What Is the First Line of Treatment for Paget’s Disease?

Reviewed on 3/2/2021

What is Paget’s disease? 

Paget's disease is a chronic condition that affects your bones. First line treatments for Paget's disease include medications, surgery, joint replacement, diet and exercise.
Paget's disease is a chronic condition that affects your bones. First line treatments for Paget's disease include medications, surgery, joint replacement, diet and exercise.

While there is no cure for Paget’s disease, treatment can help ease the discomfort associated with the disorder. With early diagnosis, it is possible to maintain a good quality of life while living with its effects.

Paget’s disease is a chronic disorder that affects your bones. Over time, your bones have a process of breaking down and regrowing. If you have Paget’s disease, this process happens excessively. 

Since the regrowth of bone occurs at a higher rate than usual, your bones become larger and softer or weaker than they should be. As a result, your bones may become misshapen and easily fracture.

There are two types of Paget’s disease: 

  • Monostotic – when a single bone is affected by the disease
  • Polyostotic – when multiple bones are affected by the disease

Causes of Paget’s disease

Scientists have not yet narrowed down the origins of Paget’s disease enough to know what causes the disorder. However, in 30% of cases, more than one member in a family suffers from the disease, so it is likely to be hereditary. Similarly, it is most prevalent in people who are of European descent.

While it hasn’t been proven, some scientists think Paget’s disease may be affected by exposure to certain viruses, like measles. In some instances, it does appear to be — at least partially — due to heredity, perhaps when triggered by exposure to a virus. However, more study is needed.

Who can get Paget’s disease? 

Paget’s disease can affect anyone, but people over the age of 65 are the most diagnosed population. If you have a family member who has been diagnosed, you are likely at risk for a diagnosis as you get older.

How do you know you have Paget’s disease?

Paget’s disease progresses slowly, and so you may not know that you have it at first. This is especially true in monostotic (single-bone) cases, since only one bone in your body has the disease, while the rest of your bones go unaffected.

Aside from the affected bones being large or misshapen, you may not experience other symptoms. However, common symptoms appear similar to those of arthritis and include:

How is Paget’s disease diagnosed?

Paget’s disease often has rippling effects on your body since it changes the structure of your bones. For example, you may experience arthritis in a limited area of your body, leading you to speak to your doctor.

An X-ray is the easiest way to examine your bones and look for inconsistencies. If your bone appears distorted on the X-ray, your doctor will order a blood test to look for an increase in serum alkaline phosphatase (SAP). Its presence is a sign that your bones are regrowing quicker than what is considered healthy. A urine test can also help your doctor estimate how quickly your bones are regrowing. 

Upon completion of these initial tests, your doctor will request a bone scan to assess how far along you are with your condition. Additionally, if your doctor suspects cancer, he or she will complete a biopsy to examine your bone under a microscope.

Treatments for Paget’s disease

Paget’s disease itself is not a huge concern, but the impact it has on your body is. With early detection, you can avoid additional damage and slow the disease’s progression rate. 

Your first line of treatment may include: 

  • Medicines. Medications such as bisphosphonates can help to reduce bone pain and slow the progression of the disease.
  • Surgery. Your doctor may recommend surgery if you have fractured a bone. If so, the surgeon will set the bone in a better position for healing.
  • Joint replacement. If your knees and hips are damaged to the point that it affects your quality of life, replacement may be necessary.
  • Diet. Maintaining a healthy diet will keep your skeleton healthy.
  • Exercise. Staying active will increase your mobility and help you maintain your weight, reducing the pressure on your bones and joints.

Risks of Paget’s disease treatment

All medications have the potential for side effects, so talk to your doctor about what to expect. Your doctor may also prescribe injections as a form of treatment, although side effects include loss of bone mass, including losing teeth.

The greatest risks you face with Paget’s disease occur in putting off treatment. As the disease progresses, its impacts to your body also increase, causing more pain and more problems. This is especially true when Paget’s disease affects major bones like the skull or hips.

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References
SOURCES:

American College of Rheumatology: "Paget's Disease of Bone."

American Family Physician: "Diagnosis and Treatment of Paget's Disease of Bone."

Medline Plus: "Paget's Disease of Bone."

National Health Service: "Treatment: Paget's disease of bone."

National Osteoporosis Foundation: "What is Paget's Disease?"

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