Osteomalacia or bone softening is a disease of the bones. It only occurs in adults. It is difficult to diagnose as different bone diseases are sometimes difficult to distinguish from one another. The main causes are deficiencies of various minerals and vitamin D, which is very important for the bones.
Find out here what a comprehensive diagnosis looks like. We will also tell you how osteomalacia develops, what the best therapy is and which doctor treats osteomalacia.
The human skeleton consists of around 206 bones of different strengths and shapes. Strong bones are a prerequisite for a stable body structure. This includes an adequate supply of nutrients and a healthy metabolism.
Osteomalacia is a mineralization disorder in the bones. It is usually caused by a vitamin D or calcium deficiency. As a result, insufficient calcium and phosphorus are incorporated into the bones. The result is demineralization and bone softening, combined with various skeletal changes. These include knee deformities such as bowlegs, knock-knees or scoliosis.
At first glance, osteomalacia resembles osteoporosis. The difference between osteoporosis and osteomalacia: in osteomalacia, the mineral content of the bone decreases, not the volume. The basic substance of the bones therefore remains intact. In osteoporosis, bone density is reduced.
Only adults can be affected by osteomalacia. In children, doctors refer to the same clinical picture as rickets.
The bones are the skeleton of the body © Alexandr Mitiuc / Fotolia
The main cause of bone softening or osteomalacia is vitamin D deficiency. Vitamin D is very important for the human body: it promotes the absorption of calcium from the intestine (resorption). This calcium is then lacking in the organism and is not stored in sufficient quantities in the bone matrix.
Vitamin D deficiency occurs for two reasons:
The following happens when the skin is exposed to sunlight: The organism forms the active vitamin D from the precursors of vitamin D (7-dehydro-cholesterol) in several steps. In technical terms, vitamin D is also called calcitriol or vitamin D3. This means that sunlight can cover 80 % of the vitamin D requirement.
Spending time outdoors is therefore an active contribution to the vitamin D balance and therefore to bone health.
If there is a lack of sun exposure, for example
leads to a deficiency of active vitamin D. This sometimes leads to osteomalacia due to reduced calcium absorption in the intestine.
Sunlight in moderation helps the body to produce vitamin D © John Smith / Fotolia
The following other conditions also lead to bone softening:
Some of the symptoms of osteomalacia are caused by the mineral deficiency. Other accompanying symptoms are consequences of the demineralized bone structure.
One of the main symptoms of bone softening is dull, persistent pain. Especially
are affected. These parts of the body carry a large part of the body weight. This is why osteomalacia usually manifests itself here first.
Other symptoms include
Bone pain is often mistaken for rheumatism. A correct and comprehensive diagnosis is therefore particularly important.
Osteomalacia causes pain in the spine, among other areas © wavenbreak3 / Fotolia
The first indications of bone softening can be found during a general medical examination. The doctor looks at the condition of the body as well as the symptoms described by the patient. He will also ask whether there are any previous cases of osteomalacia in the family.
Important laboratory parameters are checked as part of a blood test . The enzyme alkaline phosphatase and the parathyroid hormone level in the blood serum are always elevated in cases of bone softening. In addition, patients often have low vitamin D and calcium levels. If the osteomalacia was caused by kidney disease, reduced phosphate levels are also evident.
An X-ray examination provides further indications as to whether bone softening is present. Here, the already deformed bones show a blurred structure.
Skeletal scintigraphy reveals an increased bone metabolism. Bone density measurement confirms the diagnosis by showing a low mineral content in the bone matrix.
If the diagnosis is still unclear, the doctor can then carry out a bone biopsy . This allows him to differentiate bone softening more clearly from other bone diseases such as osteoporosis.
The exact prognosis for osteomalacia depends on when the disease is diagnosed. In general, osteomalacia is easily treatable and curable. The earlier deficiencies or the onset of osteomalacia are detected and corrected, the fewer the consequences of demineralization. Osteomalacia is often cured within four to six months.
Doctors rarely perform orthopaedic or surgical interventions for osteomalacia. These are considered if the bones are very deformed and the patient is suffering as a result.
If the bones are already severely affected, orthoses are an option for relief. These are medical aids that support, relieve and correct the limbs. Physiotherapy and physiotherapy are also useful supportive measures. They can help the patient to get used to a stable and healthy posture.
Sufficient vitamin D from the diet strengthens the bones. © bit24 / Fotolia
Optimal treatment of osteomalacia promotes remineralization of the bone structure. You have the following options:
High in vitamin D
Animal products provide vitamin D in the form D3, plant products contain vitamin D as D2. The chemical form vitamin D3 corresponds to the variant of vitamin D that is formed in the skin through exposure to sunlight. It can therefore be easily utilized by the body.
In general, the diet can provide a constant supply of vitamin D, but many foods contain rather little of it.
Depending on your individual constitution and symptoms, it may be advisable to have your vitamin D levels checked by a doctor. Many people have a vitamin D deficiency, especially in spring after the winter months with little sunshine.
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