What is Ringbone in Horses? Signs and Symptoms

Last Updated on November 22, 2021

For horses that develop ringbone, it can be a very painful condition. What is ringbone in horses? Ringbone, which is most commonly found in middle age horses, happens when there is new bone growth. It can occur in the pastern joint (high ringbone) or in the coffin bone (low ringbone). 

Although ringbone is a continuous and permanent condition, there are treatment options available which can help your horse. With proper treatment from a farrier or veterinarian, a horse with ringbone may be sound enough to work for several years. 

And it’s important to know that though certain horses are more prone to ringbone than others, any horse who’s worked regularly throughout their life is vulnerable to ringbone.

What is Ringbone in Horses? What Causes It?

Ringbone occurs as a result of an injury and/or inflammation. It may be articular, which affects the joints, or develops on the side of the pastern bone, which in many cases happens where the ligaments attach. When this happens, the bony overgrowths may enclose the pastern.

In certain cases, if only the bone and not the joint is affected, it could appear like just a blemish. This requires no special treatment. When low ringbone occurs, it can be very problematic. This is because of the higher range of motion that will occur in the joint. Low ringbone is often very painful because any swelling and expansion will enlarge underneath the hoof wall, as a result of adding unwanted pressure to the joint.

Types of Ringbone in Horses

There are two types of ringbone, the high ringbone which is complicated, and the low ringbone. The high ringbone is more common because, in it, the pastern takes a significant load of the horse’s weight with each stride, even when it is walking slowly. Another reason why ringbone can be so problematic.

Causes of Ringbone in Horses

Ringbone is caused by proliferation that occurs in the pastern or coffin bone over time. Horses such as jumpers and barrel horses that are prone to repetitive stress are more likely to develop ringbone. 

Some horses may also be predisposed to ringbone based off their conformation, like, if they are toed in or have upright pasterns. Similar to other types of arthritis, ringbone happens on the joints, tendons, and ligaments when stress occurs. It, therefore, triggers inflammation that spreads out of control, which instead of healing local tissues, causes further damage. 


The body’s response to too much stress and tension on the joints and ligaments is to create new bone which will help stabilize the joint.

If left untouched, the bony overgrowth of ringbone may immobilize the joint, causing the two adjacent bones to form into one structure, a process that is often referred to as ankylosis. But not for the fusion which eliminates the effect of friction and irritation, this, in turn, may cause a horse’s gait to change.

Signs and Symptoms of Ringbone in Horses

If you notice a change in your horse’s gait, such as a shortened stride or choppy movement, that may be a sign your horse has ringbone. Ringbone may also be identified by heat, swelling, or lameness in a horse’s pastern or coffin. 

Also, you can identify ringbone through bony bumps that can be seen on a horse. However, if you get to discover it when they are bony bumps are visible, then, unfortunately, the ringbone is already in its advanced state. The earlier it is caught, the more likely the ringbone can be controlled.

Thus, if you notice any of these things occurring, take note of the symptoms and contact your veterinarian as soon as possible.

Diagnosis of Ringbone in Horses

Veterinarians will perform a lameness exam if they think a horse may be suffering from ringbone. The exam will likely include regional nerve blocks and flexion tests. 

Also, radiographs are often performed to identify new bone growth around the pastern or coffin joints. And fortunately, modern science has allowed veterinarians and farriers to make advances in the treatment of ringbone. In the past, ringbone was almost always an end to a horse’s career. But now, horses with ringbone can continue to work more comfortably.

Veterinarian and Shoeing Treatment Options

When shoeing a horse with ringbone, easing break over can help decrease the impact that is put on the joints of the lower leg. And for this to be accomplished, a farrier will often use fitted squared, rocker-toe, or a roller shoe. In summary, the proper showing and upkeep of a horse’s feet is vital to the guarding against of ringbone.

A veterinarian will always recommend a variety of different treatments for horses with ringbone. Injections, designed for joints such as Legend, Adequan, or Osphos may be prescribed to horses with ringbone to ease the discomfort. And feeding supplements such as Cosequin can also benefit a horse with ringbone.

