Softening of the bones that is caused by impaired bone metabolism which in turn leads to inadequate bone mineralization causes osteomalacia. Insufficient calcium, vitamin D or phosphate or calcium resorption leads to impaired bone metabolism.

The deficiency may be due to lack of sun exposure, poor nutritional intake, low levels of phosphate, abnormal vitamin D metabolism or drug induced bone mineralization.

Clinical presentation –

Usually the diagnosis is easily missed. The symptoms are characteristically diffuse bone pain, fatigue and proximal muscle pains. A waddling gait may be noted due to muscle weakness and hip pain. Usually it is diagnosed after one has a fracture. Bony deformity may occur in the long bones or the pelvis as the disease progresses. A ctivities of daily living like climbing stairs, sit to stand may be affected due to weak and stiff muscles.

MANAGEMENT –

The main treatment is to increase your vitamin D intake. This can be achieved by medication or ensuring adequate nutritional intake of vitamin D and increasing your exposure to the sun. Fifteen minutes of sunshine in a day can be adequate.

ROLE OF PHYSIOTHERAPY IN MANAGEMENT –

Physiotherapy has an important role in a multidisciplinary approach to treatment.
Proper planned exercise programs involving strengthening and weight bearing activities like walking or jogging are important to strengthen the major muscle groups and improve ADL’s and social activities.