When a vet or farrier is called in to evaluate a lame horse that is barefoot. Whether that horse has recently come out of shoes or has been bare for a awhile, the remedial measures taken are typically to put shoes on the horse.
That seems to be the answer to all hoof issues. In fact, I've heard top docs say that if a farrier cannot get shoes to stay on a horse's hoof, and that horse has the unfortunate luck to be a gelding, it may as well be put down. At least a mare with poor hooves can be used for breeding.
The problem with shoeing a horse with lameness issues is that we take a sick hoof, that is trying like hell to heal itself, and put a shoe on it, taking important elements of the hoof even farther out of function.
The argument for doing this is that the horse walks off sound in many cases. Well, of course it does, you've provided a type of support for the hoof that inhibits that laminae and inner structures from feeling pain (that same thing can also be done with a snug pair of Marguis Hoof Boots, btw).
But just because the pain has been masked doesn't mean we've cured the hoof. And normally, the pain eventually returns and then we are told that if the horse cannot be "cured" with shoes, we might as well put him down. He will never be sound.
"And surely, if we can't add the weight of a baby to those already aching feet, what the hell good is he anyways!"
(Sorry, I let my inner voice escape there for a moment, but people actually think like that.)
Natural hoof care is tried typically as a last ditch effort to save a horse when everything else has failed. That is if the owner is willing to try one more thing. The very sad part of the usual scenerio is that if we were the first one owners would come to, we could work to return that horse's hooves back to their natural state and with some time, proper trimming and improved diet, and turn out. He (or she) could be sound again one day without anything being nailed, glued, screwed, blued or tattood to that poor horses hoof.
Now here's a novel idea! How about seeing just how healthy our horses' hooves can be if they all were started into natural hoofcare, rather than farrier trims or no hoofcare at all, as babies! Issues like clubbed hooves fixed before becoming permanent comformational faults! It's simply mind-blowing, isn't it!:0)