Many recurrent spinal problems may be due to gait problems, possibly as a result of a missed joint injury. They can also be due to poor saddle fit, poor teeth, or long term one-sided riding. Problems at specific spinal levels can reveal health problems in particular organs.

Simply treating the back is not sufficient to achieve positive, permanent changes. Also many limb injuries that are not responding to usual treatment may be aggravated by spinal malalignment or a more widespread inflammatory condition.

Hormone imbalances will also create unacceptable behaviour. However there are also instances where these responses arise from a breakdown in communication between humans and horses. These can usually be easily rectified by modifying stable routines and attitudes to give the horse clearer signals in a form that they can understand.

Whatever the problem, an expert opinion is essential.

Areas of restriction are freed, by manipulation or slower stretching techniques. Muscular stiffness is massaged. Other more gentle methods, called craniosacral technique involves lightly holding the head or pelvis. The horse (and rider) is helped to find a point of relaxed self-carriage. Problems may also be linked to the internal chemistry of the horse, such as: hormone imbalances, food intolerance's as well as loss of performance following viral infections or chronic parasite infestation.

Natural medicine uses a wide range of other techniques, such as acupuncture, nutrition, herbal and homeopathic remedies to restore balance. Behavioural problems often have a physical reason. Irritable or aggressive behaviour can be a sign of pain or fear.