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Paget’s Disease of Bone

By Anita Ballmick MOT/CHT

Paget’s Disease of bone is a chronic condition of the skeletal system. Typically, old bone is absorbed, removed and then replaced by new bone in a process called remodeling. However, Paget’s Disease causes bone remodeling to occur abnormally.  The bone goes through absorption too quickly causing the body to overreact. This happens by a new bone growing too quickly,  getting brittle, or abnormally shaped. Any bone can be affected and more than one may be affected at a time. The disease primarily appears in the:

Long Bones Paget's Disease JOI REHAB

The Femur is a Common Place for Paget’s Disease to Occur

The cause of Paget’s disease is currently unknown.  However, risk factors are present that contribute to a diagnosis. The disease occurs mainly in older adults. Additionally, in rare cases those under the age of 40 will receive this diagnosis. Genetics appear to play a part in being diagnosed with the disease.  Those who have relatives with the disease are at a greater risk of also being diagnosed.  

What Is The Initial Symptom of Paget’s Disease?

Symptoms include the effects of increased calcium levels in the cardiovascular system. This is due to the increased remodeling process of bone. Additionally, This can lead to the feeling of fatigue, weakness, abdominal pain, constipation, and loss of appetite. Symptoms tend to mimic those of arthritis, and other conditions.

Other Symptoms include: 

  • Pain around the affected bone. 
  • Hearing loss, if present in the skull. 
  • Headaches, if present in the skull due to pressure on the brain. 
  • Arthritis in the joints near the affected bone. 
  • Bone and joint deformities (Bowing, or bending of the long bones is common). 
  • Decreased sensation causing numbness and tingling from compressed nerve roots branching off the spinal cord if parts of the spine are affected. 

Rarely, the disease can progress to a type of bone cancer known as Paget’s Sarcoma. As a consequence, this leads to a malignant bone tumor with a poor prognosis occurring in extreme chronic cases of those with the disease. Paget’s Disease also leads to an increased amount of blood vessels in the affected bone which can lead to the risk of severe blood loss during a surgical procedure. If surgery is required to repair a damaged bone your doctor will prescribe a medication to reduce the effects of blood loss during surgery. 

Non-Surgical Treatment: 

Medicines such as bisphosphonates and nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce bone related pain and slow the progression of the disease. You need a prescription from your doctor.

Surgical Treatment: 

Surgery is a requirement to repair fractures, realign weight bearing bones like those in the legs, decompress nerves, correct joint deformities and severe arthritis. 

How to Live with Paget’s Disease

Additional steps can be taken in daily life to further reduce future complications of the disease.

Paget's Disease Fall Prevention Tips JOI REHAB

Fall Prevention Tips

These steps include: 

  • Fall prevention within the home environment to reduce risk of fractures. Modifying your home environment to reduce the risk of falls by incorporating grab bars in the bathroom  You can also add non-skid mats to the bathroom, avoid using step stools, and remove throw rugs. 
  • Eating well by incorporating more calcium and vitamin D into your diet if you have a prescription for bisphosphonates.
  • Consistent exercise is vital to maintain joint mobility and bone strength.  This will help to avoid the risk of contractures in your joints and reduce the risk of fractures. Consult with your doctor for the best exercise routine that is right for you based on your current medical history as to avoid excess stress on affected bones and joints. 

Written By: Anita Ballmick MOT/CHT

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