Mesotherapy is a medical treatment option for alleviating musculoskeletal pain, particularly in the area of the horse's back and neck , caused by muscular tension or bony changes like "Kissing - Spines". Multiple thin needles are placed intra - dermally in the back region. These injections contain various combinations of medications including local anesthetics, corticosteroids, and muscle re laxants. The aim is to block pain transmission within the affected area. Mesotherapy, especially when combined with shockwave therapy and a consistent and appropriate training program, shows promising results.