Symptoms
Many people with Paget's disease have no symptoms. When symptoms occur, they can include:
Bone pain (most common symptom)
Joint pain and stiffness
Deformities of bones (e.g., bowed legs, enlarged skull)
Fractures
Headaches
Hearing loss (if the skull is affected)
Nerve compression (leading to numbness, tingling, or weakness)
Enlarged head
Warm skin over the affected bone
Fatigue
Increased risk of osteoarthritis in nearby joints
Causes
The exact cause of Paget's disease is unknown, but it is believed to involve a combination of genetic and environmental factors. Some research suggests that a slow-acting virus may play a role.
Genetic Factors: A family history of Paget's disease increases the risk. Specific genes have been linked to the condition.
Environmental Factors: Some studies have proposed a possible link to a prior viral infection, such as measles, early in life, but this has not been definitively proven.
Medicine Used
The primary medications used to treat Paget's disease are bisphosphonates. These drugs help to regulate bone turnover and reduce bone pain. Common bisphosphonates include:
Oral Bisphosphonates: Alendronate (Fosamax), Risedronate (Actonel), Ibandronate (Boniva)
Intravenous Bisphosphonates: Zoledronic acid (Reclast), Pamidronate (Aredia) Calcitonin is another medication sometimes used, but it is less effective than bisphosphonates. Pain relievers (analgesics), such as over-the-counter pain medications or prescription pain medications, may be used to manage pain.
Is Communicable
No, Paget's disease of bone is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
While there aren't specific precautions to prevent Paget's disease since the cause is unknown, individuals with the condition can take measures to manage it and prevent complications:
Regular Monitoring: Follow your doctor's recommendations for check-ups and bone density tests.
Exercise: Weight-bearing exercises (as tolerated) can help maintain bone strength. Consult with a physical therapist for appropriate exercises.
Diet: Ensure adequate intake of calcium and vitamin D.
Fall Prevention: Take measures to prevent falls, such as using assistive devices (cane, walker), removing tripping hazards, and ensuring good lighting.
Medication Adherence: Take prescribed medications as directed.
How long does an outbreak last?
Paget's disease isn't characterized by "outbreaks" in the typical sense of infectious diseases. It's a chronic condition with periods of activity (increased bone turnover) and relative inactivity. Treatment with bisphosphonates can induce remission, which can last for months or years. However, the disease can reactivate at any time. The length of time a specific bone area is actively affected can vary.
How is it diagnosed?
Paget's disease is typically diagnosed through:
X-rays: These can show characteristic bone changes, such as thickening, enlargement, and deformities.
Bone Scan: A bone scan can identify areas of increased bone activity, even in the early stages of the disease.
Blood Tests: Elevated levels of alkaline phosphatase in the blood can indicate increased bone turnover, a hallmark of Paget's disease.
Medical History and Physical Exam: The doctor will ask about symptoms and perform a physical examination to assess affected areas.
Timeline of Symptoms
The onset of Paget's disease is often gradual, and some people may not experience symptoms for years.
Early Stages: May be asymptomatic or have mild, nonspecific bone pain.
Progressive Stages: Bone pain becomes more persistent and localized. Deformities may develop gradually. Neurological symptoms (e.g., hearing loss, nerve compression) may appear as the disease progresses.
Late Stages: Increased risk of fractures, osteoarthritis, and other complications. The course of the disease is variable, with periods of stability and periods of increased activity.
Important Considerations
Complications: Paget's disease can lead to complications such as fractures, osteoarthritis, nerve compression, hearing loss, and rarely, bone cancer (osteosarcoma).
Treatment Goals: The goal of treatment is to relieve pain, reduce bone turnover, prevent complications, and improve quality of life.
Long-Term Management: Paget's disease requires long-term monitoring and management.
Consult Specialists: Consult with a doctor who specializes in bone disorders (rheumatologist or endocrinologist) for diagnosis and treatment.
Individualized Approach: Treatment should be tailored to the individual's specific needs and the severity of their condition.