Rickets: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Rickets?
A pediatrician, a doctor who treats children, usually cares for a child with rickets. A doctor may also send you to a specialist for more tests, such as X-rays and bone scans. 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 rickets?
Rickets is a disorder that occurs in children before bone growth is complete. It is caused by a lack of vitamin D, calcium, or phosphate. This lack leads to softening and weakening of the bones.
Rickets is rare in the United States. In adults, the same problem is called osteomalacia.
Symptoms
Symptoms of rickets include:
- Bone pain or tenderness in the arms, legs, pelvis, and spine.
- Bowed legs. This is when the legs curve outward, so there is a large gap between the knees when you stand with your feet together.
- Swollen, painful wrists.
- Weak muscles, muscle cramps, and a loss of muscle strength that gets worse.
- Slow growth.
- More broken bones than usual.
- Changes in the way a child walks, not wanting to walk much, or getting tired more easily when walking.
- Teeth that form late, teeth with weak enamel, and more cavities.
Other bone changes can include an odd-shaped skull, bumps in the ribcage, and a breastbone that is pushed forward. The last one is called pigeon chest.
Causes and who gets it
Vitamin D helps the body control calcium and phosphate levels. If the blood levels of these minerals get too low, the body may release calcium and phosphate from the bones. This leads to weak and soft bones. The body gets vitamin D from food or makes it in the skin in sunlight.
A child might not get enough vitamin D if he or she:
- Has dark skin.
- Spends too little time outside, or has sunscreen on all the time outdoors.
- Does not eat foods with vitamin D because of lactose intolerance or a strict vegetarian diet.
- Is breastfed without getting vitamin D supplements.
- Cannot make or use vitamin D because of a medical disorder such as celiac disease.
Not getting enough calcium and phosphorous in the diet can also lead to rickets. This is rare in developed countries. Some children get an inherited form of the disease, which is passed down through families. It happens when the kidneys cannot hold onto the mineral phosphate. Kidney disorders, problems with digesting or absorbing fats, and liver disorders can also lead to rickets.
Rickets is most likely to occur in children during periods of rapid growth. It can also be seen in children ages 6 to 24 months.
How doctors diagnose it
A doctor uses lab and imaging tests to make the diagnosis. A physical exam shows tenderness or pain in the bones, but not in the joints or muscles. A doctor may check vitamin D and calcium levels with blood tests and a urine sample.
Tests that may help diagnose rickets include:
- Blood tests for calcium, phosphorous, and vitamin D.
- A blood test for alkaline phosphatase.
- Bone x-rays.
A bone biopsy, which takes a small piece of bone to study, is rarely done.
Treatment
The goals of treatment are to relieve symptoms and correct the cause of the condition. Replacing the calcium, phosphorus, or vitamin D that is lacking will eliminate most symptoms of rickets.
Treatments for rickets include:
- Vitamin D and calcium supplements.
- A healthy, balanced diet. Foods with calcium include milk, cheese, yogurt, and green leafy vegetables.
- Spending more time outside with the sun on your skin, which is a good way to raise vitamin D levels naturally.
Rickets caused by a metabolic problem, which is a problem with how the body uses nutrients, may need vitamin D supplements from a prescription. The cause must be treated to prevent the disease from returning. If another condition causes the symptoms, treating that condition will help.
Positioning or bracing may be used to reduce or prevent bone deformities. Some skeletal deformities may need surgery to correct them. If rickets is corrected while the child is young, skeletal deformities often improve or disappear with time. If it is not corrected while the child is still growing, skeletal deformities and short stature may be permanent.
When to see a doctor
Contact your child's health care provider if you notice symptoms of rickets. Long-term bone pain, bone deformities, and broken bones are possible complications.
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 look at your child's symptoms, order blood tests, and help you reach a specialist when needed.
Common questions
What causes rickets?
Rickets is caused by a lack of vitamin D, calcium, or phosphate. An inherited form also exists, which is passed down through families.
Can rickets be treated?
Yes. Replacing the calcium, phosphorus, or vitamin D that is lacking will eliminate most symptoms of rickets. Early treatment matters, because bone changes and short stature may be permanent if rickets is not corrected while the child is still growing.
Can rickets be prevented?
Yes. You can prevent rickets by making sure your child gets enough calcium, phosphorus, and vitamin D in their diet. Children who have digestive or other disorders may need to take supplements prescribed by the child's provider.
Do adults get rickets?
No. Rickets happens in children, and the same problem in adults is called osteomalacia.
Sources
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.
