Sacroiliac Joint Pain in Horses

Horses who exhibit crooked hind legs or difficulty cantering could be suffering from sacroiliac joint (SI) problems. Diagnosing such issues typically requires using multiple diagnostic techniques such as nuclear scintigraphy and ultrasound.

Pain in this area may be difficult to identify as it’s easy to mistake it for ataxia or hock arthritis, however physical exams with palpation of the rump usually reveal it’s source.


Horses suffering from Sacroiliac (SI) joint pain often exhibit subtle and difficult-to-detect signs. This issue arises when their hindquarters become unsound; therefore it may be confused with other issues affecting movement such as hock or stifle issues.

SI problems often manifest themselves as horses not moving well at canter or lope, with ataxic back legs almost moving together or seemingly offbeat movements. When lunged, these horses will appear lame on one side but appear sound on the other side of their bodies.

Veterinarians will take an extensive client history and physical exam on the horse, plus use ultrasound or scintigraphy imaging techniques to accurately diagnose problems. “That way you can start treating the appropriate structures rather than guesswork,” according to Van Wessum.

Treatment typically includes multimodal care with a physical training program tailored specifically for each horse, according to Poncelet. The goal is to strengthen and supple hindquarters quickly so horses can get back to work as soon as possible; your veterinarian will advise on the most suitable approach for your animal; likely including stall rest, anti-inflammatories and gradually increasing intensity and frequency of exercises over time – as well as massage, shock wave therapy, acupuncture or at-home exercises which help regain muscle strength and movement patterns.


Sacroiliac joint issues can be challenging to detect, with symptoms often being subtle and vague. Even “hunter’s bump,” the raised area at the top of your croup that has long been believed to indicate SI issues, isn’t always reliable as an indicator. Furthermore, due to their slow healing rate and often being associated with other hind-limb issues like hock pain and proximal hind-suspensory desmitis they’re difficult to pinpoint exactly.

If a vet suspects sacroiliac issues in a horse, they’ll usually block nerves in that region with local anesthetic (much like they would for nerves and joints in other limbs) in order to see if that helps reduce or eliminate lameness in their horse. They may also employ nuclear scintigraphy – in which radioactive substance is injected into their system that gathers where active bone growth exists such as new arthritis areas while being monitored with a gamma camera – in order to gather more reliable results.

Medications like glucosamine can provide some temporary relief, but long-term stability requires rehabilitation and physiotherapy services that focus on building strong muscles to protect the SI joint from further injury.


As a horse owner, you should be adept at recognizing the symptoms of your horse; however sacroiliac joint pain can be more challenging to recognize due to symptoms that could indicate anything from simple hind end problems to complex issues.

Physical examination is essential in diagnosing this issue and your veterinarian may need to rule out other possible causes, such as suspensory ligament desmitis or kissing spines, that might also contribute to lameness in your animal. Since large muscles cover this area, xrays and ultrasound may not provide enough information; scintigraphy (bone scan) and diagnostic rectal examination can detect changes in blood flow as well as lesions to ligaments or bones that would not otherwise be visible.

One of the primary treatments in this instance is to decrease inflammation. Your vet may recommend nonsteroidal anti-inflammatory drugs like phenylbutazone or meloxicam to alleviate pain and promote healing.

Your veterinarian can administer steroids to the SI region to reduce inflammation in its joint and ligaments. This process should be undertaken alongside physiotherapy and rehabilitation programs designed to encourage your horse to develop appropriate muscle groups in his back and pelvis to track up normally at this area while engaging the hind quarters normally as well. Lunging aids or water treadmill exercises can be highly effective ways of accomplishing this.


An attentive horse owner must remain vigilant for signs that their equine companion might be in pain. Such signs include horses that cannot back up, won’t pick their hind feet up for farrier inspection, or refuse to move forward over cavaletti or upward transitions – these could all be indicators that their partner could be experiencing sacroiliac joint discomfort.

Sacroiliac joint diagnosis can be tricky because this area of dense muscled and inaccessible to radiographs. Therefore, veterinarians may use physical exams with various components focusing on behavior and performance to look for pain in this region of a horse’s back. They might also inject him or her with nuclear scintigraphy agents that use radioactive compounds to detect areas where new bone growth has taken place such as an arthritic joint.

Preventing sacroiliac joint issues in horses is vitally important to their overall health and performance. Make sure they receive a good warm-up walk before training sessions, are given plenty of rest between sessions, are not overtired or stressed out and injuries to their sacroiliac joints are very prevalent among competition horses who jump and display high rear engagement levels; when caught early with rapid diagnosis and rehabilitation programs designed to return them back to prior levels of activity.

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