Navicular vs Arthritis in Horses: How to Tell
Navicular syndrome and arthritis both cause lameness but differ. How to tell them apart, how vets diagnose each, whether a horse can have both, and how each is managed.
When a horse goes lame and the cause is not obvious, two diagnoses come up again and again: arthritis and navicular syndrome. Owners often use the words almost interchangeably, but they describe different problems, and telling them apart matters because it shapes the whole treatment plan. To complicate things, an older horse can easily have both at once.
This guide explains what each condition actually is, the clues that point toward one or the other, why only a veterinary workup can give a reliable answer, and how each is managed. The short version: you usually cannot diagnose these from the ground, but understanding the difference helps you work effectively with your vet and farrier.
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Supplements support the feet and joints over time, but the first job is an accurate diagnosis. Let's define each condition.
What Arthritis Is
Arthritis, properly called osteoarthritis or degenerative joint disease, is the wear, inflammation, and gradual breakdown of a joint. In horses it most often affects the hocks, knees, fetlocks, pasterns, and coffin joints. Because it can settle in many joints, and frequently in pairs, arthritis often shows up as general stiffness, a shortened stride, or difficulty with particular movements rather than one dramatic limp. A classic sign is stiffness that eases, or warms out, as the horse moves.
What Navicular Syndrome Is
Navicular syndrome is a specific pain condition centered on the navicular bone, a small bone deep inside the heel of the foot, and the soft tissue structures around it, including the deep digital flexor tendon and associated ligaments. It almost always affects the front feet and is frequently bilateral, meaning both fronts are involved. Because the pain sits at the back of the foot, navicular horses often try to unload the heels, which leads to shortened, choppy strides, toe-first landing, stumbling, and pointing a foot at rest. They often feel worse on hard ground and on circles.
The Clues That Point One Way or the Other
You usually cannot diagnose either condition by watching alone, but some patterns lean one way:
- Location: Navicular is a front-foot problem. Lameness that involves the hind limbs or clearly comes from a higher joint points more toward arthritis.
- Bilateral front lameness: A horse that is short and pottery in both front feet, especially on hard ground or circles, raises suspicion of navicular.
- Landing and stance: Toe-first landing, stumbling, and pointing a front foot at rest are classic navicular signs.
- Warming out: Arthritic stiffness often improves as the horse warms up, while navicular pain may persist or worsen with work on hard surfaces.
These are tendencies, not proof. The only reliable way to know is a veterinary lameness exam.
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How Vets Tell Them Apart
The workup is the same in spirit for both: a lameness exam, flexion tests, and hoof testers, followed by nerve and joint blocks to localize the pain. For navicular, blocking the back of the foot improves the lameness, and imaging such as X-rays and often MRI reveals changes in the navicular bone and surrounding soft tissues. For arthritis, blocking and X-raying the suspected joint shows the degenerative changes. Imaging is the deciding factor, because two horses that look similar trotting up the lane can have very different problems inside the leg.
Can a Horse Have Both?
Yes, and older horses commonly do. Age makes arthritis nearly universal, so a senior with navicular changes in the front feet may also have arthritic hocks or fetlocks. This is exactly why a thorough workup matters: it finds every source of pain rather than pinning everything on one diagnosis. Managing such a horse means treating the feet and the affected joints together with a coordinated plan.
How Each Is Managed
There is significant overlap. Both conditions benefit from NSAIDs for pain, excellent farrier care, good footing, weight control, and appropriately adjusted exercise, and both are lifelong conditions managed rather than cured. The differences are in emphasis:
- Navicular leans heavily on foot-focused farrier work to ease breakover and support the heels, often using specific shoeing or pads chosen from X-rays, plus targeted joint or bursa injections and, in some cases, newer bone-targeting medications.
- Arthritis focuses on the particular affected joints, with options like intra-articular injections, systemic joint products, and joint supplements layered onto pain control and management.
