Navicular syndrome refers to a variety of conditions that create pain in and around the structures surrounding the navicular bone. Palmar heel pain is an alternate term, referring to the site of the nerve block (at the back and bottom of the front feet) that resolves pain for all these conditions.
Heel pain can occur to any horse, but the risk is higher for Quarter Horses, Thoroughbreds, and warmbloods, especially those over the age of 7. Horses with large, heavy bodies and small hooves are at even greater risk.
Watch for these symptoms and consult with your veterinarian if any appear: increased stumbling; a shortened, choppy stride; standing with a front foot pointed; front-end tenderness on hard ground or when moving in a circle.
Your vet will determine whether your horse has navicular syndrome, then try to pinpoint which disease process is at work. MRI and other advanced imaging techniques may be needed; the more precise the diagnosis of the cause, the more precise and effective the treatment.
What Can Be Done
To lower the risk that your horse will ever develop navicular syndrome, provide all the horsekeeping standards that are basic to excellent care. These include correct and regular hoof care, proper nutrition (that prevents obesity), regular exercise plus turnout, and decent footing.
If your horse does develop heel pain, your vet is likely to recommend therapeutic trimming and/or shoeing (see below). In addition, depending on the source of your horse’s pain, your vet may propose medical therapies applied systemically or injected into the coffin joint or navicular bursa to reduce inflammation or preserve bone (at right). The intermittent use of NSAIDs (such as bute) may also be a part of the plan.
Though navicular syndrome usually can’t be fully cured, proper management and treatment can reduce stress, inflammation, and pain in the affected areas, and some horses may even remain ridable.
Hoof Care Is Critical!
Correct trimming/shoeing should be the basis of all heel-pain treatment, with any medicinal or surgical strategies considered adjuncts. A skilled farrier should first remedy any pre-existing problems, including underrun, contracted, or sheared heels; mismatched hoof angles; or a broken hoof/pastern axis. The feet must be carefully balanced, with all weight-bearing structures brought into play. Hooves must be able to expand when they make contact with the ground, plus roll forward efficiently (good “rollover” requires toes to be properly shortened and beveled). In all cases, therapeutic farriery should be based on the horse's individual case needs rather than on a standard formula.