What is Hoof Pain – Diagnosis & Treatments

by | Feb 1, 2023 | All Posts, Equine Health

Horse hoof pain is a common problem that can be caused by a range of factors, including injury, infection or poor hoof care. It can be difficult to diagnose and treat, but there are a number of ways to do so. In this article, we will discuss what horse hoof pain is, some typical processes for diagnosing it, and some treatments you can try.

Key Takeaways:

    • Horse hoof pain is a common problem that can have many causes.
    • It can be difficult to diagnose and cure horse hoof pain, but many diagnoses and treatment methods exist.
    • MRIs and digital radiographs are popular for diagnosing hoof problems.
    • Some common treatments for horse hoof pain include trimming and balancing the hooves and using hoof pads or shoes.
    • If those methods aren’t successful, other hoof pain treatments are available, from medication to water treadmills and spas.
    • Some hoof pain treatments, like PEMF therapy, may also speed healing.


Hoof pain in horses is not uncommon. Hoof pain can have origins in injury, infection, disease, genetics or inadequate stable hygiene, among other things. A horse may have pain in one or more hooves.

Diagnosing and treating hoof pain can be challenging because symptoms are often vague and varied. However, we have listed a few of the most common causes of hoof pain below.


Commonly referred to as founder, Laminitis is a condition that affects horses’ hooves. Laminitis is when the laminae, the protrusions of soft tissue that connect the coffin bone to the hoof wall, become inflamed. This occurs for many reasons, including lack of exercise, lameness, acute illness, obesity and a poor diet. Horses suddenly exposed to large amounts of rich foods, like lush spring grass or considerable amounts of grain, are also at high risk of developing this condition.

A foundered horse may be reluctant to move. Diagnosis usually consists of a physical exam that includes checking for lameness and sensitivity in the frog. The vet may use digital radiographs to confirm a diagnosis.

Treating this illness begins with determining the underlying cause and addressing it. If not appropriately treated, founder can lead to permanent damage to the hooves.


Bone cysts are a relatively common problem in horses and can cause pain and lameness. These cysts are frequently caused by an injury to the hoof and can lead to the hoof becoming infected.

Symptoms of a bone cyst include inflammation of the joints, limping, reluctance to exercise and intermittent lameness. It’s unclear precisely what causes bone cysts in horses, but possible explanations include trauma to the bone, genetics and nutrition.

If you suspect your horse has a bone cyst, you should contact the veterinarian for diagnosis and treatment. Treatment may involve medication to treat the inflammation, a few months of rest or surgery.


Injury to the sole of the hoof can lead to bruising, a problem many horses encounter at some point in their lives. Bruising is most often caused by accidental injury from treading on a stone or another hard object, overreach, hoof concussion or improper shoeing.

Diagnosing a bruised sole can be tough, as the hoof may not show any visible signs of damage. However, if your horse is lame and has a hoof that is sensitive to touch, there’s a good chance the hoof may simply be bruised.

Treating a bruised sole usually means resting the horse and removing the shoe (if the horse is shod). The hoof may need to be padded or wrapped while it heals to protect it from further injury.


Fractures and puncture wounds are common injuries in horses. Fractures usually occur due to falls, kicks by other horses or collisions with fences or other objects. Puncture wounds, on the other hand, are usually caused by stepping on a sharp object, such as a nail or piece of glass.

Vets diagnose a fracture by looking for swelling, heat and pain around the injury. They may also gauge the horse’s ability to move. A fracture can be confirmed with a digital radiograph. Puncture wounds are more noticeable and are usually seen outright. If you think your horse has a fracture or notice a puncture wound, the veterinarian should be contacted. Puncture wounds have a high chance of becoming infected, so quick treatment is critical.

Fracture or puncture wound treatment may involve surgery, medication or rest. To prevent these injuries, be sure to maintain a clean and safe stable environment and pasture.


Keratoma is a growth or tumour that can form on a horse’s hoof. The exact cause of keratomas is unknown, but the tumour can lead to the hoof becoming infected. As the keratoma grows, it may cause bulging or deformity of the hoof. Lameness may worsen as the keratoma presses on nerves and blood vessels.

