Rickets and osteomalacia

Symptoms of rickets

Rickets causes a child's bones to become soft and weak. This can lead to bone deformities.

Adults can experience a similar condition. This is known as osteomalacia or soft bones.

The signs and symptoms of rickets can include:

• pain – the bones affected by rickets can be sore and painful, so the child may be reluctant to walk or may tire easily; the child's walk may look different (waddling)
• skeletal deformities – thickening of the ankles, wrists and knees, bowed legs, soft skull bones and rarely, bending of the spine
• dental problems – including weak tooth enamel, delay in teeth coming through and increased risk of cavities
• poor growth and development – if the skeleton doesn't grow and develop properly, the child will be shorter than average
• fragile bones – in severe cases, the bones become weaker and more prone to fractures

Some children with rickets may also have low levels of calcium in their blood (hypocalcaemia).

This can make the symptoms of rickets worse. It can also cause:

• muscle cramps
• twitching
• tingling in the hands and feet
• fits

Adults can experience similar symptoms. These include:

• bone pain
• muscle weakness
• fragile bones that are more prone to fractures

In adults, these symptoms are known as osteomalacia.

• Symptoms of osteomalacia

When to get medical advice

Take your child to see your GP if they have any of the signs and symptoms of rickets above.

Your GP will carry out a physical examination to check for any obvious problems. They may also discuss your child's medical history, diet, family history and any medication they're taking.

A blood test can usually confirm a diagnosis of rickets.

Your child may also have some X-rays or possibly a bone density scan (DEXA scan). This is a type of X-ray that measures the calcium content in bones.

If you're an adult and you’re experiencing bone pain or muscle weakness you should also see your GP to get it checked out.

Causes of rickets

A lack of vitamin D or calcium is the most common cause of rickets.

Vitamin D largely comes from exposing the skin to sunlight. It's also found in some foods, such as oily fish and eggs.

Vitamin D is essential for the formation of strong and healthy bones in children.

In rare cases, children can be born with a genetic form of rickets. It can also develop if another condition affects how vitamins and minerals are absorbed by the body.

Who's affected

Rickets was common in the past. But it mostly disappeared in the western world during the early 20th century. This was after foods like margarine and cereal were fortified with vitamin D.

In recent years, there's been an increase in cases of rickets in Northern Ireland. The number of cases is still small. But studies have shown a significant number of people in the UK have low levels of vitamin D in their blood.

Any child who doesn't get enough vitamin D or calcium either through their diet, or from sunlight, can develop rickets.

Treating rickets

For most children, rickets can be successfully treated, by making sure they eat foods that contain calcium and vitamin D, or by taking vitamin supplements.

Some families are eligible for free vitamin supplements from the Healthy Start scheme. Further information is available at:

• Free milk, fruit, vegetables and vitamins

If your child has problems absorbing vitamins and minerals, they may need a higher supplement dose or a yearly vitamin D injection.

Preventing rickets

Rickets can easily be prevented. This is by eating a diet that includes vitamin D and calcium, spending some time in sunlight, and if necessary, taking vitamin D supplements.

More useful links

• Rickets and osteomalacia
• How to use your health services