Ringbone in Horses 101: Causes, Symptoms and Recovery

Horses are prone to getting strange lumps and bumps throughout their lives. Lumps, bumps or swellings on the legs always need to be checked out by a vet. Any lump could lead to lameness or worse. Ringbone in horses is a strange swelling of the horse’s pasterns or coffin joints. The swelling sometimes goes all the way around the affected joint making the horse appear to have a ring on under the skin, hence the name ringbone.

Besides the swelling, ringbone in horses often causes unusual heat at the swollen area, lameness, and tenderness. The more severe the symptoms, the more advanced ringbone is. The bad news is that ringbone is incurable. The good news is that it is treatable.

Ringbone is a horseman’s term for bony arthritis, or osteoarthritis, of the pastern joint or coffin joint. Arthritis is a condition which causes inflammation of the joint. Meanwhile, osteoarthritis occurs when the inflammation within the joint causes the body to lay down bone to heal damaged tissue. Usually, the bony development appears at the joint surface or attachment site of the joint capsule to the bone. Another term used to describe this is a degenerative joint disease (DJD).

There are two different types of ringbone: low or high. The veterinary terminology for low ringbone is DJD of the distal interphalangeal joint (coffin joint). In the case of high ringbone, it’s DJD of the proximal interphalangeal joint (pastern joint).

Low ringbone is more serious. It causes bony enlargement at the coffin joint which is responsible for a high range of motion. This type develops around the joint at the top of the hoof wall and tends to cause pain and lameness. On the other hand, high ringbone is more common. It affects the pastern joint, a low motion joint but carries the weight of the horse. This joint is located between the fetlock and the top of the hoof.

The average horse weighs about 1,000 pounds. That’s a lot of weight for the pasterns and coffin joints to absorb every time a horse takes a stride. Ringbone seems to be a horse’s way to try and heal after an injury or strain to the area. The short-term solution to the problem can have bad long-term effects for the horse.

What Causes Ringbone in Horses?

The most common cause of ringbone in horses is excessive stress on the joint, causing bony development and damage to the joint surface. The stress can be due to imbalanced shoeing, poor conformation, or working on poor ground surfaces. Base-narrow or base-wide conformation, together with a toed-in or toed-out stance create increased weight bearing forces. It can cause damage to the joint surface cartilage and tear of the joint capsule or collateral ligaments.

A horse’s body reacts initially in the form of inflammation. Then, inflammatory cells release toxins which create tissue damage and thin joint fluid. As damage increases, the body responds by producing scar tissue, which can then progresses into bony development.

Ringbone in horses can produce the following symptoms: pain, swelling, lameness, heat, and tenderness. Ringbone in horses typically occurs in the front legs, but it can also occur in the hind legs. Ringbone is more often seen in older horses. But ringbone in young horses can also occur. Horses in high-stress activities such as racing or jumping are most prone.

In high ringbone, a horse can have a bony growth around the pastern area, resulting in less mobility. The horse may experience pain when the pastern joint is moved. Early cases usually have a lameness score of 1-2 out of 5. But as the ringbone worsens, the lameness can worsen to a grade 2-3. In low ringbone, a horse will have moderate lameness of 2-3, even in early cases. It’s because of the closeness of the ringbone to the other structures in the hoof.

Treatment Options Available for Ringbone in Horses

You may be asking, “Can ringbone in horses be cured?” Ringbone is a disorder that has no cure. But with treatment and good management, the progression of the disease can be slowed, allowing a horse to retain movement and function.

Ringbone in horses can be treated several ways. Often, treatment involves injecting anti-inflammatory drugs such as corticosteroids in the joint, together with hyaluronic acid (synthetic joint fluid) which helps replenish thin joint fluid. This helps stop the progression of the disease and may slow down damage to the joint surface.

Natural treatment for ringbone in horses includes warm therapy that helps loosen joints, liniments, and wraps that help supports the joint. Other treatments such as massage therapy, acupuncture, and chiropractic therapies aim to decrease inflammation and increase the range of movement.

Other forms of ringbone in horses treatment include physical therapy, exercise management, and supplements. Oral supplements such as glucosamine, MSM, chondroitin sulfate, and oral hyaluronic acid may help a horse develop more cartilage and joint fluid.

The first symptoms of ringbone in horses can be identical to other lameness problems. Lameness, heat, and tenderness tend to occur before the tell-tale ring does. Treatment needs to begin before the ring appears. The first thing that needs to get done is to receive a proper diagnosis from a reliable veterinarian. The horse may need an MRI, bone scan or radiograph as well as a hands-on examination for the vet to determine if it’s ringbone or not.

If it is ringbone, there are many facets to treatment. These include:

  • Rest: If a horse is still asked to work, the ringbone will worsen.
  • Corrective shoeing: Shoes and hoof trimming can help keep a horse with bad confirmation from putting full strain on their joints.
  • Overweight horses need to lose weight to lessen the strain on joints.
  • Give nutritional supplements chondroitin and glucosamine to help the horse’s body make more healthy cartilage.
  • Give medications such as anti-inflammatories, corticosteroids, hyaluronic acid or polysulfated glycosa-minoglycans. These medications need to be used sparingly. A horse may feel fine and want to work but will still have ringbone and therefore cannot be used to work hard. These medications may cause bad long-term effects such as to cause of gastric ulcers. Many of these medications are not allowed to be given to a horse just before a competition or race. Never assume that the rules for one show, rodeo or race are the same for another. They all differ. Read the rules closely to find out what medications are allowed on competition day and what is not.

Surgery can help severe cases, but it is not a guaranteed cure. The surgery uses screws to fuse the weakened joint together. However, all other treatments should be tried first before surgery is done.

Prevention of Ringbone in Horses

There is no 100% sure way to prevent ringbone. However, there are some things a horse owner can do to minimize the risks:

  • Do not ask the horse to do more than it is physically capable of. Horses need to be carefully trained over long periods of time to build up endurance and strength.
  • Keep the horse from getting overweight. Fat horses and ponies put more strain in their joints and can cause ringbone. Fortunately, keeping a horse from getting too fat can also help prevent many other health problems as well as prevent ringbone.
  • Get the horse checked out by a vet at the first sign of lameness, heat in the leg, sudden uncharacteristic unwillingness to let a leg or hoof be touched and sudden bad performance in training or competitions. This can help prevent early ringbone from getting worse.
  • Letting a horse rest when it has received any leg injury. Even if the horse seems fully recovered after an injury, start out working the horse slowly to avoid re-injury and ringbone.

It’s very hard to prevent ringbone in horses that have poor conformation, especially those with crooked forelegs. Horses with poor conformation should not be bred and pass this problem along to the next generation. However, few horses are blessed with perfect conformation. To help horses with less-than-perfect conformation, hooves should get trimmed and shod about every six weeks to help then walk, trot, canter and gallop more normally.


Once upon a time, ringbone in horses was a rider’s nightmare. Any horse diagnosed with it had to retire immediately. Horses that cannot be ridden or pull a wagon usually were considered useless and slaughtered or put down.

Now horses caught in the early stages of ringbone have a good chance of competing for many more years. One such horse was an American Quarter Horse champion team roping horse named Precious Speck. Despite his ringbone, he earned Heading Horse of the Year honors.

Images: pixabay.com.

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