Paget’s disease: symptoms, causes, and treatment

Paget's disease is a chronic bone disorder characterized by abnormal bone remodeling. In this condition, the normal cycle of bone renewal and repair is disrupted, leading to weakened, enlarged, and misshapen bones. Paget's disease can affect any bone in the body, but it most commonly affects the pelvis, spine, skull, and long bones of the legs.

Paget’s disease of bone symptoms

• Bone pain

• Joint stiffness

• Bone deformities

• Fractures

• Neurological symptoms

• Hearing loss

• Warmth and swelling

What causes Paget’s disease?

The exact cause of Paget's disease is not fully understood, but several factors are believed to contribute to its development:

• There appears to be a genetic predisposition to Paget's disease, as it tends to run in families. 

• Some research suggests that certain viral infections, particularly those caused by the paramyxovirus, may trigger the abnormal bone remodeling seen in Paget's disease. However, the role of viruses in the development of Paget's disease is still under investigation.

• Environmental factors, such as exposure to specific viruses or other infectious agents, may interact with genetic susceptibility to initiate the development of Paget's disease. However, the specific environmental triggers are not yet fully understood.

• Paget's disease is more common in older adults, with the majority of cases diagnosed after the age of 50. 

• Certain ethnic groups, including individuals of European descent, are more likely to develop Paget's disease compared to others. 

How to treat Paget’s disease

Treatment for Paget's disease aims to manage symptoms, prevent complications, and reduce the risk of further bone damage. The approach to treatment may vary depending on the severity of the disease and the presence of symptoms. Common treatment options include:

• Medications:

  • Bisphosphonates: These drugs are the mainstay of treatment for Paget's disease. They help regulate bone remodeling by slowing down the rate at which bone is broken down and rebuilt, thereby reducing bone turnover and preventing further damage.

  • Calcitonin: Another medication that may be used to help regulate bone turnover and relieve pain associated with Paget's disease.

  • Pain relievers: Over-the-counter or prescription pain medications may be recommended to alleviate bone pain and discomfort.

• Physical therapy:

  • Physical therapy exercises can help improve joint mobility, strengthen muscles, and alleviate pain associated with Paget's disease. 

  • A physical therapist can design a personalized exercise program tailored to the individual's needs.

• Surgery:

  • In some cases, surgery may be necessary to address complications of Paget's disease, such as fractures, deformities, or nerve compression. 

  • Surgical procedures may include bone realignment, joint replacement, or decompression of affected nerves.

• Lifestyle modifications:

  • Adopting a healthy lifestyle, including regular weight-bearing exercise, adequate calcium and vitamin D intake, and smoking cessation, can help support bone health and overall well-being.

• Regular monitoring:

  • Individuals with Paget's disease may require regular monitoring through bone scans, blood tests, and imaging studies to assess disease progression, monitor treatment effectiveness, and detect complications early.