Veterinarian and Shoeing Treatment Options

There are also new bone modeling treatments, such as Osphos and Tildren, that can be injected through the muscle. This injection helps bind calcium and prevent bone resorption. 

Intra-articular steroid injections may also be used by veterinarians. They can use it as shockwave therapy is a new form that can be used to treat ringbone. Some veterinarians also perform a surgery called arthrodesis that fuses the joint to help alleviate pain.

The reason why so many horse owners opt for injections is because it is a cheaper alternative to surgery.  Nevertheless, it is best you have a discussion with your veterinarian on which treatment option, will be more suitable for your horse.

How to Make Sure You are Helping Your Horse

It is important to make sure your horse is healthy and receiving proper nutrition. An overweight horse can suffer from excess pressure and stress on the joints, which could lead to ringbone. As such, it is necessary to keep your horse healthy. If they have ringbone already, try making them as comfortable as possible.

If you notice that your horse seems to be in discomfort or has a change in the way they move, it is important to contact your veterinarian to check and see if your horse may have ringbone. 

Even though ringbone is a progressive condition, precautions can still be taken. This will help ensure your horse is comfortable and able to continue working if diagnosed at an early stage.

If you have any questions regarding ringbone, please leave a comment!



Is ringbone dangerous for horses?

Ringbone itself isn't generally considered dangerous to horses; however, if left untreated ringbone can result in further complications that may threaten your horse's well-being. Ringbone is a degenerative disease of the pastern ring bone caused by chronic, repetitive trauma. As ringbone develops, it can enlarge and cause pain for your horse.

Can you still ride a horse with ringbone?

The short answer is yes; ringbone will not typically interfere with your ability to ride a horse. However, ringbone does affect how you ride and may significantly impact the type of riding that you do. The pain caused by ringbone can cause a horse to be less responsive and/or resist certain movements. Thus, ringbone may limit how well your horse is able to execute advanced dressage movements and jumping.
Additionally, ringbone will often cause a horse to be more lame on the affected leg than the non-ringboned one. Thus, if ringbone is present in both of your horse's hind legs you may want to consider only riding him at a walk or trot so his good front foot doesn't have to bear significantly more weight than his ringboned one.
Ringbone can be painful and dramatically impact how your horse responds to riding. If ringbone becomes severe, it may even cause further complications that put your horse's health at risk.

Can ringbone go away on its own?

Yes, ringbone can heal naturally. However, it will often return when the ringbone-causing activity is resumed. In order to allow ringbone to heal, you should keep your horse from the ringbone-causing activity.
Because ringbone can result in further complications if left untreated, ringbone is commonly treated with anti-inflammatory medications and/or an anti-shockwave therapy called electromotive drug administration (EMDA) or low level laser therapy (LLLT). Additionally, ringbone will often require the insertion of screws into the ring bone to stabilize it.

Can ringbone be treated with surgery?

Yes! Surgery is usually the best option for ringbone treatment in horses. Surgery is best performed by a veterinarian with extensive ringbone-treatment experience.
When condition is severe enough to require surgery, the ringbone will be stabilized either through screws, pins, or both. The ringbone will then be fused into its normal position using bone grafts harvested from the horse's pelvis or another ringbone.
Although the surgery is commonly performed in multiple legs, ringbone surgery has a lower success rate when problems are present in more than two legs.
The surgery may return ringbone to its original severity if not properly managed. Therefore, following your veterinarian's post-surgery management plan is crucial for successful recovery of your horse.

What are possible complications during the ringbone surgery?

One complication that may arise during ringbone surgery is the ringbone's failure to unite with the graft. If this occurs, your horse will require a second surgery for ringbone treatment.
Additionally, ringbones are often very painful when they are operated on because of the nerve damage they have already caused. Thus, it's common for the surgery to result in your horse experiencing a sharp pain response during the ringbone's manipulation and ringbone fusion. This is most often managed with intravenous (IV) analgesics such as ketamine and/or butorphanol given just before ringbone surgery begins.
Additionally, ringbones may bleed heavily when operated on due to their typically large size. Thus, the surgery may need to be stopped in order to control the bleeding using ringbone coaptation (sewing ringbones together).