Rickets: Symptoms, Causes, and Treatments

Written by Medicover Team and Medically Reviewed by Dr Girish Loya , General Medicine

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Rickets is a childhood bone disorder caused by inadequate vitamin D, calcium, or phosphate, which are essential for normal bone mineralization and growth. This condition can lead to soft, weak bones and skeletal deformities, affecting a child's bone development and overall health.

Early diagnosis and appropriate treatment are important to restore normal bone mineralization, support healthy growth, and prevent long-term complications.

Rickets occurs when growing bones do not receive enough vitamin D, calcium, or phosphate for proper mineralization. Vitamin D helps the body absorb calcium and phosphate from food, while these minerals are essential for building strong bones.

Most cases are related to nutritional deficiencies, but rickets can also result from problems affecting vitamin D metabolism, phosphate absorption, or kidney function. The condition is more common during childhood because bones are actively growing during this period.

What are the Symptoms and Warning Signs of Rickets?

Rickets symptoms can develop gradually and may vary depending on the severity and underlying cause. Recognizing early signs can help ensure timely treatment and prevent permanent bone changes.

Common Symptoms

Slow or delayed bone growth
Bone tenderness or persistent bone pain
Muscle weakness that may affect mobility
Bowed or curved legs
Enlarged forehead
Soft or fragile bones that are more prone to fractures
Widened wrists and ankles
Dental problems, including delayed tooth eruption and enamel defects
Delayed growth or difficulty achieving expected physical milestones

Severe Symptoms

Muscle cramps or spasms caused by low calcium levels
Seizures associated with severe hypocalcemia
Breathing difficulties related to chest or rib abnormalities

Children with persistent bone pain, muscle weakness, growth problems, or visible bone deformities should be evaluated by a healthcare professional.

What are the Common Causes of Rickets?

Rickets develops when the body does not have enough vitamin D, calcium, or phosphate to properly mineralize growing bones. The underlying cause may be nutritional, related to another medical condition, or genetic.

Nutritional Causes

Inadequate vitamin D intake or production
Insufficient calcium intake
Insufficient phosphate intake or absorption
Limited exposure to sunlight, which reduces vitamin D production in the skin

Other Causes

Medical conditions that interfere with vitamin D absorption or metabolism
Kidney disorders that affect phosphate or vitamin D metabolism
Genetic disorders that cause phosphate loss or impair vitamin D metabolism

When Should You See a Doctor for Rickets?

Parents or caregivers should seek medical evaluation if a child develops symptoms that may indicate abnormal bone development or mineral deficiency.

Persistent bone pain or tenderness
Bowed legs or other visible bone deformities
Muscle weakness, cramps, or spasms
Delayed growth or physical development
Delayed tooth eruption or repeated dental problems
Seizures or breathing difficulties, which require urgent medical attention

Children at increased risk because of nutritional deficiencies, limited sunlight exposure, malabsorption, kidney disease, or inherited conditions may require closer medical monitoring.

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How is Rickets Diagnosed?

Diagnosing rickets involves assessing the child's symptoms, growth, physical findings, and mineral levels. Doctors may use blood tests and imaging studies to confirm the diagnosis and identify its underlying cause.

Physical Examination: The doctor checks for bone deformities involving the legs, skull, chest, wrists, and ankles and evaluates the child's growth and muscle strength.
Blood Tests: Tests may measure vitamin D, calcium, phosphate, alkaline phosphatase, and parathyroid hormone levels to assess bone and mineral metabolism.
Urine Tests: Urine testing may help assess phosphate or calcium loss, particularly when an inherited or kidney-related cause is suspected.
X-rays: X-rays can show characteristic changes in the bones and growth plates associated with rickets.
Genetic Testing: Genetic testing may be recommended when an inherited form of rickets is suspected.
Additional Tests: Other investigations may be performed when doctors suspect an underlying kidney, liver, intestinal, or metabolic disorder.

What are the Treatment Options for Rickets?

Rickets treatment depends on the underlying cause and focuses on correcting nutritional deficiencies, restoring normal mineral levels, and treating any associated medical condition.

Nutritional Treatment

Vitamin D: Vitamin D supplementation is commonly used to correct vitamin D deficiency. The dose and duration depend on the child's age, deficiency level, and underlying cause.
Calcium: Calcium supplements or dietary changes may be recommended when calcium intake is inadequate or calcium deficiency is contributing to the condition.
Phosphate: Children with phosphate-related or certain genetic forms of rickets may require phosphate supplementation under specialist supervision.

Treatment for Underlying Conditions

Children with inherited or disease-related rickets may need specialized treatment, such as active vitamin D analogs, phosphate therapy, or medicines that address abnormal phosphate regulation.

