🐎 Navicular Bursal Injections in Horses: Advanced Lameness Care in 2025 💉🦴

By Dr Duncan Houston BVSc

Navicular syndrome remains one of the most frequent and frustrating causes of chronic front limb lameness in horses. Thanks to advancements in diagnostics and treatment—particularly navicular bursal injections and MRI imaging—horse owners and veterinarians in 2025 have better tools than ever to manage this complex issue. In this blog, I’ll walk you through what navicular syndrome is, how we diagnose it, and how targeted injections can offer relief. 🧠🐴

🦴 What Is Navicular Syndrome?

Navicular syndrome refers to pain arising from the navicular region in a horse's front feet. This area includes:

• 🛶 The navicular bone (boat-shaped, hence the name)
• 🧵 Surrounding soft tissue structures—ligaments, bursa, and tendons
• ⚙️ The coffin joint and navicular bursa (a fluid-filled sac that reduces friction)

Pain in this region can result from arthritis, inflammation, or soft tissue damage and usually causes a subtle, progressive lameness that worsens with exercise. 🐾⚠️

🔍 Recognizing Symptoms of Navicular Disease

Early symptoms may include:

• 🐌 Sluggishness during work
• 🎯 Shortened stride, especially in the front
• ↘️ Reluctance to turn tightly or go downhill
• 🧼 Hoof sensitivity—especially when using hoof testers over the frog

One hallmark is that pressure with hoof testers causes a pain reaction when applied to the central part of the foot. This clue, combined with lameness patterns, points to navicular region involvement. 👀

🧠 Why Diagnosis Can Be Tricky

Determining if lameness is truly coming from the navicular region isn't always simple. Horses can appear to be lame in the foot, knee, or shoulder, but appearances are deceiving. That’s where diagnostic nerve blocks come in. 💉

🔄 Nerve Blocks: The First Step

• 💉 Local anesthetic is injected into specific nerves to numb the foot
• 🧠 If lameness disappears, we know the pain source is in that region

This technique narrows down the area before advanced imaging is pursued. Without nerve blocks, diagnostic imaging can be misleading. 🩺

📸 Why X-Rays Aren’t Enough

While radiographs are a common first step, they don’t always reveal the true picture:

• 🦴 Some horses show navicular changes on X-ray but have no pain
• 🦶 Others experience severe pain but show normal radiographs

This disconnect is due to X-rays only showing bone—not soft tissue. So what’s the answer? 🧩

🧲 MRI: The Game-Changer

The gold standard for diagnosing navicular syndrome in 2025 is Magnetic Resonance Imaging (MRI). MRI reveals both bone and soft tissue changes, offering a complete view of the navicular region. 🧲📊

With MRI, we can identify:

• 📌 Inflammation or tears in the deep digital flexor tendon
• 💧 Swelling or fluid buildup in the navicular bursa
• 🦠 Bone edema or degeneration of the navicular bone

This precision enables more targeted treatment, including navicular bursal injections. 🎯

💉 Navicular Bursal Injections: How They Work

When pain originates from inflammation within the navicular bursa, a navicular bursal injection can provide significant relief. Here's what the procedure involves:

• 🧼 The horse is sedated and the area is sterilized
• 📍 A needle is inserted into the navicular bursa under ultrasound or fluoroscopic guidance
• 💉 Anti-inflammatory medication (such as corticosteroids or regenerative therapies) is injected

The goal is to reduce inflammation, ease pressure, and promote healing within this high-friction zone. ⏳🦶

📈 Success Rates & Expected Outcomes

When navicular bursal injections are administered in properly diagnosed cases:

• ✅ Pain relief is typically seen within days to weeks
• 🔄 Repeat injections may be needed every 6–12 months
• 🏇 Horses often return to full work with appropriate rehab

These injections are often combined with corrective shoeing, joint supplements, and workload adjustments for best results. 💪🐴

🧰 Additional Supportive Treatments

Managing navicular syndrome holistically includes:

• 🧲 Magnetic or shockwave therapy
• 📉 Controlled exercise regimens
• 🧴 Anti-inflammatory medications or regenerative therapies (e.g., PRP, IRAP)
• 🧑‍🏫 Partnering with an experienced farrier for proper shoeing

Regular monitoring and early intervention are crucial for keeping your horse sound and pain-free. 🐾👟

📲 Get Help from AskAVet.com

If your horse shows signs of navicular pain or isn’t responding to basic hoof care, visit AskAVet.com or download the Ask A Vet App. 📱🧠

Dr Duncan Houston and the Ask A Vet team can help you understand nerve blocks, guide you on when to pursue MRI, and discuss if navicular bursal injections are right for your horse. 💬🐎

🏁 Final Thoughts

Navicular syndrome doesn't have to mean the end of your horse’s career. With cutting-edge tools like MRI and targeted treatments such as navicular bursal injections, horses today have a better prognosis than ever before. In 2025, soundness starts with smart diagnostics and collaborative care. 🧠💉

Get expert lameness support today at AskAVet.com and protect your horse’s future 🐴🩺