Orthopedics Pediatric Orthopedics What Is Rickets? Rickets weakens bones and in most cases is due to a vitamin D deficiency. By Angelica Bottaro Updated on August 03, 2022 Medically reviewed by Stuart Hershman, MD Print Table of Contents View All Table of Contents Types Symptoms Diagnosis Treatment Coping In children with dangerously low amounts of vitamin D, their body’s ability to absorb nutrients becomes troublesome. When this happens, they can develop rickets, a condition that leads to bone deformities, stunted growth, and easily breakable bones. Vitamin D is an important nutrient that plays a vital role in the absorption of other minerals such as calcium and phosphorous—the two nutrients that work together to help build strong bones. When a growing child isn’t getting the nutrition they need, their bones won’t grow properly and become more susceptible to breaks and unhealthy bending. The history surrounding rickets isn’t clear, but some research suggests that it was documented prior to the discovery of vitamin D and that the condition itself could be the reason people found out about the vitamin and its importance in everyday nutrition. Catherine Falls Commercial Types of Rickets There are three types of rickets diseases. Depending on the type, each condition will affect a different part of the population. Nutritional Deficiency Bone mineralization occurs when calcium and phosphorous work together to create crystals that are designed to encourage bone growth. This process is a vital part of the production of bones and bone tissue, though it can be interrupted by any number of things. The main reason for rickets disease that halts or slows the process of bone mineralization is vitamin D deficiency. What Is Vitamin D Deficiency? Hereditary Hypophosphatemic Rickets Another form of rickets, known as hereditary hypophosphatemic rickets, can be passed down genetically from a parent to their child. This type of disease is directly related to the level of phosphate in the blood and is caused by genetic mutations that lead to the imbalance. The mutations occur in certain genes that are designed to regulate a specific protein that is in charge of the kidney’s function to absorb phosphate back into the bloodstream. When the protein becomes too active within the body, it leads to the imbalance of phosphate and hereditary rickets. Adult Rickets Although rickets is generally a children’s disease, older adults can develop a similar condition called osteomalacia. It is categorized as the softening of bones and is also caused by a vitamin D deficiency. An Overview of Osteomalacia Rickets Symptoms The symptoms presented in all types of rickets, including adult osteomalacia, are similar but can range in severity depending on the progression of the disease. Common symptoms include: Pain in the bones affected by the disease, which can affect walking and gait Thickening of the ankles, wrists, knees Bowlegs In children, softening of the skull and unnatural bending of the spine Oral health issues such as weakened tooth enamel, late tooth growth, and susceptibility to cavities Bones that are easily fractured or broken People with rickets can also have less than ideal amounts of calcium in their blood. This can lead to the worsening of the illness and with that, more symptoms. They include: Muscle cramping and twitchingPins and needles or tingling in the hands and feet. These symptoms can be debilitating and hard to manage prior to getting a proper diagnosis. The good news is that testing is a simple process. Diagnosis If you notice any of these symptoms in your child, it’s important to contact your healthcare provider. Because rickets can lead to stunted growth and bone problems later on in life, catching the disease early and pursuing prompt treatment can prevent any further bone loss. They will examine your child through blood tests and X-rays to determine whether or not the symptoms are related to a case of rickets. The blood tests are designed to check for levels of calcium, phosphorous, and vitamin D in the blood. In rare cases, bone samples can be removed to help confirm a case of the disease. Treatment The treatment depends on the type of rickets. Treatment for Nutrient-Deficient Rickets In the case of rickets caused by a vitamin D deficiency, treatment can be as simple as upping your intake. Depending on the severity of the deficiency, a tailored and specific treatment plan can be pursued under the supervision of your healthcare provider. This will improve both the levels of vitamin D, as well as the body’s ability to absorb other essential nutrients for bone health. There are a couple of ways to increase vitamin D naturally such as getting more regular sunlight and by eating a diet with optimal levels of the vitamins and nutrients essential to health. Foods that contain helpful amounts of vitamin D include: Oily fishRed meatEggsSome cerealsCheeseLegumesNutsSeedsSoy products Receiving the proper treatment for a deficiency-related case of rickets will depend on a wide variety of factors. For example, in terms of sunlight-induced vitamin D levels, people with darker skin have a harder time absorbing the essential nutrient from the sun and may require longer periods of exposure to achieve the same results. Treatment for Hereditary Rickets In the instance that the case of rickets disease is genetic, treatment is done through the oral consumption of phosphate in order to increase levels within the blood. It can also be helpful to take calcitriol, an active form of vitamin D, to help with the absorption of phosphate. Another medication has shown promise in the treatment of hereditary rickets. The drug in question is called Burosumab and was developed to address the symptoms and prevalence of the rare disease. Coping Having a child with rickets can be a scary experience. The good news is that, although the symptoms can be debilitating and severe, they can be treated easily with the use of supplementation and a well-developed medical plan. The outlook when it comes to treating all forms of rickets is good, and many children with rickets can see a regression in both symptoms and bone deformities within three months of beginning their treatment plan. A Word From Verywell If you notice any of the above symptoms in yourself or your child, it’s important to speak the help of your medical healthcare provider right away. They will be able to create a tailor-made plan for you depending on the level and progression of rickets. Although the effects of the disease can have a great negative impact on your day-to-day life, treatment is easily attainable and effective You will be better able to cope with rickets diagnosis when you know exactly what to do to recover. The reversal of bone deformities is possible, and healing is only a few steps away even when the illness is at its worst stages. 13 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Craviari T, Pettifor JM, Thacher TD, et al. Rickets: an overview and future directions, with special reference to Bangladesh. A summary of the Rickets Convergence Group meeting, Dhaka. J Health Popul Nutr. Trautvetter U, Ditscheid B, Jahreis G, Glei M. Calcium and phosphate metabolism, blood lipids and intestinal sterols in human intervention studies using different sources of phosphate as supplements-pooled results and literature search. Nutrients. 2018;10(7):936. doi:10.3390/nu10070936 O'Riordan JL, Bijvoet OL. Rickets before the discovery of vitamin D. Bonekey Rep. 2014;3:478. doi:10.1038/bonekey.2013.212 Genetics Home Reference. Hereditary hypophosphatemic rickets. Shikino K, Ikusaka M, Yamashita T. Vitamin D-deficient osteomalacia due to excessive self-restrictions for atopic dermatitis. BMJ Case Rep. 2014;2014:bcr2014204558. doi:10.1136/bcr-2014-204558 National Health Service. Rickets and osteomalacia—symptoms. Pettifor JM. Rickets. Calcif Tissue Int. National Health Service. How to get vitamin D from sunlight. Office of Dietary Supplements. Vitamin D. Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506 National Organization for Rare Disorders. Familial hypophosphatemia. Imel EA, Glorieux FH, Whyte MP, et.al. Burosumab versus conventional therapy in children with X-linked hypophosphataemia: a randomised, active-controlled, open-label, phase 3 trial. Lancet. 2019 Jun 15;393(10189):2416-2427. doi:10.1016/S0140-6736(19)30654-3 Sahay M, Sahay R. Rickets-vitamin D deficiency and dependency. Indian J Endocrinol Metab. 2012;16(2):164-176. doi:10.4103/2230-8210.93732 By Angelica Bottaro Angelica Bottaro is a professional freelance writer with over 5 years of experience. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and engaging content in the health space. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit