Osteomalacia - Introduction

Rickets is a condition that affects bone development in children. It causes the bones to become soft and weak, which can lead to bone deformities.

Rickets in adults is known as osteomalacia or soft bones.

Rickets can cause bone pain, poor growth and deformities of the skeleton, such as bowed legs, curvature of the spine, and thickening of the ankles, wrists and knees.

Children with rickets are also more likely to fracture their bones.

Read more about the signs and symptoms of rickets.

What causes 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, but 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 after foods like margarine and cereal were fortified with vitamin D.

However, in recent years, there's been an increase in cases of rickets in the UK. The number of rickets cases is still relatively small ‐ less than 700 cases were diagnosed in hospitals in England in 2013-14 ‐ but studies have shown a significant number of people in the UK have low levels of vitamin D in their blood.

Any child whose diet doesn't contain enough vitamin D or calcium can develop rickets, but the condition is more common in children with dark skin, as this means they need more sunlight to get enough vitamin D, as well as children born prematurely or taking medication that interferes with vitamin D.

Treating rickets

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

Some families are eligible for free vitamin supplements from the government's Healthy Start scheme ‐ find out if you qualify for Healthy Start.

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 by eating a diet that includes vitamin D and calcium, as well as spending some time in sunlight.

Your hands and face only need to be exposed to sunlight for about 15 minutes a few times a week during spring and summer to provide enough vitamin D.

In some cases, vitamin D supplements may be recommended to reduce the risk of rickets.

Read more about preventing rickets, including information about good sources of vitamin D and calcium.

When to seek medical advice

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

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 to measure calcium, phosphorous and vitamin D levels can usually confirm a diagnosis of rickets, although your child may also have some X-rays or possibly a bone density scan (DEXA scan). This is a special type of X-ray that measures the calcium content in bones.