Your veterinarian will likely perform a physical examination of the hoof and take X-rays or other diagnostic tests to determine if your horse has a keratoma. Treatment for a keratoma usually involves removing the tumour surgically and using antibiotics to treat any infection. Keratomas are less common than some of the other conditions we’ve discussed, but they can be a real problem if they develop.


Navicular Disease is a degenerative condition that affects the navicular bone and surrounding tissues in the front hooves. The pain from Navicular Disease can be debilitating.

Symptoms of Navicular Disease include lameness and stumbling. The hoof may also be sensitive to touch, and the horse may have a shortened stride. Research currently shows no known cause for Navicular Disease and no cure, but it can be successfully managed in some horses with corrective hoof trimming and balancing of the hoof, along with periods of rest. Medication and surgery may be necessary, depending on severity.


Hoof cracks occur in two types: vertical and horizontal. Vertical cracks extend from the bottom of the hoof towards the coronary band, while horizontal cracks run horizontally across the hoof.

Hoof cracks can signify that the hoof is not correctly trimmed and balanced. If you notice hoof cracks, it’s vital that you treat the problem right away. If left alone, hoof cracks can widen and worsen, become infected and lead to severe lameness. Farriers normally treat a hoof crack by trimming and balancing the hooves. Sometimes, hoof pads or shoes are necessary.


With White Line Disease, bacteria and fungi invade the hoof wall, destroying the tissue. As the infection progresses, horse owners may notice tender hooves, lameness, a “powdery” or “chalky” looking inner surface of the hoof, a hollow-sounding hoof and separation of the hoof wall. Other White Line Disease symptoms include hoof swelling and a foul odour.

Treatment usually consists of removing the infected hoof tissue, treating the hoof with an antiseptic and resting the animal while the hoof regrows. A skilled farrier is fundamental to achieving the best results when treating White Line Disease.


Not to be confused with White Line Disease, thrush is a hoof infection in horses caused by bacteria and fungus in the horse’s frog. The most common symptoms of thrush are a bad smell and discharge from the hoof. The hoof may also be sensitive, and the horse may exhibit discomfort with behaviour changes, like a poor appetite or irritability.

Farriers often treat thrush by cleansing the area and carefully removing necrotic debris to expose healthy tissue. Sometimes, an antiseptic is applied. The horse should also be moved to a clean, dry location.


Hoof pain is sometimes difficult to diagnose, as horses cannot tell us where or how much pain they are in. However, owners should watch for a few noticeable signs of hoof pain to protect their horses’ health. We’ve listed a few common symptoms of hoof pain below.

Shifting Weight

Horses with hoof pain often shift their weight in an attempt to relieve the discomfort. This is an unmistakable signal that the horse is hurting somewhere, usually in the hoof or leg region.


Lameness is an immediate red flag that a horse needs veterinary attention. A horse with hoof pain may favour one hoof over the other and put more weight on the hoof that is not painful, changing their gait and stance. Eventually, lameness may worsen to the point where the horse cannot put any weight on the affected hoof.

Head Carriage Changes

If a horse is experiencing foot pain, it will often hold its head in an abnormal position–either high or very low. The horse may also hold the head rigidly as it moves or bob it unnaturally.

An “Off” Stance

Generally, horses stand differently depending on where their pain is situated. For example, those with heel pain usually stand with their feet more towards their belly rather than directly underneath them. The opposite is true for those feeling pain along the toe or front of their foot. This isn’t always the case, but stance can be valuable to your evaluation.

Shortened Stride

A horse with hoof pain often has a shortened stride or a stiff gait. Many horses tend to move slowly when they’re hurting, almost as if they’re shuffling. In more extreme cases, the horse will look like it’s walking on eggshells.

A “wooden” gait is usually indicative of a horse in pain. That said, it’s helpful to remember that a stiff gait can also be caused by other factors, such as arthritis or even abdominal discomfort.

Reluctant to Turn

Turning or moving tightly in a circle puts more weight on the leg on the inside of the turn, which may enhance the horse’s pain and cause a reaction.

Irritability (Lashing Out)

Horses in distress tend to be irritable and may lash out when touched. This is especially true if the hooves are painful. The horse may pin its ears back and bite or kick when someone tries to touch its hooves or force it to move.

Avoidance of Hard or Rocky Ground

Horses that aren’t shod may start to avoid hard or rocky ground if they have hoof problems. Hooves can be easily damaged on these surfaces, worsening pain.

