Osteomalacia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Osteomalacia?
A primary care doctor can often start the evaluation for osteomalacia. An endocrinologist, a doctor who treats hormone and mineral problems that affect bones, or a rheumatologist, a doctor who treats diseases of the joints and bones, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is osteomalacia?
Osteomalacia is softening of the bones. It most often occurs because of a problem that leads to vitamin D deficiency. Vitamin D helps your body absorb calcium. Your body needs calcium to keep bones strong and hard.
In children, the same problem is called rickets. In adults, it is called osteomalacia. Osteomalacia is not the same as osteoporosis. It is a distinct condition.
Symptoms
Symptoms include:
- Widespread bone pain, especially in the hips.
- Bone fractures that happen without a significant injury.
- Muscle weakness, which can make it hard to climb stairs or get out of a chair.
- Pain in the back, shoulder, ribs, pelvis, or legs.
- Bowed legs or a waddling way of walking.
A low calcium level can also cause numbness around the mouth. It can cause numbness or tingling of the arms and legs, and spasms or cramps of the hands or feet. Symptoms often build up slowly, which can make early diagnosis hard.
Causes and who gets it
A low vitamin D level in the blood can lead to low blood calcium, which makes bones weak and soft. Your skin makes vitamin D when it is exposed to sunlight, and you also get it from food. You may make less vitamin D if you:
- Live where there is little sunlight, or stay or work indoors during the day.
- Wear clothes that cover most of the skin, or use very strong sunscreen.
- Have dark skin.
You may not get enough vitamin D from food if you follow a vegetarian diet or do not eat or drink milk products. You may also not absorb it well from the intestines, such as after gastric bypass surgery. Other causes include kidney failure, liver disease, and too little phosphate in the diet. Side effects of seizure medicines and rare tumors that cause a low phosphate level can also be causes.
How doctors diagnose it
If a doctor thinks you may have osteomalacia, they check your vitamin D and calcium levels. This can include blood tests and a urine test. Blood tests also check phosphate, alkaline phosphatase, and parathyroid hormone levels. No single lab finding is specific to osteomalacia.
Bone x-rays and a bone density test can help find pseudofractures, bone loss, and bone softening. Osteomalacia can look like osteoporosis on a bone density test. In some cases, a bone biopsy is done to see if bone softening is present.
Treatment
Treatment may involve vitamin D, calcium, and phosphorus supplements taken by mouth. People who cannot absorb nutrients well through the intestines may need larger doses. Doctors monitor blood and urine calcium levels, and the dose can be adjusted to prevent too much vitamin D.
Treatment should also reverse the underlying cause when possible. If another condition is causing your symptoms, treating that condition will help. Treatment can also include a healthy, balanced diet and spending more time outside with the sun on your skin, which is a good way to increase vitamin D levels naturally. Spend time in the shade when the sun is at its strongest. If bones have been bent or damaged, some people may need surgery.
When vitamin D deficiency is the cause, treatment may significantly improve strength and relieve bone tenderness within weeks. Complete healing can take many months to over a year, depending on the cause. Symptoms can return.
When to see a doctor
Contact a health care provider if you have symptoms of osteomalacia or think you may be at risk. Low blood calcium can cause seizures or tetany, which means muscle spasms. If someone has a seizure, call 911.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can order or review blood tests, start a treatment plan, and arrange follow-up checks.
Common questions
Is osteomalacia the same as osteoporosis?
No. Osteomalacia is a distinct condition from osteoporosis. It can look like osteoporosis on a bone density test, so doctors also use blood tests.
Is osteomalacia the same as rickets?
Yes, mostly. Rickets is the name used in children, and osteomalacia is the name used in adults.
What causes osteomalacia?
Most often, a low vitamin D level. It most often occurs because of a problem that leads to vitamin D deficiency. Other causes include kidney failure, liver disease, and low phosphate levels.
Can osteomalacia be treated?
Yes. Treatment may involve vitamin D, calcium, and phosphorus supplements taken by mouth. Treating the cause matters too, and healing can take many months.
Sources
- MedlinePlus - Osteomalacia
- NHS - Rickets and osteomalacia
- StatPearls (NCBI Bookshelf) - Osteomalacia
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