Orthopedic Treatment

Severe or persistent bone deformities may require orthopedic treatment. Bracing may be considered in selected children, while surgery is rarely needed and is generally reserved for significant deformities that do not improve with medical treatment.

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What are the Risk Factors for Rickets?

Certain factors can increase a child's likelihood of developing rickets, particularly when they reduce vitamin D or mineral availability.

Dark skin pigmentation, which can reduce vitamin D production from sunlight
Limited sunlight exposure
Living in regions with limited sunlight during certain seasons
Exclusive breastfeeding without appropriate vitamin D supplementation
Dietary patterns low in vitamin D or calcium
Conditions that cause poor absorption of nutrients
Certain kidney, liver, or intestinal disorders
Family history of inherited forms of rickets

What is the Recovery Process After Rickets Treatment?

Recovery from rickets depends on its cause, severity, the child's age, and how early treatment begins. Nutritional rickets often responds well to appropriate vitamin D and mineral treatment.

Regular follow-up visits to monitor growth and bone development
Blood tests to monitor vitamin D, calcium, phosphate, and other relevant levels
Continuing vitamin D, calcium, or phosphate treatment as prescribed
Maintaining a balanced diet that supports healthy bone development
Monitoring bone deformities as the child grows

Many children improve with appropriate treatment, although severe or longstanding rickets can result in persistent skeletal deformities or growth problems.

What are the Risk Factors for Rickets?

Certain factors can increase a child's likelihood of developing rickets, particularly when they reduce vitamin D or mineral availability.

Dark skin pigmentation, which can reduce vitamin D production from sunlight
Limited sunlight exposure
Living in regions with limited sunlight during certain seasons
Exclusive breastfeeding without appropriate vitamin D supplementation
Dietary patterns low in vitamin D or calcium
Conditions that cause poor absorption of nutrients
Certain kidney, liver, or intestinal disorders
Family history of inherited forms of rickets

What Precautions Can Help Prevent Rickets?

Many cases of nutritional rickets can be prevented by ensuring adequate vitamin D and calcium intake and addressing risk factors early. Preventive measures should be tailored to the child's age, diet, health, and medical needs.

Prevention

Ensure adequate vitamin D intake according to pediatric recommendations
Provide calcium-rich foods as part of a balanced diet
Include vitamin D-fortified foods when appropriate
Follow medical advice regarding vitamin D supplementation for infants and children
Address medical conditions that interfere with nutrient absorption or mineral metabolism
Schedule regular pediatric check-ups for children at increased risk

Complications If Untreated

Permanent bone deformities
Abnormal growth or short stature
Increased risk of fractures
Dental abnormalities
Muscle weakness and difficulty with movement
Severe hypocalcemia, which can cause seizures or muscle spasms

Do's and Don'ts for Rickets

Following the prescribed treatment plan and maintaining adequate nutrition can support recovery and healthy bone development.

Do's	Don'ts
Give vitamin D, calcium, or phosphate supplements exactly as prescribed.	Do not start supplements or high-dose vitamin D without medical advice.
Include calcium- and vitamin D-rich foods in the child's diet.	Do not rely on unproven home remedies to treat rickets.
Attend scheduled follow-up appointments and recommended blood tests.	Do not stop prescribed treatment without consulting the doctor.
Follow pediatric recommendations for vitamin D supplementation.	Do not give excessive vitamin D, calcium, or phosphate supplements.
Seek medical attention for persistent bone pain, deformities, seizures, or muscle spasms.	Do not ignore signs of abnormal growth or skeletal deformities.

Our Experience Treating Rickets

At Medicover, we understand how rickets can affect a child's growth, bone development, and daily activities. Our healthcare team evaluates the underlying cause of the condition and develops an individualized treatment plan based on the child's nutritional and medical needs.

Through appropriate diagnostic testing, nutritional management, specialist care, and regular follow-up, we support children throughout their recovery and help promote healthy bone development.

Frequently Asked Questions

1. Can rickets affect adults?

Adults usually don't get classic rickets but can develop osteomalacia, a bone-softening condition caused by vitamin D deficiency, leading to weak bones and increased fracture risk.

2. Is sunlight exposure enough to prevent rickets?

Sunlight helps produce vitamin D, but in areas with limited sun or in people with darker skin, diet and supplements are often needed to maintain healthy bone mineral levels.

3. Are vitamin D supplements safe for children?

Yes, when used as directed by a doctor. Overuse can lead to toxicity, causing symptoms like nausea or kidney problems, so proper dosing and monitoring are essential.

4. Can untreated rickets cause permanent damage?

Yes. Without timely treatment, children risk permanent bone deformities, growth delays, and weak bones that may fracture easily, impacting overall physical development.

5. How do I know if my child needs vitamin D supplements?

Consult your pediatrician for proper assessment through clinical evaluation and blood tests before giving supplements, to ensure safety and effectiveness.