For both, a strong vet and farrier partnership and a consistent long-term plan are what keep the horse comfortable. The reputation of navicular as a career-ender is outdated for many horses: with modern care, plenty stay sound enough for light work or a happy retirement, just as many arthritic horses do.
The bottom line is that you do not need to diagnose your horse yourself. If you see persistent or worsening lameness, especially short, pottery steps in both front feet or stiffness that does not warm out, get a lameness exam. Naming the problem correctly is the first step to managing it well.
This article is educational and complements, but does not replace, advice from your equine veterinarian and farrier.
Related Guides
- Ringbone and Sidebone - Two more lower-limb conditions explained.
- Arthritis in Senior Horses - Signs, treatment, and relief.
- Senior Horse Stumbling - When a stumble signals foot pain.
- Best Footing for Arthritic Horses - Surfaces that ease sore feet.
Frequently Asked Questions
What is the difference between navicular and arthritis?
Arthritis, or degenerative joint disease, is wear and inflammation of a joint, which in horses commonly affects the hocks, knees, fetlocks, and pasterns. Navicular syndrome is a specific pain condition centered on the navicular bone and surrounding structures deep inside the heel of the front foot. Both cause lameness, but arthritis can affect many joints throughout the body, while navicular is a foot problem localized to the back of the front feet. A vet distinguishes them with blocks and imaging.
How do I know if my horse has navicular or arthritis?
You usually cannot tell them apart by watching alone, because both cause stiffness and lameness. Some clues help: navicular horses often have bilateral front-foot lameness, point or stumble, land toe-first, and shorten their stride, and they may feel worse on hard ground or circles. Arthritis often shows as stiffness that warms out and can affect hind limbs and upper joints too. Only a veterinary lameness exam with nerve blocks and imaging can give a reliable diagnosis.
Can a horse have both navicular and arthritis?
Yes, and older horses often do. Arthritis is extremely common with age, and a horse with navicular changes in its front feet can easily also have arthritic hocks or fetlocks. This is one reason a thorough veterinary workup matters: it identifies all the sources of pain rather than assuming a single cause. Managing a horse with both means addressing the feet and the affected joints together, which is very doable with a coordinated vet and farrier plan.
Is navicular more serious than arthritis?
Neither is automatically more serious; it depends on severity and location. Navicular syndrome has a reputation as a career-ending diagnosis, but modern farrier care, medication, and newer treatments mean many navicular horses stay comfortable and useful for years. Likewise, arthritis ranges from a minor nuisance to a major lameness. What matters more than the label is how advanced the changes are, which structures are involved, and how well the horse responds to a thoughtful management plan.
How are navicular and arthritis diagnosed?
Both start with a lameness exam, flexion tests, and hoof testers, then nerve and joint blocks to localize the pain. For navicular, blocking the back of the foot improves the lameness, and imaging such as X-rays and MRI shows changes in the navicular bone and nearby soft tissues. For arthritis, blocks and X-rays of the suspected joint reveal the degenerative changes. Imaging is what separates the two, since they can look similar on the ground.
What farrier care helps navicular horses?
Farrier work is central to navicular management. The aims are to ease breakover, support the heels, and improve the balance of the foot to reduce strain on the navicular region. This often involves specific trimming and shoeing, sometimes with bar shoes, wedge pads, or other support chosen by the vet and farrier together based on the horse's foot and X-rays. Because navicular is so foot-centered, a skilled farrier working from imaging is one of the most important parts of the plan.
Can navicular and arthritis be managed the same way?
There is real overlap. Both benefit from NSAIDs for pain, excellent farrier care, good footing, weight control, and appropriate exercise, and both are lifelong conditions managed rather than cured. The differences lie in the specifics: navicular leans heavily on foot-focused shoeing and sometimes targeted injections or newer bone-targeting medications, while arthritis management focuses on the particular affected joints. A vet tailors the plan to the diagnosis, which is exactly why getting that diagnosis right matters.
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