My mare has been diagnosed with it for about 1 1/2 years now. She is 17. She never had a lame day in her life until then. Except for 1 abscess.
One day they were running in the pasture and she suddenly came up non weight bearing. I called the vet asap and X-rays were done on site. After banamine she was walking a little and after shoes/ pads were put on she was immeasurably more comfortable.
I can only speak as to her specific situation. She only has it in her left front. I have no idea why she has it or what may have started it. She has been ridden regularly and moderately by only me and I have owned her since she was a weanling.
She is shod regular ( only fronts) except when the ground is extremely hard and then we add pads. I ride her normally and she does fine but so far she has had 2 flare ups where she has been very lame for weeks.
Both times was when she got excited by something out in the pasture and ran around on hard ground like an idiot. In both cases it has resolved itself with just turnout.
We take things one day at a time.