If you notice any clues that your horse may be having hoof pain, reach out to a veterinarian as soon as possible. Hoof pain can quickly become serious if it’s not treated properly. Even when hoof pain is mild, it can limit a horse’s ability to move and exercise, which can lead to weight gain and other health problems.


There are a few different approaches for diagnosing hoof pain in horses. The first is evaluating the horse’s hooves and checking for abnormalities. If abnormalities are spotted, the hooves may be trimmed and balanced, and a further evaluation conducted.

The second is by observing the horse’s gait. A horse with hoof pain often adjusts how it carries itself, altering its stride and head carriage.

The third way to diagnose hoof pain is by looking at the horse’s hooves for signs of inflammation or infection. The hooves may be red, warm to the touch and/or swollen. There may be apparent pus or discharge coming from the hooves as well.

In addition to the physical exam, some vets use MRIs or digital radiographs to diagnose hoof disorders and injuries.


An MRI is the best imaging tool for diagnosing Navicular Disease and other nuanced hoof problems. An MRI allows the vet to see the soft tissue structures in the hoof, including the navicular bone and cartilage. MRIs give veterinarians a deep look inside that hoof structure.

Digital Radiographs

Digital radiographs are another way to take images of the hoof. They are less expensive than MRIs and are more commonly used by vets and farriers, but they don’t provide as much detail. Digital radiographs are often used to diagnose things like hoof fractures.


Treatment for hoof problems depends on the underlying cause of the issue. However, there are some standard treatments that vets and farriers use to treat pain and restore a horse to soundness.

Trimming & Balancing

This is often the first step in treating hoof pain. A trained farrier should trim the hooves carefully to correct any imbalances that may cause discomfort. The farrier takes into account the horse’s conformation, hoof shape and hoof size when trimming, shaping the hoof uniquely to meet the horse’s needs.

Shoeing & Hoof Pads

Hoof pads or shoes can protect the hooves and make the horse more comfortable. The right shoes or pads can dampen hoof concussion to prevent sole bruising or cracks. Shoes can also change how the hoof hits the ground, which can help with certain hoof disorders.

Rest & Therapy

Injured horses often need a lot of recovery time and may require physical therapy. Physical therapy has many benefits, including strengthening the muscles and tendons around the hoof and conditioning the horse without overextension during its healing period.

A variety of therapeutic products are available that aid in healing hoof injuries and conditions.

Water Treadmill

Water treadmills are often ideal for horses recovering from hoof injuries. The water provides resistance, which strengthens the muscles and tendons. It also exercises the horse with limited concussion to the hooves, making the horse’s recovery period more comfortable. In addition, many treadmills have a mixture of features that shorten the healing process.

The Animal Therapeutics Equine Water Treadmill, for example, allows users to adjust the water type, temperature and depth for maximum effectiveness. Its cold water setting reduces inflammation, while its saltwater option encourages wound and infection healing. Water treadmills are a great choice for effective rehabilitation.

Equine Spa

Equine spas are versatile in that they can be used to prevent injuries and rehabilitate them. For instance, the ActivoMed Equine Spa is designed to improve horse health through multiple rehabilitation and injury prevention methods. The spa uses saltwater hydrotherapy and vibration stimulation to alleviate pain and improve circulation, speeding healing and promoting comfort.

The chilled saltwater is aerated to guarantee consistent circulation and an even temperature. The ActivoMed Equine Spa is an excellent rehabilitative tool for horses recovering from Laminitis, bruising, wounds and other injuries.

Electromagnetic Field Therapy

Pulsed Electro-Magnetic Field Therapy is a non-invasive technique of treating the cells in the body with magnetic fields. Pulsing an electromagnetic impulse at different frequencies and intensities creates this effect. When the impulse interacts with certain types of cells, it causes an acceleration of activity and a quicker flow of oxygen and nutrients.

PEMF therapy assists cellular healing processes and quickens toxin and waste disposal, so your horse feels better faster. Rehabilitation tools sometimes combine PEMF with other therapeutic modalities, like vibration or light therapy, to hasten healing. For example, the ActivoMed Combi Floor offers a combination of controlled vibration with pulsed electromagnetic field therapy (PEMF) and a weighbridge.

