Paget’s disease – what is Paget’s disease and why you need to be informed?

Paget's disease

Paget’s disease

Paget’s disease of bone disrupts the normal cycle of bone renewal, causing bones to become weakened and possibly deformed.

It’s a fairly common condition in the UK, particularly in older people. It’s rare in people under 50 years of age.

There are treatments that can help keep it under control for many years, but it can cause persistent pain and a range of other problems in some people.

 

Symptoms of Paget's disease of bone

Paget's disease of bone can affect one or several bones. Commonly affected areas include the pelvis, spine and skull.

Symptoms can include:

constant, dull bone pain

joint pain, stiffness and swelling

a shooting pain that travels along or across the body, numbness and tingling, or loss of movement in part of the body

But in many cases there are no symptoms and the condition is only found during tests carried out for another reason.

Read more about the symptoms of Paget's disease of bone.

When to see your GP

See your GP if you have:

persistent bone or joint pain

deformities in any of your bones

symptoms of a nerve problem, such as numbness, tingling or loss of movement

Your GP can organise tests to check your bones and look for problems such as Paget's disease of bone.

Read more about how Paget's disease of bone is diagnosed.

Causes of Paget's disease of bone

Bone cells regenerate in a similar way to skin - old bone is removed and replaced by new bone. This is known as bone remodelling.

Two cells are responsible for this:

osteoclasts - cells that absorb old bone

osteoblasts - cells that make new bone

In Paget's disease of bone, something goes wrong with the osteoclast cells and they start to absorb bone at a much faster rate than usual.

The osteoblasts then try to produce new bone more quickly, but the new bone is larger and weaker than normal.

It's not clear what triggers this, but you're at a higher risk if you have a family history of Paget's disease of bone. You may inherit a genetic fault that means you're much more likely to develop the condition.

Treatments for Paget's disease of bone

There's currently no cure for Paget's disease of bone, but treatment can help relieve the symptoms.

If you don't have any symptoms, your doctor may suggest keeping an eye on your condition and delaying treatment until any problems occur.

The main treatments are:

bisphosphonate medication - medicines that help control bone regeneration

painkillers - usually over-the-counter painkillers such as paracetamol and ibuprofen

supportive therapies - including physiotherapyoccupational therapy and devices such as walking sticks or shoe inserts

surgery - this may be needed if further problems develop, such as fractures, deformities or severe joint damage

Ensuring you get enough calcium and vitamin D can also help. Some people may need to take supplements.

Read more about how Paget's disease of bone is treated.

Further problems caused by Paget's disease of bone

Paget's disease of bone can sometimes lead to further, potentially serious problems.

These include:

fragile bones that break more easily than normal

enlarged or misshapen bones

permanent hearing loss (if the skull is affected)

too much calcium in the blood

heart problems

in rare cases, bone cancer

Read more about possible complications of Paget's disease of bone.

Other types of Paget's disease

In addition to Paget's disease of bone, there are several other types of Paget's disease.

These include:

Paget's disease of the breast or nipple - a rare type of breast cancer

Paget's disease of the penis - a rare type of penile cancer

Paget's disease of the vulva - a rare type of vulval cancer

The general term "Paget's disease" is sometimes used to refer to Paget's disease of bone.

Paget’s disease – what is Paget’s disease and what are the signs and symptoms?

Paget's disease

Paget’s disease

Symptoms of Paget’s disease of bone include bone pain, joint pain and problems caused by a nerve being squashed or damaged.

But in many cases, there are no obvious symptoms and the condition is only found during tests carried out for another reason.

One or several bones may be affected. Commonly affected areas include the:

pelvis

spine

skull

shoulders

legs

Read more about the main symptoms below.

Bone pain

Bone pain caused by Paget’s disease is usually:

dull or achy

deep within the affected part of the body

constant

worse at night

The affected area may also feel warm.

Joint pain

Abnormal bone growth can damage nearby cartilage, the spongy tissue that cushions your joints.

This can lead to “wear and tear” of the affect joints (also known as osteoarthritis), which can cause:

joint pain

joint stiffness

swollen joints

The symptoms are usually worse when you wake up and improve a bit as you start to move.

Nerve problems

Abnormal bone growth can result in bone squashing (compressing) or damaging a nearby nerve.

Possible signs of this can include:

pain travelling from the spine down into your legs (sciatica)

pain travelling from your neck into your arms and chest

numbness or tingling in the affected limbs (peripheral neuropathy)

partial loss of movement in your limbs

balance problems

loss of bowel control or loss of bladder control

Other problems

Paget’s disease of bone can also cause a range of other problems, including:

fragile bones that are more likely to break

deformities in affected bones, such as curved legs (bow legs) or a curved spine (scoliosis)

hearing lossheadachesvertigo (a spinning sensation) and tinnitus (a noise in your ears) – these may occur if the skull is affected

too much calcium in the blood

heart problems

Read more about the complications of Paget’s disease of bone.

When to see your GP

See your GP if you have:

persistent bone or joint pain

deformities in any of your bones

symptoms of a nerve problem, such as numbness, tingling or loss of movement

Your GP can organise tests to check your bones and look for problems such as Paget’s disease of bone.

Read more about how Paget’s disease of bone is diagnosed.