Paget’s Disease

Paget’s disease is the second most common type of bone disease after osteoporosis. It is a disorder of the bone remodeling process, in which the body absorbs old bone and forms abnormal new bone.


In my experience, most often people are not aware they have Paget’s disease simply because they don’t have any noticeable symptoms. Often Pagets disease is found incidentally on x ray imaging or with an abnormal lab test.

Patients might also mistake some symptoms for another bone disorder or arthritis.

The most common symptoms that occur relate to bone or joint pain. Other symptoms could include swelling of joints, tenderness, or redness of the skin that covers the areas affected by Paget’s disease.

Many times people only become aware of their symptoms of Paget’s disease after experiencing a fracture in a weakened bone.

Paget’s disease will most commonly occur in these bones:

  • the pelvis
  • the spine
  • the skull
  • the femur, or thighbone
  • the tibia, or shin bone.

Many major nerves in the body run through or alongside our bones, so abnormal bone growth could cause a bone to compress, pinch, or damage a nerve which triggers pain.


The cause of Paget’s disease is currently unknown. Scientists suspect a combination of environmental and genetic factors contribute to the disease. Several genes appear to be linked to getting the disease.

Some scientists believe Paget’s disease of bone is related to a viral infection in your bone cells, but this theory is controversial.


If you are not manifesting any symptoms, you may not need treatment. However, if the disease is active as indicated by elevated alkaline phosphatase levels, your doctor might recommend treatment to prevent complications, even if you don’t have symptoms.


Osteoporosis medications are the most common treatment for Paget’s disease of bone. Bisphosphonates are very effective and most often used. This class of drug has been around for many years and can be taken by mouth or injection. Oral bisphosphonates are generally tolerated well, but they may irritate your stomach if not taken properly.

Some examples are below:

  • Alendronate (Fosamax)
  • Ibandronate (Boniva)
  • Pamidronate (Aredia)
  • Risedronate (Actonel)
  • Zoledronic acid ( Reclast)

Rarely bisphosphonate therapy has been linked to muscle, joint or bone pain. Very rarely osteoporosis medication can also increase the risk of a condition in which a section of jawbone dies and deteriorates (osteonecrosis of the jawbone), usually associated with active dental disease or oral surgery.

Another option might be calcitonin (Miacalcin), a naturally occurring hormone involved in calcium regulation and bone metabolism. Calcitonin is a drug that you can administer to yourself by injection or by a nasal spray. Side effects may include nausea, facial flushing and irritation at the injection site.