Paget's disease of bone

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
• 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.

When to see your GP

Paget’s disease is a fairly common condition in Northern Ireland, particularly in older people. It's rare in people under 50 years of age.

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.

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.  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 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 physiotherapy, occupational 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

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

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

Other types of Paget's disease

As well as 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.

More useful links

• Paget's disease of bone
• How to use your health services