Paget's disease is a bone condition. In this, your bones become weak and deformed. This disease progresses too fast and unevenly, making bones painful and fragile. Mostly older people are affected by this, and it is rarely seen in younger people.
So, as you age, your bones naturally become thinner and weaker anyway. Paget's disease speeds up this problem dramatically. Affected bones become larger but softer. They break easily. Common areas are the spine, hip, and skull. If your skull is affected, hearing loss can happen. Early signs include bone pain, warmth over bones, and limping. Learn more about this disease and what to do for treatment.
What are the Signs of Paget Disease?
Paget’s disease often develops slowly, and many people may not notice symptoms at first. When signs do appear, they can affect daily movement and bone strength.
- Persistent bone pain that feels dull and aching and does not go away easily
- Enlarged or misshapen bones, which may start to bend abnormally
- Bowing of the legs, especially in the lower limbs
- Warmth over the affected bone, caused by increased blood flow
- Weak and fragile bones, making them more likely to fracture
- Frequent fractures even after minor falls or mild injuries
- Hearing loss if the skull is involved
- Increase in hat size due to skull enlargement
- Difficulty walking or standing because of bone pain or deformity
- Tingling or numbness in the arms or legs from nerve compression
- Unexplained fatigue and weakness
Note: Some people have no noticeable symptoms. In such cases, Paget’s disease is often discovered incidentally during X-rays or scans done for other reasons.
How is Paget’s Disease Caused?
The exact cause of Paget's bone disease is not completely understood. However, it is believed to result from a combination of abnormal bone turnover, genetic predisposition, and possible environmental triggers.
Weak and Enlarged Bones
In healthy bones, old bone tissue is gradually broken down and replaced with new, strong bone. In Paget’s disease, this process becomes uncontrolled. Bone is destroyed too quickly and rebuilt in a disorganized manner, resulting in bones that are larger, weaker, and more prone to fractures and deformities.
Genetic Predisposition
Paget’s disease often runs in families. Individuals with a close relative affected by the condition have a higher risk, suggesting that inherited genetic mutations may make bones more vulnerable to abnormal remodeling.
Environmental or Viral Triggers
Researchers believe that certain environmental factors or viral infections earlier in life may trigger Paget’s disease in people who are genetically predisposed. While this link is still under investigation, it may help explain why the disease develops later in life.
Old Age
Paget’s disease is more commonly seen in people above the age of 50, and the likelihood increases with age. This suggests that long-term changes in bone metabolism may play a role in disease development.
Treatments for Paget's Disease
Surgery is usually considered after the age of 40–50, when complications become severe and significantly affect daily life. Doctors always try medications and conservative treatments first.
Surgery is a last-resort option, recommended only when pain, deformity, or disability is severe and medications are no longer effective. Seeking a second medical opinion before major bone surgery is always advisable.
Non-Surgical Treatment for Paget’s Disease of Bone
Paget’s disease can be controlled without surgery. Doctors usually prescribe bisphosphonate medications, which significantly slow down abnormal bone damage and help restore healthier bone turnover. These medicines are highly effective and may be given as tablets or injections, depending on the severity of the condition. By controlling the rapid breakdown of bone, they reduce pain and lower the risk of fractures.
Along with medical treatment, supportive care plays an important role in managing symptoms and maintaining bone strength. Over-the-counter pain relievers and anti-inflammatory medicines help ease bone pain and swelling. Regular, gentle exercise helps keep bones and muscles strong, while calcium and vitamin D supplements support bone health. Maintaining a balanced, nutritious diet further aids overall recovery and long-term bone stability.
To monitor progress, doctors regularly assess bone health using blood tests and imaging scans. Surgery is usually considered only in advanced cases involving severe fractures, bone deformities, or nerve compression. Most people are able to manage Paget’s disease successfully through medication and lifestyle adjustments. When diagnosed and treated early, surgery is often unnecessary, complications can be prevented, and patients can remain active, mobile, and relatively pain-free.
