Potential back pain is frequently investigated as a cause of poor performance or behavioural problems in horses. The term ‘back pain’ encompasses a range of osseous, muscular and ligamentous pathologies and it is often challenging for the equine veterinarian to determine whether a horse has primary back pain, back pain secondary to lameness and an alteration in gait pattern, or has a training or behavioural issue. Careful examination and analysis is essential to reach an accurate diagnosis in these cases. This article, the first in a two-part series, will discuss the approach to investigating suspected back pain, including the appropriate choice of diagnostic tests and imaging modalities to aid decision making in these potentially difficult cases. The second article, to be published in a subsequent issue of In Practice, will describe the conservative and surgical treatment options for the management of thoracolumbar and sacroiliac region pain.
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