X-ray image of a horse’s hoof showing clear internal structures such as the navicular bone, coffin bone, and coffin joint. The image illustrates navicular syndrome in horses, a degenerative condition affecting the navicular bone and the deep digital flexor tendon, which can lead to lameness.

Navicular in horses: Symptoms, treatments and prevention of the navicular syndrome

Q: What are the most common signs of navicular syndrome?

Typical symptoms include lameness, toe-walking, stumbling, and gait irregularities, especially on hard surfaces or during turns.

Q: What are the first signs of navicular in horses?

The early signs of navicular in horses often include subtle lameness, shortened stride, or reluctance to move forward. Horses may begin to land toe-first or stumble more frequently.

Q: How to tell if a horse has navicular?

Diagnosis includes clinical evaluation, nerve blocks, X-rays of navicular disease in horses, and advanced imaging like MRI to assess both bony and soft tissue changes.

Q: What are the changes in a horse's navicular X-ray?

Radiographs may show irregular bone surfaces, increased bone density, navicular bone cysts, or narrowing of joint spaces. However, not all changes are visible early – this is why MRI is often recommended.

Q: What is the difference between navicular syndrome and navicular disease?

The terms are often used interchangeably. Technically, navicular syndrome refers to a group of conditions causing pain in the navicular region, while navicular disease specifically refers to degeneration of the navicular bone itself.

Q: What is the best treatment for navicular in horses?

There is no single solution. The best results come from a combination of therapeutic shoeing, anti-inflammatory medication, and in some cases bisphosphonates, shockwave therapy, or surgery. Supportive care may include Equi-bone or other supplements.

Q: What supplements are good for navicular syndrome?

Some owners use supplements aimed at joint support and bone metabolism, such as Equi-bone, MSM, hyaluronic acid, or omega-3 fatty acids. However, their effectiveness may vary by case.

Q: How do you treat navicular bone edema in horses?

Navicular bone edema is often managed with rest, anti-inflammatory medication, corrective shoeing, and in some cases, bisphosphonate therapy. Close veterinary monitoring is essential.

Q: How do you corrective shoeing for navicular disease?

Corrective shoeing aims to reduce stress on the navicular region. Common options include egg bar shoes, rocker toes, wedge pads, and rolled toes. Shoeing must be tailored to the individual horse and guided by a farrier and vet.

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Reading Time: 12 minutes

Navicular disease in horses is among the most common causes of lameness, especially in sport and leisure horses. In this article, we explain clearly what navicular syndrome in horses is, how to recognize the signs, what treatment options exist, and what the long-term prognosis looks like. You’ll also receive helpful tips on prevention and daily management of affected horses.

Table of Contents

What is navicular in horses?

Navicular syndrome – also known as navicular disease or podotrochlosis – is a degenerative condition involving multiple structures within the navicular apparatus of the horse’s hoof. The most commonly affected components include the navicular bone in horses (also called navicular bone horse), the deep digital flexor tendon, the navicular bursa (bursa podotrochlearis), and surrounding ligaments and soft tissues.

Definition

Navicular syndrome in horses is an inflammatory and/or degenerative disorder affecting the navicular region, which can gradually lead to chronic lameness. The condition is most frequently diagnosed in the front limbs, particularly in Warmbloods, Western horses, eventing horses, and those under high physical stress.

Anatomy: The Navicular Apparatus Explained

To fully understand the signs of navicular disease in horses, it helps to take a closer look at the anatomy involved.

The navicular unit consists of:

The navicular bone (a small bone located between the coffin bone and the short pastern)
The deep digital flexor tendon, which runs over the navicular bone
The navicular bursa, a fluid-filled sac that cushions the tendon
Surrounding blood vessels, nerves, and connective tissue

The navicular bone in horses functions like a pulley system: each time the hoof moves, the tendon glides over this small bone. This area is subject to intense stress and is therefore especially vulnerable to degenerative changes and injury.

Anatomical diagram of the navicular apparatus in horses, labeled with the coffin bone, navicular bone, short pastern bone, long pastern bone, and the deep digital flexor tendon. The image highlights the central role of the navicular structure in navicular disease (podotrochlosis).

Causes: How Does Navicular Disease Develop in Horses?

The exact causes of navicular syndrome in horses are not always clear-cut. In most cases, it results from multiple stressors and risk factors acting together. Here are the most common triggers:

Misconformations

Horses with improper hoof conformation – for example, those with laminitic feet, displaced heels, or excessively long toes – are particularly vulnerable. These misalignments can change the load distribution on the navicular bone in horses, making it more susceptible to degeneration. In other words, when you ask, what is navicular syndrome in horses, one key answer is that what causes navicular in horses can frequently be traced back to such conformational issues.

Overload

Continuous high-intensity work – such as frequent jumping, rigorous dressage, or intense Western training – places enormous stress on the forelimbs. This overload promotes wear and tear on the navicular bone horse and the surrounding structures. In many cases, riders and trainers wonder, Can a horse with navicular be ridden? Proper management of workload and appropriate navicular horse treatment are essential to prevent further damage.

