What is Paget's disease?

Paget’s disease is a bone disorder that weakens and deforms bones. It can affect bones in one or more places in the body, usually the skull, pelvis, spine or leg.

Bone is a living tissue, constantly being broken down and renewed. Paget’s disease occurs when something goes wrong with this process — the bone breaks down more quickly than normal, and the new bone that is formed is larger and weaker than normal bone.

Paget's disease mainly affects people aged over 55. In Australia, it is the most common metabolic bone disorder after osteoporosis. Although its cause is unknown, people are more likely to develop Paget’s disease if someone else in their family has it.

What are the symptoms of Paget's disease?

Many people with Paget’s disease have no symptoms.

Some people have bone pain. Often, the pain is worse after lying down or resting.

People with Paget’s disease may also have:

• enlarged or deformed bones
• bowed legs
• deafness or ringing in the ears caused by pressure on nearby nerves from enlarged or deformed bones
• troubles with sight, balance or muscle strength caused by the same pressure
• bones that break easily
• neck pain
• headache
• joint pain or stiffness
• tingling or numbness
• warmth over the affected bone
• getting shorter
• changes in the shape of the skull or other bones

How is Paget's disease diagnosed?

Paget’s disease is often diagnosed by chance during tests for an unrelated medical condition, or when a bone is fractured.

If you show certain signs of the disease (such as bone pain or deformity), your doctor may refer you to a specialist. You may be asked to have blood or urine tests, an x-ray or a bone scan. In some cases, imaging tests such as a CT scan or MRI scan or a bone biopsy (taking a sample of bone to test in the laboratory) may be needed to confirm the diagnosis.

How is Paget's disease treated?

There is no cure for Paget’s disease, but treatment can ease symptoms and reduce the chances of having complications.

Usually, people with no symptoms do not need treatment. If treatment is needed, it can include:

• over-the-counter pain relievers such as paracetamol and ibuprofen
• vitamin D, if you need it
• bisphosphonates, which are prescription-only medicines that can help control bone renewal
• surgery (very rarely) to treat osteoarthritis or a fracture

Good nutrition is important, particularly getting enough calcium to help keep your bones healthy. Supportive therapies such as physiotherapy or occupational therapy may also help.

People with Paget’s disease need ongoing monitoring by their doctors.

If you experience bone pain or notice any bone deformities, see your doctor as soon as possible.

What are the complications of Paget's disease?

Complications of Paget’s disease are uncommon, but can be serious. They include bone fractures and deformities, hearing loss and osteoarthritis.

Very rarely, Paget’s disease can cause heart failure or bone cancer.