by Kimberly Allen, RN
Paget’s disease is a chronic condition that affects normal bone growth. It affects approximately 3 million people in the US though most experts believe that figure to be low because many people with Paget’s disease don’t have any noticeable symptoms so they have never been diagnosed. Paget’s disease affects men more often than women and if you are over 40 years of age you are more like to develop the condition also. However, there is a form of Paget’s disease that occurs in children, but it is very rare.
many people don’t realize it but even after you appear to stop growing your bones actually continue to grow. Bone tissue constantly regenerates itself, in other word the cells in your bone tissue are constantly being broken down and absorbed into your body and replaced with new cells. Like all the other cells in your body this occurs in a specific cycle. In Paget’s disease this cycle is disrupted, the cells in the bone tissue breaks down and is absorbed much faster than normal requiring your body to speed up production of the new bone tissue cells, which frequently leads to weak and brittle bones that fracture more easily.
Though the exact cause of Paget’s disease is unknown, many believe there is a genetic link. In one study as much as 40% of those diagnosed with Paget’s disease has a first degree relative that also had the condition. There have also been studies that found the condition exhibited an autosomal dominant pattern of inheritance in some families. Recently researchers were able to link certain genes with Paget’s disease including a gene on chromosome 5 known as the sequestrosome 1 gene. Researchers have also discovered certain viruses that can linger in the body that may trigger Paget’s disease in people that are already susceptible to it. The suspected viruses so far are the paromyxoviruses, which are known for the measles, and synctial virus which is known as a respiratory virus. Some researchers are also investigating the possibility there may be an inflammatory cause.
In many cases people with Paget’s disease show no symptoms of the disease, it is discovered accidentally when X-rays have been taken for other reasons. The doctor reading the X-rays will be able to see changes in your bone. However, some people do experience symptoms the most common being bone pain. Because Paget’s disease leads to brittle bone many people experience frequent fractures. In fact many times it is when a person has suffered a fracture and x-rays are taken that the disease is first discovered. Some people also have bone deformities like bowed legs or a curved spine as well as an enlarged skull or hips. Other symptoms depend on which bone or bones in your body is affected by Paget’s disease. The most common site is the pelvis, however it also occurs in other bones including the spine and femur, which is your large thigh bone, and the shin bone as well as the skull and upper arm. So if you have Paget’s disease in you skull you may experience headaches and dizziness as well as muscle weakness in your facial muscles, you might even experience problems with your vision and hearing. On the other hand, if your Paget’s disease is in your spine you would probably experience pain as well as numbness and weakness in your legs, you could even develop cauda equina, which is considered a medical and surgical emergency.
In most cases, if you are not having symptoms, you will not require treatment. However, in some cases, depending on the location of the disease and your health, the doctor may recommend treatment to prevent complications. If you have active Paget’s disease with symptoms your doctor will recommend treatment. The standard treatment for Paget’s disease today is the use of biophosphonate medications like Fosamax and Boniva. If you are unable to tolerate the biophsphonates your doctor may recommend a naturally occurring hormone called calcitonin. Calcitonin plays a significant role in bone metabolism and calcium regulation.
If you have Paget’s disease it important to prevent complications like fractures. Avoid wet, slippery surfaces and be sure to have either a mat or non-skid adhesives in your tub or shower. Limit things like scatter rugs and extension cords on your floors. Basically anything that can increase your risk of falling. It’s also important to eat a well balanced diet with sufficient calcium and vitamin D. Regular exercise is crucial to maintaining bone strength and joint mobility.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.