Osteomalacia in adults is a condition where the bones become soft and weak due to poor mineralization, primarily caused by a deficiency of vitamin D, calcium, or phosphate. The signs of osteomalacia develop gradually and can affect bones, muscles, and overall physical function.
One of the earliest and most common signs is **bone pain and tenderness**, often felt in the lower back, hips, pelvis, legs, and ribs. This pain is usually dull and persistent, worsening with movement or pressure on the affected bones. People may notice discomfort when walking or standing for long periods. The pain arises because the bones are not properly mineralized and become softer and more prone to stress[1][5][6].
**Muscle weakness** is another key symptom, especially in the muscles closest to the trunk of the body, such as the thighs and hips. This weakness can make everyday activities like climbing stairs, standing up from a chair, or walking difficult. The muscle weakness often leads to a waddling gait or a noticeable limp. This happens because the muscles are not supported well by the weakened bones and may also be affected by low calcium levels[1][6].
People with osteomalacia often experience **fatigue and general tiredness**. This fatigue is not just feeling sleepy but a deep lack of energy that makes even simple tasks exhausting. Vitamin D deficiency affects energy production at the cellular level, which contributes to this persistent tiredness[1][5].
**Stiffness in joints and muscles** can occur, especially after periods of inactivity such as sitting or lying down for a long time. This stiffness may improve with gentle movement but can be uncomfortable and limit mobility[1].
In more advanced cases, osteomalacia can cause **difficulty walking or a waddling gait** due to the combination of bone pain and muscle weakness. The bones may become so soft that they bend or deform under the body’s weight, leading to changes in posture and walking style[6].
Another sign is **increased risk of fractures or bone breaks** with minimal trauma. Because the bones are softer and weaker, even minor falls or bumps can cause cracks or fractures, often in the ribs, hips, or legs. Sometimes, these fractures may be small and not immediately painful but can be detected on X-rays[1].
Some people may notice **numbness or tingling sensations** in the hands and feet, which can be related to low calcium levels affecting nerve function. This is less common but can occur alongside other symptoms of calcium deficiency[2].
Other subtle signs linked to the underlying vitamin D or calcium deficiency include **dry skin, brittle nails, and dental problems** such as tooth decay or slow healing of dental wounds. These occur because calcium and vitamin D are essential for maintaining healthy skin, nails, and teeth[2][5].
In summary, the signs of osteomalacia in adults include:
– Persistent bone pain and tenderness, especially in the lower back, hips, ribs, and legs
– Muscle weakness, particularly in the proximal muscles (thighs and hips)
– Fatigue and low energy levels
– Joint and muscle stiffness after inactivity
– Difficulty walking or waddling gait
– Increased susceptibility to fractures with minor injuries
– Possible numbness or tingling in extremities
– Dry skin, brittle nails, and dental issues
These symptoms develop gradually and can be mistaken for other conditions, so medical evaluation is important if they persist. Early diagnosis and treatment can improve bone strength and reduce complications.
