Paget’s disease causes new bone to be made more quickly than normal. There are two types of bone cells: osteoclasts and osteoblasts. Osteoclasts are responsible for breaking down old bone tissue, and osteoblasts are responsible for building new bone tissue. If you have Paget’s disease, your osteoclasts are breaking bone down more quickly than normal, causing the osteoblasts to produce new bone more quickly than normal.
This leads to weak bones that may not be correctly shaped. Imagine if someone built your house in a rush – it may turn out disorganised and not entirely structurally sound. The new bone that’s made when someone has Paget’s disease is not as organised or as strong as the new bone that’s made in people without Paget’s disease.
Common symptoms of Paget’s disease include:
These widespread symptoms are due to the fact Paget’s disease can affect different parts of the body in different people. There are plenty of people with Paget’s disease that do not experience symptoms at all – but when people do experience symptoms, they usually have bone pain. Signs and symptoms really depend on what part of the body is affected.
Paget’s disease occurs when the cells that break old bone down accelerate the process, causing the cells that make new bone to build new bone faster. This new bone produced in people with Paget’s disease is not as strong or stable as bone usually is.
While doctors understand that this is the mechanism of disease in Paget’s, it’s not understood what causes this to happen in the first place. While there are many genes linked to developing Paget’s, research is still ongoing about what causes it.
Risk factors for Paget’s include being over 50, being assigned male at birth, and having relatives with the condition. It’s also more common in people born in England, Scotland, Greece, and central Europe.
If your doctor believes you may have Paget’s after hearing your medical history and current symptoms, they will do a thorough physical exam to get an idea of your current range of motion and levels of pain. They may also choose to perform X-rays, which can show areas where the bones have broken down, overgrown, or deformed, or do bone scans to highlight the areas of your bone that have been affected by the disease.
They may also do blood tests. People with Paget’s disease usually have elevated levels of a certain compound called alkaline phosphatase. While this is not enough to make a diagnosis alone, it will help confirm your provider’s suspicions.
Complications of Paget’s disease include bone fractures and deformities that may make it difficult to move like normal, osteoarthritis, neurological problems, heart failure, and bone cancer.
Individuals who are not experiencing symptoms of Paget’s disease may not need treatment. However, if you show signs that the disease is affecting your body, whether you’re experiencing symptoms or have abnormal blood work, your doctor may recommend preventative treatment to get ahead of complications.
Treatment may include osteoporosis drugs, which can be taken orally or given in an IV. Surgery may also be necessary in the case of a bone fracture, to treat deformed bones, or to take the pressure off of nerves where bones are compressing them.
Some actions you can take to manage your quality of life with Paget’s disease include fall-proofing your living spaces, eating well, using walking assistance, and exercising regularly at an intensity that’s right for you.