Surgical Treatment for Paget’s Disease of Bone
Surgery is not the first-line treatment for Paget’s disease. It is considered only when medications fail to control symptoms or when the bones are severely damaged, leading to pain, disability, or nerve problems. Most patients never require surgery if the disease is diagnosed and treated early.
Bone Realignment Surgery
When Paget’s disease causes bones—especially in the legs—to bend or bow, surgeons may realign them. This helps improve walking, posture, balance, and overall mobility while reducing long-term strain on joints.
Joint Replacement Surgery
If Paget’s disease severely damages weight-bearing, joint replacement may be recommended such as hip replacement or knee replacement surgery. The damaged joint is replaced with an artificial one to relieve pain and restore movement.
Fracture Repair Surgery
Paget’s disease can make bones weak and prone to fractures. If a bone breaks, surgeons may use plates, rods, or screws to stabilize the bone and allow it to heal properly.
Bone Cutting and Reshaping Surgery (Osteotomy)
In cases of significant bone deformity, surgeons may cut and reposition the bone to restore a more normal shape and function. This procedure helps correct alignment and reduces pressure on nearby joints.
Nerve Decompression Surgery
Enlarged or misshapen bones can press on nearby nerves, causing pain, numbness, tingling, or weakness. Nerve decompression surgery removes excess bone to relieve pressure and improve nerve function.
Tumor Removal (Rare Cases)
Very rarely, Paget’s disease may lead to bone cancer. In such cases, surgery is performed to remove the affected bone tissue and prevent further spread.
How Artemis Hospital Cares for Patients with Paget’s Disease
At Artemis Hospital, Gurugram, patients with Paget’s disease receive comprehensive, multidisciplinary care tailored to their specific needs. The hospital’s approach combines expert clinical evaluation, advanced diagnostics, and personalized treatment planning to manage this complex condition effectively.
Artemis Hospitals has a dedicated team of orthopaedic and rheumatology specialists experienced in musculoskeletal disorders, including Paget’s disease. These specialists work together to assess, diagnose, and design individualized care plans that address both symptoms and long-term bone health.
Once Paget’s disease is diagnosed, the clinical team develops a tailored treatment strategy. This typically includes:
- Medication management to regulate abnormal bone remodeling (e.g., bisphosphonates and other approved therapies).
- Pain control and functional support, integrating pharmacologic and non-pharmacologic measures.
To book an appointment at Artemis Hospitals, Gurugram, call +91 98004 00498, or visit the website and fill an online form with your contact details and preferred doctor.
Article by Dr. Dheeraj Kapoor
Chief - Endocrinology
Artemis Hospitals
Frequently Asked Questions
What is Paget's bone disease?
Paget’s disease is a chronic bone disorder in which normal bone remodeling is disrupted, causing bones to become enlarged, weak, and deformed over time.
Who is most at risk of Paget’s disease?
It commonly affects people over the age of 50 and those with a family history of the condition.
What are the common symptoms of Paget’s disease?
Symptoms include persistent bone pain, bone deformity, fractures from minor injuries, joint problems, hearing loss (if the skull is affected), and difficulty walking.
Can Paget’s disease be cured?
There is no permanent cure, but the disease can be effectively controlled with medications and lifestyle measures in most cases.
How is Paget’s disease diagnosed?
Diagnosis is done using blood tests (especially alkaline phosphatase levels), X-rays, and bone scans to assess bone changes.
What medicines are used to treat Paget’s disease?
Bisphosphonates are the main treatment. They help slow abnormal bone turnover and reduce pain and complications.
Is surgery always required?
No. Surgery is only needed in severe cases with fractures, deformities, nerve compression, or joint damage. Most patients manage well without surgery.
Can Paget’s disease cause disability?
If left untreated, it can lead to fractures, joint damage, and mobility issues. Early treatment helps prevent disability.
Is Paget’s disease cancerous?
No, Paget’s disease itself is not cancer. Very rarely, it may increase the risk of bone cancer.
How can Paget’s disease be prevented?
There is no proven way to prevent it, but early diagnosis, regular monitoring, and timely treatment reduce complications.
Can people with Paget’s disease live a normal life?
Yes. With proper treatment and follow-up, most people lead active and comfortable lives.
