Navicular Syndrome in Horses

Navicular syndrome or navicular disease is the cause for one-third of all chronic front-end lameness in horses. This condition can be difficult to diagnose and typically involves the navicular bone, navicular bursa, deep digital flexor tendon and other soft tissue structures that make up the navicular apparatus. Research has demonstrated that while many treatment options are available only 65% to 75% of affected horses will see an improvement in performance and approximately 50% of those that experience an improvement will be able to maintain that condition for one to two years, making long term success variable and increasing owner frustration.

A horse with navicular syndrome will commonly experience heel pain and will shift their weight to their toe while moving. This creates a shortened, choppy stride. They will also commonly display a pain response when hoof testers are applied over the middle third of the frog. The degree of lameness varies based on the severity of the progression and pain tolerance of each individual. Navicular syndrome is a complex and multifactorial condition. The exact cause remains unclear, but there are several factors that may contribute to the disease.

  • Biomechanical stress: The repetitive strain on the navicular bone, often due to poor conformation or the type of work a horse is subjected to, can lead to degeneration. Horses with upright pasterns, small hooves relative to their body size, or those working on hard surfaces are at higher risk. Improper or unbalanced shoeing or trimming can exacerbate the stress on the navicular area and ultimately increase inflammation and pain experienced in the region.
  • Genetics: Certain breeds, such as quarter horses, thoroughbreds and warmbloods, are predisposed to navicular syndrome due to hereditary conformational traits.
  • Poor blood supply: Reduced blood flow to the navicular bone can lead to its degeneration. Over time, this can result in bone remodeling and damage to surrounding structures, including tendons and ligaments.

Treating navicular syndrome is often challenging due to its chronic nature and the involvement of multiple structures within the hoof. However, several approaches can manage symptoms and potentially slow disease progression:

  • Corrective shoeing: One of the most common treatments involves modifying the horse’s shoeing regimen. Farriers may use specialized shoes, such as egg bar shoes, or techniques like raising the heels to reduce pressure on the navicular bone.
  • Medication: Nonsteroidal, anti-inflammatory drugs (NSAIDs) are commonly used to manage pain and inflammation. Bisphosphonates, which inhibit bone resorption, are also increasingly used to treat navicular syndrome. In some cases, corticosteroid injections directly into the affected area can provide temporary relief.
  • Physical therapy: Regular, controlled exercise can help maintain circulation in the hoof and keep the horse in shape, preventing additional stress from weight gain or muscle loss.
  • Surgery: In severe cases, a surgical procedure called a palmar digital neurectomy, which involves cutting the nerves to the affected area, may be considered. This approach can alleviate pain, but it also comes with risks, including the potential for the horse to become more prone to injury without the ability to feel pain in the hoof.
  • Alternative therapies: Some horse owners and veterinarians explore alternative treatments such as acupuncture, magnetic therapy or the use of therapeutic ultrasound. These methods aim to improve blood flow and reduce pain, although their efficacy can vary.

The progression of the disease varies; some horses may manage with mild symptoms for many years, while others might experience a rapid decline in hoof function. Early diagnosis and proper management are crucial in extending a horse's performance career. With appropriate treatment and care, some horses can continue to perform at a competitive level, though they may require modifications to their workload and shoeing regimen. Unfortunately, the chronic nature of navicular syndrome often leads to a gradual decline in a horse's ability to perform. As the condition progresses, affected horses may need to be retired from high-impact activities. Their roles may shift to less demanding tasks, or they may transition into a breeding or companion animal role. Horse owners and veterinarians must work closely to tailor a management plan that addresses the individual needs of each horse, with the ultimate goal of maintaining their quality of life and extending their useful careers.

X-ray of a horse's foot.

A navicular x-ray. Photo by Meredith Hicks

Diagram of navicular bone, deep digital flexor tendon, and navicular bursa of a horse's foot.


4/17/2025 7:53:33 PM
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