Functional anatomy of the equine thoracolumbar spine related to equine back rehabilitation

Back pain and diseases of the spine are prevalent issues in sport horses, with diagnosis of the underlying pathology proving a challenge for the clinician. Historically, veterinary medicine, like human medicine, has concentrated on identifying the pain generator linked to specific anatomical lesions. However, significant work in human back pain patients has revealed that many cases exhibit no identifiable lesion on imaging, or that changes to images may not correlate with the patient’s pain. This has resulted in physiotherapy-led research focusing on effects of acute, sub-acute and chronic pain on spinal muscles, as well as the implications for rehabilitation. This review aims to summarize existing literature on muscular changes due to back pain in both human and equine patients, while exploring the physiotherapy-led rehabilitation principles tailored to the various stages of back pain. • Back pain syndromes may involve multiple different structures as their pain generator. • Improving neuromotor control has been found to be effective in reducing pain. • Structural muscle changes vary in acute, sub-acute and chronic back pain. • Functional activation patterns are affected by back pain. • Exercise prescription should commence with neuromotor control training.