Back problems are a major cause of poor performance and gait abnormalities in sport and race horses. Although it is often possible with the history and clinical (physical and dynamic) examination to suspect functional abnormalities of the vertebral column, definitive diagnosis of the cause of the pain is a challenge. There is undoubtedly a complex relationship between subtle (usually bilateral) hindlimb lameness, back pain, and poor performance. It can be challenging practically to differentiate and definitively determine the relative importance of differing orthopedic pathologies in such cases.
Once back pain is suspected or established in a horse, identification of the cause requires imaging procedures. This discipline has seen major advances, particularly relating to integrating radiographic, ultrasonographic, and nuclear scintigraphic findings. In addition, there is greater understanding of the relationships between identification of specific imaging findings and the possibly of such findings leading to pain.