Genetic Predisposition

Some breeds appear to be more susceptible to navicular disease in horses. Breeds like Quarter Horses and Hanoverians, for example, often display a higher incidence of navicular syndrome. Understanding this genetic disposition can help in early diagnosis when looking for early signs of navicular in horses.

Management and Movement Deficiencies

Several factors related to the horse’s daily environment and care can contribute to the development of navicular in horses:

Lack of turnout: Limited pasture time can lead to insufficient movement.
Prolonged stall confinement: Extended periods of box rest can result in poor hoof circulation.
Inadequate footing: Hard or uneven surfaces increase stress on the hoof.
Inappropriate hoof care: An incorrectly fitted shoe or improper barefoot trimming disrupts the biomechanics of the hoof. This improper care can complicate shoeing the navicular horse and contribute to the overall risk.

ℹ️ Who Is Particularly at Risk?

→ Warmbloods and Western horses are more frequently affected, as they often participate in disciplines that subject their front limbs to intense stress.

→ Horses with misalignments, such as laminitic feet or excessively steep heel angles, are more prone to navicular issues.

→ Additionally, sport horses that consistently endure high levels of workload – particularly on hard ground or in tight, maneuvering situations – are at elevated risk for degenerative changes of the navicular bone in horses.

Symptoms: How to Tell if a Horse Has Navicular

The signs of navicular disease in horses often develop gradually and can be difficult to pinpoint in the early stages. The condition may go unnoticed until performance issues or lameness become more apparent.

Typical navicular in horses symptoms include:

Lameness, initially only during work or on hard surfaces, but potentially becoming constant over time
Frequent stumbling or tripping
Irregular rhythm (gait asymmetry), especially noticeable in circles or tight turns
The horse lands on its toe to relieve pressure on the heels
Tension in the back muscles due to compensatory movement
Pain reaction during hoof tester examination

In many cases, the lameness affects one front limb, but it may also occur on both sides, which can lead to a vague or generalized lameness pattern.

❗ What to Do if You Suspect Navicular Syndrome

If your horse stumbles, shows irregular rhythm, or appears lame, you should seek veterinary advice without delay. The earlier a diagnosis is made, the better the chances of managing the condition and preventing progression through appropriate navicular treatment for horses.

Diagnosis: How Is Navicular Syndrome Diagnosed?

Accurately diagnosing navicular syndrome in horses requires a structured, step-by-step approach. Because navicular in horses symptoms can be subtle or overlap with other orthopedic issues, a thorough clinical and diagnostic workup is essential. The process typically involves the following steps:

A veterinarian or equine clinic with experience in diagnosing navicular disease in horses should always be consulted. Imaging is crucial for confirmation.

Gait Evaluation and Flexion Tests

Initial assessment includes observing the horse’s movement on different surfaces, both hard and soft. A shortened, cautious stride on the affected front limb is often seen. Flexion tests are then used to apply targeted pressure to joints and soft tissues. If the lameness increases, this may point toward involvement of the navicular bone in horses.

Nerve Blocks (Diagnostic Anesthesia)

Diagnostic nerve blocks are a key tool to localize pain. The palmar digital nerve, which innervates the navicular region, is commonly blocked first. If the lameness significantly improves after the injection, the source of pain is likely in the deep structures of the hoof, including the navicular bone horse, navicular bursa, or surrounding ligaments.

X-Rays of Navicular Disease in Horses

X rays of navicular disease in horses can reveal bony changes such as:

Degeneration of the navicular bone
Increased bone density or calcification
Cyst-like lesions (→ navicular bone cysts in horses)
Irregular or rough bone surfaces

However, since soft tissue structures like tendons or the navicular bursa cannot be seen clearly on radiographs, further imaging is often required for a complete diagnosis.

Scintigraphy (Bone Scan)

In cases of unclear or hard-to-localize lameness, scintigraphy can be used as an advanced diagnostic method. This nuclear medicine technique highlights areas with increased metabolic activity – such as inflammation in the navicular bone in horses. It is particularly useful when standard diagnostic methods like flexion tests or X rays of navicular disease in horses do not produce conclusive results.

Scintigraphy is especially valuable for identifying:

Subtle early signs of navicular in horses
Hidden navicular bone cysts in horses
Diffuse pain sources in the deep hoof structures

Magnetic Resonance Imaging (MRI)

MRI is considered the gold standard for evaluating the navicular region in detail. This imaging method allows for high-resolution visualization of:

Tendons
Ligaments
Cartilage
The navicular bursa
And the navicular bone horse itself

MRI is particularly helpful when diagnosing:

Soft tissue injuries not visible on radiographs
Fractured navicular bone in horses
Early degenerative changes in the navicular bone in horses

Because navicular disease in horses often affects both bony and soft tissue components, MRI offers the most complete and accurate picture of the damage. This makes it essential for determining the best navicular horse treatment strategy, especially in borderline or progressive cases.

Navicular treatment for horses

The right navicular treatment for horses depends on how advanced the condition is. Most horses require a combination of conservative, orthopedic, and sometimes surgical treatments.

