Ringbone is a form of osteoarthritis that can affect a horse’s pastern or coffin joint, causing abnormal bone growth, stiffness, pain, and, in more advanced cases, significant lameness.
But a ringbone diagnosis does not necessarily mean the end of a horse’s riding or performance career.
How a horse responds can vary significantly depending on the severity of the condition, how early it is identified, and the individual horse. With the right veterinary care, farrier support, nutrition and a long-term management plan, there are many options available to help horses with ringbone stay comfortable and, in many cases, continue working.
To take a closer look at ringbone in horses, we asked Dr. Jared Sharp, DVM, of Sharp Sports Medicine to answer some of the questions horse owners ask most often.
What Is Ringbone in Horses?
Ringbone is abnormal bone growth and the formation of osteoarthritis around a horse’s pastern joints.
According to Dr. Sharp, ringbone is essentially osteoarthritis and the body’s attempt to fuse the affected joint.
A veterinarian will typically diagnose ringbone through a lameness evaluation that includes a physical exam, looking for changes such as thickening around the pastern, followed by diagnostic imaging such as radiographs when indicated.
What Is the Difference Between High Ringbone and Low Ringbone?
The primary difference between high and low ringbone is the joint affected.
High ringbone affects the pastern joint, while low ringbone affects the coffin joint. When horse owners use the term “ringbone,” however, Dr. Sharp says they are most commonly referring to changes involving the pastern.
Neither location automatically means a better or worse prognosis.
Several factors influence how serious a case may be and how difficult it will be to manage, including:
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The horse’s level of lameness
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The amount of arthritis or joint damage already present
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The horse’s workload
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How well the horse responds to veterinary management
Because of those variables, what one horse may be capable of with proper treatment and management can look very different from another.
In more severe cases, high ringbone involving the pastern does have additional surgical options available, including pastern arthrodesis, or surgical fusion of the joint.
*photo provided by US Equestrian
What Causes Ringbone in Horses?
Repeated stress or trauma is one of the most common factors Dr. Sharp sees associated with ringbone, although it is not the only possible cause.
Risk may increase when that repeated stress occurs alongside less-than-ideal conformation or improper shoeing. These factors can create imbalance and place additional strain on the joint.
This is one reason Dr. Sharp emphasizes regular farrier radiographs when appropriate. Giving the farrier more information about what is happening internally can help the veterinarian and farrier work together to improve hoof balance and reduce unnecessary stress beginning at the foot.
Other potential causes can include infection or traumatic instability.
As far as discipline is concerned, Dr. Sharp says he does not necessarily see ringbone concentrated within one particular equestrian discipline.
Instead, he emphasizes paying attention to the horse’s care from an early age—from nutrition and hoof care to regular veterinary management.
“Being proactive instead of reactive is what we strive for, from day one.”
Interestingly, Dr. Sharp notes that he does see ringbone more frequently in mules.
Is Ringbone Hereditary or Genetic?
Dr. Sharp would not consider ringbone itself to be directly hereditary or genetic.
However, conformation can be inherited, and poor conformation can contribute to uneven loading or additional strain on the joints. In that sense, a horse may inherit physical characteristics that increase the likelihood of developing orthopedic problems, including ringbone.
Athletic injury, trauma, and joint inflammation remain more common causes of the disease.
When considering whether a horse with ringbone should be bred, Dr. Sharp recommends looking at why that particular horse developed the condition.
If the ringbone resulted from trauma, it may not create the same breeding concern. If a horse has bilateral abnormalities in both limbs suggesting a congenital or conformational component, that may influence the recommendation differently.
What Are the Early Signs of Ringbone?
Early signs of ringbone may include:
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Lameness
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Soreness
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Thickening around the pastern
As the condition progresses, the horse’s lameness may become more noticeable or frequent, and owners may begin to feel or see firmness or enlargement around the affected area.
Not every mild case of pastern arthritis will immediately cause obvious lameness.
As the arthritic changes progress, however, lameness may become more frequent or severe. This is one reason Dr. Sharp stresses the importance of early management and working with a veterinarian experienced in sports medicine and lameness.
How Is Ringbone Diagnosed?
A veterinarian evaluating a horse for ringbone may first notice lameness along with atypical thickening around the pastern.
Radiographs are commonly the next diagnostic step once lameness and physical changes are identified.
However, earlier cases can sometimes require more advanced diagnostic imaging.
Dr. Sharp explains that MRI or CT imaging may identify changes occurring deeper within the joint that cannot yet be seen clearly on standard radiographs. In more severe or advanced cases, radiographic changes may be much more straightforward.
Can Ringbone in Horses Be Cured?
The arthritic damage caused by ringbone is not reversible.
That does not mean, however, that every horse with ringbone immediately becomes unusable or uncomfortable.
Dr. Sharp says many horses can be medically managed for quite some time, although the outlook depends heavily on how early the condition was identified and how severe the changes have become.
For severe cases—or horses that stop responding adequately to medical management—surgical fusion can be an option and can have very successful outcomes.
When a joint “fuses,” there is eventually no longer joint space or movement within that joint.
Natural fusion is possible in cases of ringbone, but Dr. Sharp says it is very rare. In his experience, he has not seen a case reach complete fusion without surgical intervention.
How Is Ringbone Treated?
Treatment depends on the individual horse, the severity of the arthritis, the degree of lameness and the horse’s intended workload.
A management plan may include several approaches.
