Osteomalacia

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is osteomalacia?

Osteomalacia is a disease that causes an adult’s bones to soften, resulting in muscle weakness and bone pain. The most common cause of osteomalacia is a lack of vitamin D.

In children osteomalacia is known as rickets. People at risk for developing soft bones typically possess one or more risk factors associated with low vitamin D levels. These risk factors may come from environmental, genetic and dietary sources.

Osteomalacia is caused by a dysfunction in the bone-building process. Because vitamin D is needed to build strong bones, any disorder that affects vitamin D levels in your body will affect your bones. Sunlight helps your body produce vitamin D, so if you live in an area where the weather is often cloudy, the environment may be contributing to your lack of vitamin D. Genetic disorders affecting vitamin D metabolism also commonly cause osteomalacia. Not consuming enough milk and dairy products, which are high in vitamin D and calcium, is also associated with developing osteomalacia. Other less common causes of osteomalacia are liver and kidney diseases and cancer.

The signs and symptoms of osteomalacia can be constant or occur periodically. Osteomalacia varies from person to person. Some people with osteomalacia have mild symptoms, such as muscular discomfort, while others may have frequent bone fractures. Fortunately, osteomalacia can be treated with nutritional supplementation to resolve vitamin D and calcium deficiencies. Lifestyle changes can reduce the risk for osteomalacia and include receiving adequate sun exposure, eating a well-balanced diet that includes milk and dairy products, not smoking, and always taking all medications or supplements as prescribed.

In some cases, osteomalacia can lead to serious bone fractures and should be treated. Seek immediate medical care (call 911) if your osteomalacia includes serious signs and symptoms, such as deformity or dislocation of a joint, extensive swelling, numbness, bone protruding through the skin, or inability to feel the bone.

Seek prompt medical care if you are being treated for osteomalacia but mild symptoms, such as numbness, swelling, or trouble moving your joints, recur or are persistent.

What are the symptoms of osteomalacia?

Osteomalacia causes softened bones and may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of osteomalacia

You may experience osteomalacia symptoms daily or just once in a while. At times any of these common symptoms can be severe:

Symptoms that might indicate a serious condition

In some cases, osteomalacia can result in broken bones, a serious condition that may cause complications. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

  • Extensive swelling
  • Inability to move a body part
  • Numbness or coldness in the area of the fracture
  • Severe discomfort or pain
  • Visible deformity of the affected bone or joint

What causes osteomalacia?

Osteomalacia is caused by a dysfunction in the bone-building process. Because vitamin D is needed to build strong bones, any disorder that affects vitamin D levels in your body will affect bone strength and development. The environment can play a role in vitamin D deficiency, since sunlight is responsible for the production of vitamin D in the body. Not consuming enough milk and dairy products, which are high in vitamin D and calcium, is also associated with developing osteomalacia. Other less common causes of osteomalacia are liver and kidney diseases, genetic disorders, and cancer.

What are the risk factors for osteomalacia?

A number of factors increase the risk of developing osteomalacia. Not all people with risk factors will get osteomalacia. Risk factors for osteomalacia include:

  • Anorexia nervosa
  • Antiseizure medications
  • Cancers
  • Diet that has little variety or is strictly vegetarian
  • Diet that is low in milk products
  • Diet that is low in phosphate
  • Diet that is low in vitamin D
  • Environmental conditions, such as limited sunlight and smog
  • Family history of vitamin D metabolism disorders
  • Kidney failure
  • Liver disease (includes any type of liver problem, such as hepatitis, cirrhosis and liver failure)
  • Overuse of sunblock
  • Previous gastrectomy surgery (removal of stomach)

Reducing your risk of osteomalacia

You may be able to lower your risk of osteomalacia by:

  • Consuming recommended amounts of milk and dairy products
  • Quitting or not starting smoking
  • Receiving enough sun exposure
  • Taking calcium supplements if recommended by your healthcare provider
  • Taking vitamin D supplements if recommended by your healthcare provider

How is osteomalacia treated?

Treatment for osteomalacia begins with seeking medical care from your health care provider. To determine whether you have osteomalacia, your health care provider will ask you questions, request a blood sample, and possibly order other diagnostic testing. It is important to follow your treatment plan for osteomalacia precisely and to take all your medications as instructed.

The treatment approach for osteomalacia depends on treating the underlying cause of the condition. Treatment will include returning vitamin D and possibly calcium or phosphorous to normal levels in your body. Administering supplements will help to replenish these substances until balance is restored. For individuals who have vitamin D deficiency disorders, therapy will last longer than for those who have nutritional deficiencies in vitamin D.

What are the potential complications of osteomalacia?

You can help minimize your risk of serious complications of osteomalacia by following the treatment plan you and your health care professional design specifically for you. Complications of osteomalacia include:

  • Further risk of bone fractures
  • Growth deformity in children
  • Hypocalcemic seizures
  • Kidney failure
  • Physical disability
  • Recurrence or progression of osteomalacia
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 11
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Osteomalacia. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001414/
  2. Vitamin D. Medline Plus, a service of the Vitamin D. National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/002405.htm
  3. Bhan A, Rao AD, Rao DS. Osteomalacia as a result of vitamin D deficiency. Endocrinol Metab Clin North Am 2010; 39:321