Introduction

Paget's disease of bonedisrupts the normal cycle of bone renewal, causingbonesto 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.

This page covers:

Symptoms

When to see your GP

Causes

Treatments

Further problems

Other types of Paget's disease

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, dullbone pain
• Joint pain , stiffness and swelling
• a shooting pain that travels along or acrossthe 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.

This is known as bone remodelling.

Two cells are responsible for this:

• osteoclasts cells that absorb old bone
• osteoblasts cells thatmake new bone

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

The osteoblasts thentry 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 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

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

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Further problemscaused 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

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Other types of Paget's disease

In addition toPaget'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.