Understanding Paget’s Disease

We all have aches and pains from time to time, but if you notice severe pain in one of your bones, it could be Paget’s disease.

Symptoms of this condition vary. Our health writer, Jackie Mitchell, talked to an expert to find out more.

“The most common symptom is pain,” Professor Stuart Ralston, chairman of the Paget’s Association, says. “While any bone can be affected, common sites are the pelvis, spine, thigh bone (femur), shin (tibia) and skull.  

“The affected bone may become enlarged and misshapen.

In some cases, this can cause bending of the bone (usually shin bone) or even cause the bone to break.”

Named after Sir James Paget 

The condition is named after Sir James Paget, who discovered it more than 100 years ago.

In the UK, it affects 1% of people over fifty-five. When explaining the condition, it’s helpful to understand how our bones normally renew and repair.

This process is called bone remodelling and is important in maintaining a healthy skeleton by ensuring that old or damaged bone is removed from the skeleton and replaced with healthy bone tissue.  

“It’s a normal process, like having new skin or hair,” Professor Ralston explains, “but with Paget’s, the repair process becomes accelerated, and the bone expands.”  

Paget’s disease can be picked up because of symptoms or as the result of an X-ray taken for another reason.  

“A routine blood test to test the liver function can also identify the condition if an enzyme called alkaline phosphatase (ALP) is higher than it should be,” Professor Ralston says. “A test called a radionuclide bone scan is the best way to determine the distribution and extent of Paget’s.”  

Understanding Paget’s disease: genetic factors

The exact cause of Paget’s disease is uncertain, but the condition can run in families.  

“Genetic factors play a key role in the predisposition to Paget’s disease,” Professor Ralston says. “Environmental influences can also affect the condition. For example, a poor diet during childhood could be a contributory factor.”  

Unfortunately, as the cause of Paget’s is not clear cut, there isn’t any advice on how individuals can avoid it. Although Professor Ralston says general advice is “to follow a healthy diet and take regular exercise”.  

“The usual treatment is bisphosphonates, which are powerful drugs that turn off and stop the abnormal repair process of the bone,” Professor Ralston explains. “This is often administered through a drip in the arm for about fifteen minutes and the effects can last for three or four years.

“Tablets are an alternative – the effects of a two-month course can last two years.  In certain cases, surgery may be required. The earlier it is treated the better.”  

For more information, visit The Paget’s Association website, clicking here.  

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