Nutrition Diet: Does lack of vitamin C cause bone pain?

October 16, 2025 •

4 min read

Vitamin C is essential for collagen synthesis, the foundational protein that provides bones with their strength and structural integrity. However, when deficiency becomes severe, it leads to a disease called scurvy, and a lack of vitamin C does cause bone pain.

Quick Summary

Severe vitamin C deficiency, known as scurvy, can cause significant bone pain by impairing collagen production, weakening the bone matrix, and causing painful subperiosteal hemorrhages.

Key Points

Scurvy is the cause: Severe vitamin C deficiency, known as scurvy, is the primary reason it leads to bone pain.
Collagen is compromised: Vitamin C is essential for producing collagen, the protein framework that provides bones with their structure.
Hemorrhage causes pain: The excruciating bone pain in scurvy is often caused by bleeding (hemorrhages) under the periosteum, the membrane covering the bone.
Bone density is affected: Even less severe, long-term deficiency can contribute to lower bone mineral density and higher fracture risk.
Diet is the best prevention: Eating a balanced diet rich in fruits and vegetables is the most effective way to prevent vitamin C deficiency.
Scurvy is rare but still occurs: While uncommon in many developed nations, scurvy still occurs in at-risk populations with restricted diets or malabsorption issues.
Recovery is possible with treatment: The bone pain and other symptoms of scurvy typically resolve quickly with appropriate vitamin C supplementation.

The Crucial Role of Vitamin C in Bone Health

Vitamin C, or ascorbic acid, is a water-soluble vitamin vital for numerous bodily functions beyond just immune support. Its role in maintaining the integrity of our bones and connective tissues is fundamental. Without adequate levels, the body's entire skeletal and vascular system can be compromised, leading to a cascade of painful symptoms.

Collagen Synthesis: The Bone's Framework

At the heart of vitamin C's importance for bone health is its role in collagen synthesis. Collagen is the most abundant protein in the body, and it forms the flexible matrix, or organic framework, of our bones. The bone matrix provides a scaffold upon which minerals like calcium are deposited, giving bone its hardness.

Vitamin C is a necessary cofactor for the enzymes that convert amino acids into stable collagen molecules. This process is critical for forming the mature, triple-helix collagen structures that provide strength and resilience to bones. A lack of vitamin C disrupts this process, resulting in weak, unstable collagen that is easily degraded by the body.

Antioxidant Properties and Bone Resorption

Beyond collagen, vitamin C acts as a powerful antioxidant, protecting bone and joint tissues from oxidative stress caused by harmful free radicals. Oxidative stress can lead to inflammation and increase bone resorption, the process by which bone tissue is broken down.

In cases of deficiency, a process known as osteoclast proliferation is triggered. Osteoclasts are cells responsible for breaking down bone tissue. Elevated activity of these cells, combined with impaired function of osteoblasts (bone-forming cells), leads to increased bone turnover and, ultimately, bone loss. Research has shown a positive association between sufficient vitamin C intake and higher bone mineral density, further underscoring its protective effect.

When Deficiency Becomes Severe: Scurvy and Bone Pain

Severe and prolonged deficiency of vitamin C leads to scurvy, a disease historically known for afflicting sailors with poor access to fresh fruits and vegetables. While rare in developed countries today, it can still affect individuals with very restricted diets. Scurvy is the condition in which lack of vitamin C directly causes bone pain.

The Mechanism Behind Bone Pain in Scurvy

In scurvy, defective collagen synthesis leads to fragile blood vessels. This fragility causes widespread hemorrhage (bleeding) throughout the body, including under the periosteum, the membrane that covers the surface of bones.

Key steps include:

Weakened Blood Vessels: Without enough vitamin C, capillaries become weak and easily break.
Subperiosteal Hemorrhage: This leads to internal bleeding under the periosteum, causing the membrane to lift away from the bone.
Excruciating Pain: The resulting pressure and inflammation cause intense pain and tenderness, often leading to a reluctance to move the affected limb.
Impaired Growth: In children, this can be particularly severe, affecting growth plates and causing leg pain and swelling.

Clinical Manifestations of Severe Deficiency

Bone pain is not the only symptom of scurvy. The disease presents as a multisystem disorder due to defective collagen throughout the body. Other clinical signs of scurvy include:

Fatigue and weakness
Swollen, bleeding gums
Easy bruising and petechiae (small red-blue spots on the skin)
Poor wound healing
Anemia due to poor iron absorption and hemorrhage
Coiled or corkscrew hairs

Comparison of Scurvy-Related Bone Pain vs. Other Causes

It is important to distinguish scurvy-related bone pain from pain caused by other conditions. The following table compares scurvy with some other common causes of bone pain.