We discuss a couple of other PEMF therapy tools below.

PEMF Hoof Boots

The ActivoMed Hoof Boots specifically target hoof pain. The boots direct PEMF impulses through the hoof capsule, delivering pain relief and stimulating healing. They can be used on the front or back hooves, and the adjustable strap means the boots fit various hoof sizes.

These hoof boots can be used to treat numerous hoof conditions, including Laminitis, hoof abscesses and injuries.

Leg Wraps

ActivoMed Leg Wraps either come with PEMF alone or combine PEMF with massage to soothe hoof and leg pain and facilitate healing. The wraps fit around the horse’s legs and use gentle pulses of electromagnetic energy to calm discomfort and boost circulation. They’re great for treating arthritis, stiffness, Laminitis and injuries, in addition to other problems.


Changing the horse’s diet may be necessary if the hoof pain or sensitivity is due to a lack of nutrients or weight issues. Horses should be fed a balanced diet that includes all the essential nutrients for healthy hooves.


Owners can use medication to manage a horse’s hoof pain, but they should only be given under the guidance of a veterinarian. Massage and the above-mentioned therapy tools can also manage discomfort while the horse heals.

The vet may also prescribe antibiotics to treat infections.


A neurectomy is a surgical procedure to sever or block the nerves in the hoof. This is usually done as a last resort to relieve pain if other methods haven’t worked. It’s a surgical procedure that requires recovery time, so it’s not the first choice for most horse owners.


You can do several things to discourage hoof problems and keep your horse’s hooves healthy.

First of all, ensure your horse gets all the nutrients he needs by feeding him a balanced diet. Hooves are made of keratin, which contains sulphur. So, the equine diet should include foods rich in sulphur, such as alfalfa, soybean meal and garlic. You can also supplement the horse’s diet with hoof supplements that contain biotin, zinc, and other nutrients essential to hoof health. Just make sure not to over-supplement the horse, as that can be just as damaging as a lack of nutrients.

Also, keep the hooves clean and dry. Regular hoof-picking and the use of hoof dressing help prevent bacterial growth and keep hooves supple. And have the animal’s hooves trimmed and shod regularly by a qualified farrier. This will help prevent cracks, chips and other hoof damage.

Finally, make sure the horse gets plenty of exercise. Exercise helps stimulate blood flow to the hooves and supports their health.


Horses are complicated animals that require dedicated care. With that in mind, horse owners usually have a lot of questions about hoof care and conditions.

Do Horses Feel Pain In Their Hooves?

Yes, horses have some nerves in their hooves that register pain. However, a horse’s hooves are also very tough and resilient, so they can withstand a lot of wear and tear. And the outer portion of the hoof (the hoof wall) has no nerves, so it doesn’t have sensation. That’s why horses’ hooves can be trimmed and shod without discomfort.

How Often Should You Have Your Horse’s Hooves Trimmed?

It’s generally recommended that your horse’s hooves be trimmed every six to eight weeks. However, horses’ hooves grow at different rates, so your farrier may recommend a different trimming schedule.

It’s important not to let the hooves grow too long, as that’s bad for the horse, but you can also over trim the hooves, exposing the sensitive inner hoof tissue and nerves, so you shouldn’t trim too often either.

What Happens When a Horse’s Hooves Are Overgrown?

Hooves that are allowed to grow too long can cause pain and make walking difficult. Horses with overgrown hooves may be forced to walk awkwardly, stretching and damaging their tendons. In extreme cases, untrimmed and overgrown hooves can lead to severe hoof cracks, abscesses and lameness.

How Frequently Should You Shoe Your Horse?

It depends on the horse, but most horses need to be shod every four to six weeks–the same schedule as trimming. Again, hooves grow at different rates, so your farrier will be able to advise you on the best shoeing timetable for your horse.


Though hoof pain is sometimes to be expected, there’s a lot that horse owners can do to enable good hoof health and stop hoof problems. By feeding horses a balanced diet, keeping hooves clean and dry, having hooves trimmed and shod regularly and making sure horses get plenty of exercise, hoof pain can be minimized.

In most cases, with a little care and attention, a horse’s hooves can stay healthy and strong for a lifetime, so you can enjoy the trails or the show ring comfortably together for many years.


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