often given to this radiographic picture, but Svend strongly believes that this terminology should only be used for a clinical situation where the radiographic changes are confirmed  in one or other ways,  such as scintigraphy, regional analgesia or “diagnostic medication” as being significant  and the reason for back pain and reduced performance.

Kissing spines is a complex performance reducing problem and therefore frequently not realised by the rider until significantly affecting performance. Surprisingly few thoughts have been given to the cause(s) of this debilitating condition, but material published in the German literature has supported Svend’s observations that this may be a problem caused and accelerated by skeletal immaturity, incorrect training and certain types of use of the horse and in particular its back.


Early cases of kissing spines with minimal radiographic changes can be managed by injections and a change of training with the emphasis on improving the horse’s core musculature. More severe cases require surgery which can be a “gap widening” procedure or a more involved reduction in height of alternative processes. Svend has now performed approximately 400 such surgeries with excellent results, in many horses followed over a 10-15 year period post surgery!

Rehabilitation post surgery is extremely important and aims at as little interruption of training as possible.  4-6 weeks of hand walking is therefore followed by an intense lunging programme over an additional 4-6 weeks using Pessoa-lines (see video below) or similar aids to rebuild both the upper and lower contraction system. The aim is to have the horse back in ridden work 3 months after surgery or sooner.