Feature	Scurvy-Related Bone Pain	Arthritis-Related Pain	Osteoporosis-Related Pain	Cancer-Related Bone Pain
Underlying Cause	Severe vitamin C deficiency leading to defective collagen and hemorrhage.	Inflammation of joints (e.g., osteoarthritis, rheumatoid arthritis).	Weakened, porous bones due to mineral loss, increasing fracture risk.	Primary bone cancer or metastasis from other cancers.
Pain Location	Often in the long bones of the legs (tibia, femur), but can be anywhere subperiosteal hemorrhage occurs.	Concentrated in and around joints.	Back pain from spinal compression fractures; fractures anywhere.	Can be localized to the tumor site, or widespread if metastatic.
Onset	Gradual onset after a period of prolonged, severe deficiency.	Can be acute (e.g., infectious) or chronic (e.g., autoimmune).	Often insidious, with acute pain triggered by a fracture.	Can be initially mild and intermittent, but progresses to constant pain.
Associated Symptoms	Fatigue, weakness, bleeding gums, easy bruising, and poor wound healing.	Swelling, stiffness, and warmth in the affected joints.	Loss of height, stooped posture, and increased fracture risk.	Fatigue, unexplained weight loss, swelling, and increased fracture risk.

Preventing Deficiency Through Dietary Choices

The best way to prevent vitamin C deficiency and associated bone pain is to ensure a balanced diet rich in fruits and vegetables. Since the body does not store vitamin C, a consistent daily intake is crucial. Cooking can reduce vitamin C content, so consuming some raw foods is beneficial.

Excellent sources of vitamin C include:

Fruits: Oranges, kiwis, strawberries, cantaloupe, and guava.
Vegetables: Bell peppers (especially red and yellow), broccoli, Brussels sprouts, and kale.
Other Sources: Potatoes and tomatoes also contain vitamin C.

Conclusion: The Bottom Line on Vitamin C and Bone Pain

Yes, a lack of vitamin C can cause bone pain, but it is typically a sign of a severe deficiency known as scurvy, rather than a milder insufficiency. The pain is a direct result of defective collagen synthesis, which weakens the bone's structural matrix and causes painful internal bleeding under the bone's surface. For most people with access to a varied diet, scurvy is uncommon. However, those with restricted diets, malabsorption issues, or other risk factors should be aware of the symptoms. Ensuring adequate daily intake of vitamin C through a diet rich in fruits and vegetables is the best defense against this preventable condition and is foundational for maintaining overall musculoskeletal health.

This article is for informational purposes only and is not a substitute for professional medical advice. If you suspect a vitamin C deficiency, please consult a healthcare professional.(https://ods.od.nih.gov/factsheets/VitaminC-Consumer/)

Frequently Asked Questions

Mild vitamin C deficiency typically does not cause frank bone pain, though it can lead to general weakness, fatigue, and muscular aches. The distinct and often severe bone pain is a hallmark of scurvy, which is caused by a profound and prolonged deficiency.

The primary cause of bone pain in scurvy is subperiosteal hemorrhage, which is bleeding underneath the periosteum, the membrane covering the bones. This is caused by the fragile blood vessels that result from defective collagen synthesis.

Vitamin C deficiency disrupts the synthesis of collagen, the main protein component of the bone matrix. Without stable collagen, bones become weak and brittle, and their normal growth and repair processes are impaired.

Other symptoms of scurvy include fatigue, weakness, irritability, swollen and bleeding gums, easy bruising, petechiae, poor wound healing, and anemia.

People who eat a very limited variety of foods, infants fed evaporated or boiled cow's milk, smokers (who need more vitamin C), and individuals with medical conditions causing malabsorption are most at risk.

Excellent food sources of vitamin C include citrus fruits, kiwifruit, strawberries, red and green peppers, broccoli, Brussels sprouts, and kale.

Vitamin C deficiency is treated with oral or, in severe cases, intravenous vitamin C supplements. Symptoms like fatigue and pain often improve within days of starting treatment.

Vitamin C plays an important role in the formation and maintenance of cartilage, and its antioxidant properties can help reduce inflammation. Some studies suggest that adequate vitamin C intake may help with joint conditions like osteoarthritis, but its effects vary by condition.

While necessary for bone health, studies have shown that very high-dose supplementation may have variable effects, and a balanced, food-first approach is generally recommended. Over-supplementing can interfere with the body's adaptive responses to exercise.