Conservative navicular horse treatment

Stall rest or controlled movement
Anti-inflammatory medication (e.g. phenylbutazone)
Physiotherapy and massage
Adjusted training with reduced strain on the front limbs

Shoeing the navicular horse

Corrective shoeing is often critical. A properly fitted shoe can relieve pressure on the navicular bone in horses and support better heel-first movement.

Goals of therapeutic shoeing:

Offloading the navicular bone horse
Improving biomechanics and hoof balance

Common corrective shoeing options:

Egg bar shoes
Rocker-toe or wedge shoes

Some owners also support the treatment with supplements such as Equi-bone, which are intended to improve bone density, although clinical evidence is limited.

Medical injections for navicular syndrome

Corticosteroids for inflammation control
Hyaluronic acid to support tendon gliding over the navicular area
Bisphosphonates (e.g. Tildren) to reduce bone resorption and slow down degeneration

Surgical navicular treatment for horses

If conservative methods fail, two main surgical options exist:

Neurectomy – surgical severing of the pain-transmitting nerves.
- Risk: Without pain feedback, the horse may injure itself unknowingly.
Navicular bone drilling – pressure relief through small boreholes in the navicular bone

Prognosis: Can a horse with navicular be ridden?

The prognosis varies greatly depending on when navicular syndrome is diagnosed and how well it is managed.

Mild cases: With early treatment and correct training, many horses can return to work.
Severe cases: Chronic progression often leads to limited long-term performance.
Post-neurectomy: Horses may become pain-free, but this is not a cure.

A full recovery is rare. The realistic treatment goal is long-term pain management and quality of life.

Preventing navicular syndrome in horses

Regular hoof trimming every 6–8 weeks, tailored to the individual conformation
Avoiding excessive stress – including warm-ups, varied footing, and rest periods
Natural, species-appropriate management with turnout and social contact
Balanced training – gymnastic, non-repetitive exercise routines
Early detection through regular gait analysis and veterinary checks

Navicular syndrom: Frequently Asked Questions (FAQ)

What is navicular syndrome in horses?

Navicular syndrome is a degenerative and/or inflammatory condition affecting the navicular bone in horses, the navicular bursa, and the deep digital flexor tendon. It is also commonly referred to as navicular disease in horses.

What are the most common signs of navicular syndrome?

Typical symptoms include lameness, toe-walking, stumbling, and gait irregularities, especially on hard surfaces or during turns.

What are the first signs of navicular in horses?

The early signs of navicular in horses often include subtle lameness, shortened stride, or reluctance to move forward. Horses may begin to land toe-first or stumble more frequently.

How to tell if a horse has navicular?

Diagnosis includes clinical evaluation, nerve blocks, X rays of navicular disease in horses, and advanced imaging like MRI to assess both bony and soft tissue changes.

What are the changes in a horse's navicular X-ray?

Radiographs may show irregular bone surfaces, increased bone density, navicular bone cysts, or narrowing of joint spaces. However, not all changes are visible early – this is why MRI is often recommended.

What is the difference between navicular syndrome and navicular disease?

The terms are often used interchangeably. Technically, navicular syndrome refers to a group of conditions causing pain in the navicular region, while navicular disease specifically refers to degeneration of the navicular bone itself.

What is the best treatment for navicular in horses?

There is no single solution. The best results come from a combination of therapeutic shoeing, anti-inflammatory medication, and in some cases bisphosphonates, shockwave therapy, or surgery. Supportive care may include Equi-bone or other supplements.

What supplements are good for navicular syndrome?

Some owners use supplements aimed at joint support and bone metabolism, such as Equi-bone, MSM, hyaluronic acid, or omega-3 fatty acids. However, their effectiveness may vary by case.

How do you treat navicular bone edema in horses?

Navicular bone edema is often managed with rest, anti-inflammatory medication, corrective shoeing, and in some cases, bisphosphonate therapy. Close veterinary monitoring is essential.

How do you corrective shoeing for navicular disease?

Corrective shoeing aims to reduce stress on the navicular region. Common options include egg bar shoes, rocker toes, wedge pads, and rolled toes. Shoeing must be tailored to the individual horse and guided by a farrier and vet.

Can a horse with navicular be ridden?

Yes, in mild cases and if the horse is pain-free with proper treatment. Always consult a vet before riding a horse with navicular issues.

How long can a horse live with navicular?

Many horses with navicular can live a long and comfortable life if properly managed. Long-term soundness depends on severity, treatment, and use.

How long can a horse live with navicular disease?

With early diagnosis and the right treatment plan, horses can remain pasture-sound or even lightly ridden for many years.

What is the prognosis for navicular disease in horses?

The prognosis varies. Mild cases often respond well to conservative management, while advanced cases may have limited athletic potential. Surgery can help in selected cases but is not curative.

Can navicular disease be prevented?

Complete prevention is not always possible, but the risk can be reduced with:

Balanced hoof care
Proper training
Avoiding overload
Early intervention when signs appear

Author

Sina Schulze DISCOVER CMH.TV