Equine Navicular Syndrome and Heel Pain; New Perspectives

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Navicular syndrome is a very common problem in the equine industry, likely impacting 30% or more of horses, dependent on the breed and discipline. We see this condition commonly in the western disciplines but also to varying degrees in other sports, including jumping, dressage and even racing. There are many factors that contribute to the problem, which can make it difficult at times to manage. All too often, though, we tend to wait until the condition has progressed, with irreversible damage, before we properly intervene. With a better understanding, hopefully we can recognize the condition sooner, see contributing factors and produce better results for the patient in the long term.

When we mention the words "navicular disease", we really have to define what we are referring to in the patient. The condition is quite complex, having various stages of development, some more readily recognized than others. Given this, we often use the term 'navicular syndrome' as this can be more accurate, encompassing the many stages of progression. In some horses, we use the term 'caudal heel pain', which is not far removed from 'navicular syndrome', as it is likely just a general categorization for the patient.

Overall, the situation in which we have heel pain and lameness is quite common in equine practice, involving many structures within the caudle hoof including the navicular bone, associated ligaments, joint capsule, navicular bursa, deep flexor tendon and even collateral cartilages of the coffin bone. Due to progression or stage of the condition, localization of the exact source of pain can be difficult as many other areas are impacted due to compensation. This is often seen more in chronic cases, evident not only by heel pain, but also stiffness higher up in the limb, including the shoulder and even neck region. In some cases, we will see toe sensitivity, due to improper loading and landing of the foot. In others, especially with progression, we may see compensatory lameness even in a rear limb or lower back...

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