Last Updated on March 18, 2022 by Allison Price

Horses suffering from sacroiliac pain can cause performance problems that can be difficult to manage. Understanding the anatomy of horses is essential to understanding why they develop this condition.

The pelvis is made up of three bones that have been fused together: Ilium, ischium, and pubis. The sacrum (lower part of horses’ back) is made up of five fused vertebrae. The joint between the sacrum and the top of your pelvis is called the sacroiliac (SI). The ligaments that support the SI joint are dorsal and ventral sacroiliac, interosseous sacroiliac, and interosseous. SI pain can be caused by either inflammation of the joint or the ligaments surrounding it. The SI joint transfers propulsion from the hindlimbs into the spine. It supports the horses back and drives them forward when they are in motion.


SI pain is more common in taller, heavier horses between the ages 5 and 15. It is not known if SI problems can be linked to confirmation in horses. Horses used for dressage and show jumping are also overrepresented, as well as Thoroughbreds, Thoroughbreds, and Thoroughbred cross horses. This may be because of the athletic demands that these horses are subject to during their work.

SI pain can be subtle and gradual in its onset and progression. The signs can be worsened if the horse is riding under-saddle. This makes it easier for the rider to see the signs than an observer. Sometimes there may not be any obvious lameness. The most common symptoms of SI pain are listed in Table 1.

Common SI pain complaints
* Inability to perform or poor performance.
* Inability to impel or animate
* Intermittent lameness
* Reluctance or refusal to have the leg flexed for prolonged periods of time.
* Disunited canter or poor canter.
* Do not jump through your back.
* Poor lateral work
* Performance or behavior changes when the bit is worked on

Because of the SI joint’s mass, diagnosis can be difficult due to its complexity. To rule out other conditions, a thorough physical exam must be done by a veterinarian. SI pain can be caused by a change in the mechanics and movement of the hindlimbs and back of the horse. SI pain can also be caused by conditions like suspensory ligament desmitis, kissing spines (impinging spunous processes), and other factors.

Because of the anatomy, Xrays and ultrasound of the SI area are limited. A bone scan (nuclear scintigraphy) is the most sensitive method of diagnosing SI joint problems. Anesthesia can be used to block the SI joint and, if necessary, a pain relief may be administered.

SI pain can be treated with medication, physiotherapy, and a rehabilitation program. To reduce inflammation and swelling in the SI region, steroids can be administered. Your veterinarian will perform this procedure if necessary. It is not uncommon for more than one treatment. Rehabilitation and physiotherapy are essential in order to ensure that the horse’s SI region is properly protected. A tailored rehabilitation program will be developed for each horse suffering from an SI condition. It will outline the exercises and the time frame. Anti-inflammatories and joint supplements can be helpful in reducing inflammation and encouraging healthy joints. Although acupuncture and magnetic rugs/boots may also be beneficial, there is not much evidence to support this.

The SI, in short, is the link between the horse’s hindlimbs and the horse’s head. This condition is most common in horses that are larger than those who show jump or dressage. SI pain is very subtle. It is difficult to diagnose SI pain. Treatment involves both medication and rehabilitation

Allison Price
Allison Price

I’m Allison, born and raised in San Diego California, the earliest memory I have with horses was at my grandfather’s farm. I used to sit at the stable as a kid and hang out with my Papa while he was training the horses. When I was invited to watch a horse riding competition, I got so fascinated with riding!