Back pain induced lameness or lameness induced back pain?

When horses are clearly lame it is usually easy to determine the origin of the lameness. Mild or subtle lamenesses are more difficult to define and there is a difference between acute or chronic lame horses. When we examen the horse fully and systematically on both back and extremity we can distinguish between primary lameness or back pain induced lameness. But when the horse is chronically lame, there is a grey area. 

There is some literature available based on induced lameness and back pain and their effect on gait and performance but these are based on acute effects and the power of these studies are low. Relationship between spine or sacroiliac joints diseases and front or hindlimb lameness is described, but detailed information of the history of the horse is usually absent. 

In general we can observe some clinically features that are common with back pain induced lameness. Acute effects are usually poor performance and a decrease of speed. A decrease in hindlimb impulsion more obvious when ridden is described by multiple authors when originated caudal to the cervical spine. When ataxia occurs, the cervical spine has to be examined.

The examiner must determine the source of the abnormal gait. Is the gait abnormality influenced by the position of the head and neck or spine? Then we must examen the spine for abnormal kinematics; pain; atrophy or asymmetry. If not, a specific palpation of structures in the extremities and a clinical examination by the veterinarian has to be included in the exploration of the origin of the problem. 

Acute effects of induced lameness and back pain on spinekinematics are small. Chronic changes in gait and kinematics are complex and a detailed clinically examination is essential for determination of the primary problem. The primary problem must be addressed for a successful treatment.

Descriptives of occurrence with back pain induced lameness or lameness induced back pain is presented in the table below,based on literature found of this topic. You can read a summary of these articles trough the following links:

Effect of induced hindlimb lameness on thoracolumbar kinematics

Effect of induced forelimb lameness on thoracolumbar kinematics

Lesions of the neck resulting in lameness or poor performance

Effect of induced back pain on gait and performance