Rest or Changes in Workload
Reducing workload can help decrease stress on the affected joint and limit recurrent inflammation.
Corrective Hoof Care and Farriery
Proper trimming and shoeing can help reduce leverage and keep the mechanics of the limb and joint more appropriately aligned.
The relationship between veterinarian and farrier can be particularly important when managing orthopedic problems such as ringbone.
Anti-Inflammatory and Pain Management
Anti-inflammatory medications, joint injections, and other veterinary therapies may be used to reduce inflammation and improve the horse’s comfort.
Dr. Sharp emphasizes, however, that these treatments do not reverse the arthritis that is already present.
Rehabilitation and Exercise
An appropriate rehabilitation or exercise program may help reduce the risk of secondary or compensatory lameness as the horse alters the way it moves in response to discomfort.
Regenerative and Injectable Therapies
Dr. Sharp also encourages horse owners to have open conversations with their veterinarian about the joint therapies available today.
Options may include regenerative or injectable treatments such as PRP, Renovo, A2M and other therapies, depending on the horse and the joint involved.
One misconception he would like owners to reconsider is the idea that a horse can automatically be “too young” for joint injections.
When inflammation is identified within a joint, addressing that inflammation before it causes additional joint damage can be an important part of protecting the horse's long-term soundness.
Can a Horse With Ringbone Still Be Ridden?
Yes, in many cases.
Whether a horse can continue working depends largely on its degree of lameness and how well it responds to medical treatment.
Sometimes reducing the workload may be enough.
But Dr. Sharp’s goal is not automatically to remove a horse from work simply because ringbone has been diagnosed.
Whenever possible, he aims to create a treatment plan that allows the horse to remain in work and continue a successful career doing what both the horse and rider love to do.
Retirement may become appropriate when the horse no longer responds adequately to treatment and surgical intervention is either not an option for the owner or is not appropriate for that particular case.
How Should Owners Manage a Horse With Ringbone Long-Term?
Ringbone management should be viewed as a team effort.
Your veterinarian, farrier and nutrition support team can all play a role in keeping the horse comfortable and addressing factors that could create additional stress.
Horse owners should pay particular attention to changes such as:
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Increasing lameness
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Increasing frequency of lameness
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Progression of swelling
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Increased thickening or enlargement around the affected area
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Changes in the horse’s comfort or willingness to work
Any noticeable progression should prompt another conversation with your veterinarian.
Can Ringbone Be Prevented?
Unfortunately, there is no guaranteed way to prevent ringbone.
Consistent routine care can still help reduce unnecessary stress on the horse’s joints.
That includes proper farrier work, maintaining appropriate hoof and limb alignment, thoughtful conditioning and involving your veterinarian early when something changes.
Dr. Sharp particularly emphasizes early intervention when joint inflammation is identified.
Rather than waiting for inflammation to create permanent damage, horse owners should work with their veterinarian to understand the treatment and regenerative options available.
“Being proactive instead of reactive is what we strive for, from day one.” — Dr. Jared Sharp, DVM.
Can Supplements Help a Horse With Ringbone?
Nutritional support can have a place within a larger management program, but it is important to understand what a supplement can—and cannot—do.
Dr. Sharp says supportive nutrition may help reduce systemic inflammation, which can in turn help reduce the risk of pain and discomfort.
What it cannot do is reverse existing arthritis or deliver anti-inflammatory medication directly into an affected joint.
For horses dealing with chronic joint issues, Dr. Sharp commonly reaches for Omega-3 fatty acids.
One product he specifically uses is Omega Stride for Horses.
“We would commonly reach for the Omega Stride, which also can help reduce airway inflammation in addition to joint health benefits. This is a staple in our personal program, and every horse in our program has this added to their daily feed.”
— Dr. Jared Sharp
Supporting the Horse Beyond the Joint
At Silver Lining Herbs, our approach to nutritional support is to help maintain the systems and structures surrounding the problem—not to replace diagnosis or veterinary treatment.
Omega Stride for Horses provides essential Omega-3 fatty acids and is formulated to support joint mobility, flexibility and the body's normal inflammatory response.
For additional structural support, Feet & Bone Support for Horses is formulated to help maintain strong bones, tendons, ligaments, and healthy hoof growth. It can be used as part of a broader nutritional program for horses whose owners are focused on long-term structural health and soundness.
Supplements should always be considered part of the larger picture alongside appropriate veterinary treatment, hoof care, exercise, and management.
The Bottom Line on Ringbone in Horses
A ringbone diagnosis can sound intimidating, but the condition—and a horse’s response to it—can vary considerably.
There are many options available for managing these horses, from adjustments in workload and farrier care to veterinary treatments, regenerative therapies, nutritional support, and, when necessary, surgery.
The most important thing is to build the right team around the horse.
As Dr. Sharp puts it, successful management means working with the right veterinarian and support team, from your nutrition specialist to your farrier.
Early identification, proactive care, and individualized management can make an enormous difference in what a horse with ringbone may be able to continue doing.
About Dr. Jared Sharp
Dr. Jared Sharp, DVM, is an equine veterinarian and co-founder of Sharp Sports Medicine, a mobile veterinary practice focused on equine sports medicine, lameness, diagnostic imaging and performance-horse care.
His background includes extensive experience evaluating equine athletes through advanced imaging, including bone scans, MRI and CT, as well as years of sports medicine and lameness work with performance horses.
