Back pain are common issues in equine practice and are often considered to be a cause of poor performance, stiffness in the back and/or abnormality of the hindlimb gait in sport horses.1 History and clinical signs are often nonspecific and a definite diagnosis is a challenge. Back pain has been more and more recognized as a contributing or even causing factor in equine lameness in recent years. The prevalence of back problems in horses varies greatly ( from 0.9% to 94%), depending on the specialization or type of practice surveyed. Diagnosis of back pain requires a thorough clinical examination combined with imaging techniques. Veterinarians often have difficulties when dealing with a horse that has no obvious localized pain or a vague, unspecified lameness. Neck or back problems and limb lameness are often interrelated.2 Distal limb injuries can cause an alteration in carriage of the affected limb and altered gait, which can subsequently overwork or injure proximal limb musculature and the paraspinal musculature.2,3 Similarly, vertebral column or sacroiliac joint injuries can produce gait abnormalities, increased concussive forces, and distal limb lameness.4

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