Paget's disease of the bone disrupts your body's regular recycling mechanism, in which new bone tissue progressively replaces old bone tissue. Bones can become weak and deformed over time. The most usually afflicted areas are the pelvis, head, spine, and legs.
The risk of Paget's disease of bone increases with age and if the ailment runs in the family. However, for unexplained reasons, the condition has grown less frequent in recent years and is less severe when it does arise. Broken bones, hearing loss, and pinched nerves in your spine are all possible complications.
Bisphosphonates, which are drugs designed to strengthen osteoporotic bones, constitute the backbone of treatment. If difficulties arise, surgery may be required.
WHAT ARE THE SYMPTOMS OF PAGET'S DISEASE OF BONE?
The majority of persons with Paget's disease of bone show no symptoms. The most common complaint when symptoms appear is bone discomfort.
Because this illness causes your body to make new bone more quickly than normal, the rapid remodeling results in bone that is less organized and weaker than normal bone, which can lead to bone discomfort, deformities, and fractures.
The sickness may simply affect one or two sections of your body or it may be extensive. Your signs and symptoms, if any, will be determined by the portion of your body that is afflicted.
- Pelvis: Hip discomfort can be caused by Paget's disease of the pelvic bones.
- Skull: Hearing loss or headaches can result from an expansion of bone in the skull.
- Spine: Nerve roots might become squeezed if your spine is compromised. This might result in arm or leg discomfort, tingling, and numbness.
- Leg: As your bones deteriorate, they may flex, leading you to become bowlegged. Bones in your legs that are enlarged and deformed might place extra strain on neighboring joints, leading to osteoarthritis in your knee or hip.
WHAT ARE THE CAUSES OF PAGET'S DISEASE OF BONE?
The etiology of Paget's bone disease is uncertain. Scientists believe the condition is caused by a mix of environmental and hereditary causes. Several genes appear to be associated with the condition.
Some researchers believe Paget's disease of bone is caused by a viral infection in your bone cells, however this is a contentious viewpoint.
WHAT ARE THE RISK FACTORS FOR PAGET'S DISEASE OF BONE?
The following factors can raise your risk of Paget's disease of bone:
- Age: People older than 50 are more prone to get the condition.
- Sex: Men are more prone to be affected than women.
- National origin: Paget's disease of the bone is more frequent in England, Scotland, Central Europe, and Greece, as well as in places where European immigrants have lived. It is unusual in Scandinavia and Asia.
- Family history: You are more prone to get Paget's disease of bone if you have a family who has the disorder.
WHAT ARE THE COMPLICATIONS OF PAGET'S DISEASE OF BONE?
Paget's disease of bone usually advances slowly. In almost all cases, the condition can be adequately controlled. Complications might include:
- Deformities and fractures: Affected bones are more prone to breaking, and additional blood arteries in these malformed bones lead them to bleed more during healing procedures. Leg bones might bow, impairing your ability to walk.
- Neurological issues: When Paget's disease of bone occurs in areas where nerves travel through the bone, such as the spine and skull, the overgrowth of bone can compress and injure the nerve, resulting in pain, weakness, or tingling in an arm or leg, as well as hearing loss.
- Heart failure: In extreme circumstances, your heart may have to work harder to deliver blood to afflicted portions of your body. This increased workload might sometimes result in heart failure.
- Bone cancer: Up to 1% of persons with Paget's disease of the bones develop bone cancer.
- Osteoarthritis: Misshapen bones can put more strain on surrounding joints, leading to osteoarthritis.
HOW IS PAGET'S DISEASE OF BONE DIAGNOSED?
Your doctor will evaluate any regions of your body that are giving you discomfort during the physical exam. He or she may also request X-rays and blood testing to assist confirm Paget's disease of bone.
Imaging tests
Bone alterations can be detected using the following methods:
- X-rays: The initial sign of Paget's disease of bone is frequently anomalies seen on X-rays taken for other causes. X-ray scans of your bones can reveal regions of bone disintegration, bone overgrowth, and disease-specific abnormalities, such as bending of your long bones.
- Bone scan: A radioactive substance is put into your body during a bone scan. This substance flows to the afflicted areas of your bones, which light up on the scan photos.
- Lab tests: Paget's disease of bone is characterized by high levels of alkaline phosphatase in the blood, which may be detected by a blood test.
WHAT ARE THE TREATMENTS FOR PAGET'S DISEASE OF THE BONE?
If you do not have any symptoms, you may not require therapy. However, if the illness is active — as shown by an elevated alkaline phosphatase level — and affects high-risk regions in your body, such as your skull or spine, your doctor may advise therapy to avoid problems, even if you don't have symptoms.
Medications
The most frequent treatment for Paget's disease of bone is osteoporosis medications (bisphosphonates). Bisphosphonates are normally administered through venous injection, however they can also be taken orally. Bisphosphonates are typically well tolerated when given orally, however they can irritate the stomach.
Intravenously administered bisphosphonates include:
- Zoledronic acid (Zometa, Reclast)
- Pamidronate (Aredia)
- Ibandronate (Boniva)
Oral bisphosphonates include:
- Alendronate (Fosamax, Binosto)
- Risedronate (Actonel, Atelvia)
Bisphosphonate treatment has been related to rare cases of severe muscular, joint, or bone pain that may persist after the medicine is stopped. Bisphosphonates can also raise the risk of a rare syndrome in which a piece of jawbone dies and deteriorates, which is typically associated with active dental disease or oral surgery.
If you are unable to take bisphosphonates, your doctor may give calcitonin (Miacalcin), a naturally occurring hormone that regulates calcium and bone metabolism. Calcitonin is a medication that you can take via injection or nasal spray. Nausea, face flushing, and discomfort at the injection site are all possible side effects.
Surgery
Surgery may be necessary in rare circumstances to:
- Assist in fracture healing
- Replace joints that have been destroyed by severe arthritis.
- Realign misaligned bones
- Reduce nerve pressure
Paget's disease of bone frequently leads the body to create an abnormally large number of blood vessels in the damaged bones, raising the risk of significant blood loss after surgery.
If you're having surgery on bones affected by Paget's disease of bone, your doctor may give drugs to lessen the disease's activity, which may assist reduce blood loss during surgery.
HOME REMEDIES FOR PAGET'S DISEASE OF BONE
Try the following strategies to lower your risk of problems from Paget's disease of bone:
- Eat healthily: Make sure your diet has enough calcium and vitamin D, which helps bones absorb calcium. This is especially critical if you are taking a bisphosphonate. Consult your doctor about your diet and whether you need take vitamin and calcium supplements.
- Regular exercise is essential: Maintaining joint mobility and bone strength requires regular exercise. Before beginning an exercise program, consult with your doctor to identify the best type, duration, and intensity of exercise for you. Some activities may put undue strain on your damaged bones.
- Avoid falls: You are at greater risk of bone fractures if you have Paget's disease of the bone. Consult your doctor for fall prevention tips. He or she may advise you to use a cane or walker.
- Make your home fall-proof: Remove slick floor coverings, use nonskid mats in the bathtub or shower, tuck cables away, and add handrails and grab bars in the bathroom.